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Welome to The Long-Term Care Team. |
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| CNA - Certified Nursing Assistant/Orderly |
 CNA/Orderly (Privates) - The most overworked, underpaid, unappreciated of the health-care team. BUT, the most important! They are the eyes and ears for every department of the nursing home. That is in addition to being the work horse of the home.
The CNA/Orderly deals with the resident on a daily basis. They are the first to notice changes in the residents moods, level of conciousness (LOC), changes in ambulation, range of motion (ROM), changes in skin condition and a thousand other details. They assist the resident with getting out of bed in the morning, washing , brushing of teeth/dentures, dressing, ambulation or transfer to a wheel chair.
They assist the resident with eating, changing, turning and repositioning and again, a thousand other activities of daily living. The CNA/Orderly is the person that the nurses, dietary, and housekeeping turn to when asked a question about the everyday details that they don't see. Without the CNA/Orderly the nursing home would not function. I think that they need to be afforded a higher wage, a benefit package, but most importantly MORE RESPECT!
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| Licensed Practical Nurse |
 Licensed Practical Nurse (Sargeants) - The middle man. The mediator between the CNA/Orderly and the upper echelons. We, since this is the niche I fit into, do all the nurse-type grunt work. Passing medications, doing treatments, nursing assessments of residents who the CNA/Orderly have reported have a change of condition, notify the physicians of changes in condition, order newly prescribed medications from the pharmacy, accompany Physicians on Doctors rounds,
monthly assessments, insert and remove catheters, G-tube feedings, supervise the CNA/Orderly, incident reports, and paperwork and paper work and MORE paper work. There are many other fuctions of the LPN that are to numerous to mention. In my opinion, a good LPN Charge Nurse will also assist the CNA/Orderly with the daily care of the residents. We, as the CNA/Orderly, are not afforded the respect or the pay that you would expect. In fact some of the higher echelon do not consider us as "REAL NURSES". I personally resent that assumption. WE are Nurses! Live with it Higher echelon!
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| Staff Nurse |
 Registerd Nurse (Warrant Officer) - The RN can hold several different positions in the nursing home. I will tell you some of the other positions later. Right now it is the shift supervisor, unit manager, staff nurses. Basically, their job is to oversee the LPNs and CNA/Orderly. To ensure that the lower echelons are performing their job duties. If the facility has a skilled unit the RN is there to start or stop I.V.s, set I.V. drip rates, any other nursing job that the LPN is not allowed to perform. Of course their lot is to do lots of paper work. The RN will do assessments on the residents to ensure that the LPNs are doing their jobs correctly, such as are the LPNs obtaining new orders for treatments or medications that have proven ineffective etc. These RNs usually do the MDS and Rap sheets, assessments that demonstrate a decline or improvement in a residents condition. They usually get the information for these assessments from the CNA/Orderly or LPN since they are swamped with paper work. These RNs also have many other duties to numerous to mention.
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