If you or a loved one have been thinking about nursing homes either for yourself or a member of your family. You likely have questions about what to expect and what the nurses do in the nursing home setting. Anyone in a nursing home can tell you that the staff, namely the nurses, are a large part of the experience. So, what does a nurse do in a nursing home?
Nursing homes will employ different types of staff:
- Nursing Aides/Assistant
- Licensed Practical Nurses
- Registered Nurses
- Nursing Administrators
- Basic hygiene
- Administer medication
- Making care plans
- Supervising staff
- Housekeeping
- Change bandages
- Giving IVs
- Managing facility
For all nurses, their primary role is to take care of patients or residents within the home. However, based on their qualifications and the type of patients nursing homes attend to, nurses may have somewhat different roles. If you are interested in learning more about nursing responsibilities, continue reading.
What Does A Nurse Do In A Nursing Home?
Nurses in nursing homes may have different responsibilities based on their medical training levels, but they are all in charge of the necessities that their patients need to live. Maintaining a balanced diet, distributing medication, assisting patients with basic hygiene, and keeping the living space clean are all primary duties.
Nursing aides and assistants are the most numerous nursing home employees and have the most day-to-day interaction with the residents. They are responsible for more of the essential duties like helping residents with their daily activities, keeping them clean, and maintaining each patient’s accurate records.
Licensed practical nurses do not spend as much time with the residents, although many of their duties may overlap with the nursing aides and assistants. In addition to the assistance with residents’ transport, licensed practical nurses are also responsible for administering medication to residents and treating minor injuries like bedsores.
Registered nurses often carry out some of the supervisory tasks, in addition to the nursing administrators. However, registered nurses are the people who consult with the doctors in order to finalize care plans for residents. In addition, they are responsible for administering intravenous medication and monitoring blood sugar levels.
| Nursing Aides/Assistants | Licensed Practical Nurses | Registered Nurses | Nursing Administrators |
| Personal hygiene | Administer medication | Creating care plans | Supervising nursing staff |
| Change bedpans | Give injections | Administering IVs | Managing facility |
| Assist with transport | Change bandages | Monitoring blood sugar | Deciding budgets |
| Assist with mobility | Treat bedsores | Consulting with doctors | Understanding the laws |
| Keep patient records | Insert catheters | Nurse supervision | Maintaining records |
The nursing supervisor often helps coordinate telehealth visits with providers in the community and the medical providers who cover the facility. This role has taken on new meaning since the Covid 19 pandemic started. Many specialists and providers have added telehealth to their service line. However, this creates new responsibilities for nurses who assist with the visit.
Nursing Aides And Assistants
Nursing aids make up the majority of nurses at a nursing home. These people usually do not have extensive medical qualifications. They take care of the residents’ most basic needs, like personal hygiene and keeping their room clean. Nursing aides might help residents with simple tasks, including:
- Brushing their teeth
- Taking a bath
- Trimming their hair or nails
- Getting dressed or undressed
- Making their bed
- Getting to the bathroom
In addition, nursing aides are often responsible for changing bedpans or emptying catheters for residents with limited or no mobility. Nursing aides typically spend the most time interacting with the residents and get to know them on a personal level. They will also maintain patient records, relay any potential problems to the other nurses, and generally help out around the home.
If a resident is looking for someone to talk to about an ongoing issue or is noticing new symptoms, they will usually have the opportunity to speak to a nursing aide about it, who can then help them decide if it is something that needs to involve a doctor or not. They often report directly to licensed practical nurses.
Nursing aides might also help the residents talk to or interact with visitors, like family members and other loved ones. Using an iPad or phone to speak to long-distance loved ones can be a challenge, but nursing aides are there to help assist with the technology or to prop up the tablet so that the residents can stay in touch with people outside of the nursing home.
Licensed Practical Nurses
Licensed practical nurses are the next tier in the hierarchy and report to registered nurses. They often fall in the middle of duties and responsibilities because they can either help registered nurses with their tasks or help out new nursing aides or assistants with their jobs. Although licensed practical nurses perform many of the functions above, they also keep track of:
- Patients’ breathing
- Patients’ blood pressure
- Patients’ heart rate
- Patients’ oxygen levels
- Patients’ temperature
In addition to monitoring those aspects of the residents, licensed practical nurses are often responsible for administering medications through injections, changing bandages or splints, and treating minor injuries like bedsores. A licensed practical nurse may work with a registered nurse to create a care plan for a patient.
Licensed practical nurses do spend a fair amount of time with residents, although not as much as nursing aides and assistants do. A licensed practical nurse will often look in on a resident once or twice per shift, aside from in the case of an emergency, so that a resident will be familiar with the licensed practical nurses on staff.
However, in nursing homes with fewer nursing aides and assistants, the responsibilities for personal hygiene and helping residents eat and go to the bathroom may fall to the licensed practitioner nurses. A lot of their duties depend on the size of the nursing home and how many people are on staff.
Registered Nurses
Registered nurses are in charge of monitoring the other members of the nursing staff, in addition to staying on top of residential medical needs. Licensed practical nurses report to registered nurses and check with them if a patient has reported new symptoms or needs a modification to their care plan.
Registered nurses rarely interact with healthier patients on a daily basis, instead of focusing on patients who have long-term illnesses or who require extensive medical care. Although they are less involved in the day-to-day activities of the residents, the registered nurses are an integral part of the nursing home hierarchy. Registered nurses are also responsible for:
- Administering intravenous medications
- Checking patients’ levels of blood sugar
- Consulting with doctors
- Modifying or creating care plans for residents
Registered nurses often create schedules and rotations for the staff. While working with the supervision of the consulting doctors, registered nurses are often the ones who make the final decision about whether or not to call in the presence or expertise of a doctor in the case of an emergency or worsening medical condition of a resident.
If there does need to be a change to a resident’s treatment plan, a registered nurse is a person who interfaces with that resident’s next of kin. Together, they discuss the changes and what would be appropriate next steps for the resident so that the family or loved ones are duly notified of the incoming changes.
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Nursing Home Administrators
Nursing home administrators function as the principal supervisors for all of the staff working in a nursing home. Although registered nurses perform some of the supervisory functions within a nursing home, they are often busy with other medical tasks and taking care of patients with complicated illnesses or injuries.
Nursing home administrators do not perform any of the functions that involve interacting with the residents so they can focus on managing the whole nursing home. Nursing home administrators are often former registered nurses, so they know what is expected of all types of nurses on staff. Their primary duties include:
- Deciding on budgets
- Understanding the laws applicable
- Managing the facility
- Supervising the nursing staff
Nursing home administrators also work closely with social workers in order to revise their safety precautions and other facilities as regulated by federal and local laws. Nursing home administrators are in charge of complying with those laws and must satisfy them with regular inspections of the facilities.
However, they may also take on some of the supervisory duties that the registered nurses would typically be responsible for if the nursing home has a large number of patients who require advanced care. Those duties might include assigning the schedule for the week or month for the other nursing staff members.
Other Staff Roles In A Nursing Home
In addition to the nurses on staff, there are plenty of other types of medical professionals in a nursing home to address all of their residents’ complex needs. Consulting physicians can often be found on the premises in case of emergency or to evaluate current patient treatment plans, but they are not usually part of the central staff. Main staff includes:
- Occupational therapists
- Physical therapists
- Social workers
- Speech and language therapists
- Activities directors
- Dieticians
Occupational Therapists
Not all residents in a nursing home plan to be there for the rest of their lives. In fact, many residents of nursing homes are short-term and plan to leave once they have recovered enough from their illness or injury to return to living in their homes. Although they may require the help of an at-home living assistant, they are still designated as short-term residents.
For these short-term residents, an occupational therapist is invaluable. An occupational therapist teaches necessary life skills for someone who plans to live on their own for some or all of the time. They also address potential safety issues and monitor the patient to determine when they are ready to leave the nursing home.
For patients with cognitive disorders, an occupational therapist may consult with the next of kin about modifying the home in order to accommodate their loved one when they leave the nursing home and return to their assisted living facility or their original home. An occupational therapist’s duties might include teaching the resident how to:
- Make use of crutches, canes, a walker, or other mobility assistants.
- Modify or simplify daily tasks
- Bathe, eat, and move while recovering
- Administer their own medication
- Modify their home
Some patients who leave nursing homes after training with an occupational therapist move into halfway houses or assisted living homes in order to keep working with that therapist while they master the skills necessary for living on their own or moving back into their own home. Those skills might take months to master, but the therapist sticks with them.
Physical Therapists
A physical therapist might work with someone coping with a long-term disability or illness or recovering from something in the short term. While an occupational therapist focuses on how to perform necessary activities with some kind of disability, a physical therapist focuses instead on basic movements and muscle groups.
A physical therapist might meet with a resident once or twice a week and evaluate their ability to perform basic exercises like extending their arms fully or manipulating the digits on their hands and feet. For people who have lost most or all of their mobility, a physical therapist might be responsible for stretching those limbs to try to help them regain their range of motion.
Physical therapists work with both short and long-term residents of nursing homes in order to bolster their muscle strength and endurance, in addition to helping with flexibility and range of motion. Posture and balance are crucial for residents who have difficulty walking or mental trouble processing their surroundings.
Social Workers
Social workers assist long-term residents in nursing homes in order to advocate for their rights and ensure that they are being given the proper treatment based on their conditions. Social workers evaluate their nursing home residents and their corresponding care plans to make sure they are in accordance with state and local laws.
The sad truth is that some nursing homes are understaffed or do not have the budget to address every patient’s needs adequately. Social workers are advocates for residents who do not have next of kin or loved ones who are readily available to check on their rights. Plus, social workers have extensive knowledge of the law and pursue matters through the legal system.
If the family of a long-term care facility wants to file a lawsuit against that facility, it is with the help of the social worker. They are familiar with the state and federal laws governing the care of residents and can verify whether or not the nursing home complies with them. They stick up for the residents, regardless of their conditions.
Social workers also work with nursing administrators and registered nurses in order to check on their general practices within the facility and make sure that they are up to date with local, state, and federal laws and mandates. Social workers do their best to educate staff, residents, and next of kin to ensure that everyone receives the care they need.
Speech And Language Therapists
For residents who have suffered from a stroke or another type of cognitive disorder, speech and language therapists can help them regain part or all of their ability to communicate with others and to read. They also help residents who are dealing with problems that make it difficult for them to swallow.
They typically give residents cognitive or physical exercises to improve their ability to speak, understand words and phrases, manipulate their tongues, or to swallow. Speech and language therapists might also be able to provide helpful exercises for memory impairments and residents who have trouble focusing on conversations.
There is nothing more rewarding than being able to talk to the nurses and loved ones about what you are thinking and feeling. Speech and language therapists give that power back to residents who have lost the ability from a stroke or other injury or illness so that residents can communicate their needs to the people around them.
Activities Directors
Although most of the staff are concentrated on pain management, physical rehabilitation, and cognitive impairments, it is essential to remember that most people who live in nursing homes have their mental faculties about them, and they need emotional support as well. Activities directors keep everyone happy by organizing fun events.
From everything like day-to-day activities to once a year events, activities directors are in charge of organizing the events and learning from the residents what they enjoy doing. Daily, those activities might include bringing in an art therapist or having drawing time, watching some movies, or listening to music and dancing.
For less frequent activities, the directors might organize an outing to a concert, a museum, holiday celebrations, a park, or exercise classes. An activities director works hard to keep the spirits up of the residents and allow them to enjoy their time living in the nursing home to the best of their abilities.
Dieticians
For many patients living in nursing homes, their diets need to be strictly monitored in order to not conflict with their physical conditions or the medications that they are taking. Dieticians work with the staff and nursing administrators to create a unique diet plan for each resident according to his or her personal nutritional needs.
Although not every nursing home has a dietician on staff, federal law mandates that all nursing homes in the United States must consult with one when new patients are admitted or every so often in order to reevaluate the food available and whether the current diet plans are working for the residents.
For patients undergoing treatments like dialysis or who have been diagnosed as being over or underweight, dieticians play a more active role in dictating the nutritional plan in order to meet the patient’s needs. Dieticians also periodically evaluate the patients themselves in order to test for nutritional deficiencies or other negative symptoms.
Dieticians may work with social workers to evaluate and instruct the facility’s cooking staff about the preparation of certain foods, the inclusion of certain appetite stimulants for patients having trouble eating, and to ensure that the cooking facilities are following federal sanitation laws. This keeps everyone safe too.
What Is The Main Purpose Of A Nursing Home?
The primary purpose of a nursing home is to provide short or long-term care for patients who are suffering from a severe injury or illness that impairs their ability to live on their own. Some patients eventually recover from their illness or injury and leave the nursing home, but while they are there, they typically need around-the-clock care.
Nursing homes are not just for the elderly, either. For people of any age, specific cognitive or physical impairments might make it too difficult for their families to take care of them at home. Adults are especially difficult to take care of because they are larger, and if they have difficulty moving or need medication frequently, a nursing home might be preferable.
The staff inside the nursing home work to ease the pain of their residents and give them the best life possible. They have a large range of duties, including cooking, cleaning, helping the residents perform basic hygiene, and teaching the residents how to be more independent or modifying their tasks so that they can manage better.
By helping residents in addition to administering medicine, nursing homes provide the care that their residents need and also give them a chance to continue enjoying life in a more limited capacity. Nursing homes need not be disdained or feared like mental asylums used to be; they are much more than that nowadays.
What Is The Average Age To Enter A Nursing Home?
Typically, a person will enter a nursing home around the age of 79. This age is just an average and only accounts for people who enter nursing homes due to the disorders and disabilities that come with advanced age. Many people do enter nursing homes as short-term residents in order to have around-the-clock care when recovering from temporary injuries or illnesses.
Generally, when older people have been admitted to a nursing home for age-related disabilities, they spend their last year or two in that home. However, for people who are in nursing homes because their next of kin cannot care for them or administer the around the clock medications or care they need, they often live for many years in the facility.
Nursing Home Facilities
Nursing homes are made explicitly for people with illnesses or disabilities who cannot be cared for from their own homes. Typically, this is because they require various medications to be administered frequently, and they have mobility issues that prevent them from administering the drug themselves.
Those mobility issues can also be the reason why the next of kin cannot care for them. Nursing homes provide access to three meals a day, professional nurses to care for residents, social workers to advocate for their needs, and other staff members to assist residents with all of their daily needs and activities.
Dementia care is one of the multiple facilities offered by most nursing homes. This is the care for residents with a variety of cognitive disorders. These might include working with a speech and language therapist in order to facilitate better communication or assigning specific activities to boost memory and other types of cognition.
Nursing homes provide a room for patients to stay in, trained nurses on staff at all times, access to a dietician to create a meal plan that satisfies all of the residents’ nutritional needs, and activities to keep them healthy both mentally and physically. Nursing homes can be either for short or long-term patients.
In Summary
The role of nurses within a nursing home depends on the number of staff in the nursing home and what kinds of schooling or certifications they have earned. There are many other staff members in the nursing home that keep the facility running that we haven’t discussed. Everyone working in the home is important to the overall success of the facility operations. In general, all staff work towards creating a clean and healthy environment for their residents so that they can get the most out of their lives while they stay there.
Sources
https://work.chron.com/role-nurse-nursing-home-16042.html
https://www.assistedliving.org/the-role-of-nurses-in-a-nursing-home/
https://www.nursinghomes.com/8-12-16-roles-of-nursing-home-staff/
https://www.morningstar.com/articles/564139/40-must-know-statistics-about-long-term-care
