Nursing Taken Beyond the Hospital

nurse in elderly care for the elderly in nursing homes

When one thinks of Nursing, the first notion of a work environment typically floats toward a hospital setting. That's hardly the only place a nurse, be it an RN, BSN or licensed practical or vocational nurse, can practice.

Nursing goes far beyond the acute care hospital, according to one of our Concorde experts. It delves into about every place that requires a nurse to assist patients or promote better health.

Nursing in the skilled nursing facility/rehab hospital/sub-acute level

The most common place for the licensed vocational nurse is the skilled facility/rehabilitation hospital/sub-acute level of Nursing, according to Carol Carotenuti, RN, MSN/Ed, Vocational Nursing Program Director at Concorde's campus in San Diego.

"The LVN is required to work as a team member, charge nurse, medication/treatment nurse for all patients," Carotenuti said. "It can be adults, children and geriatric patients."

Carotenuti said there are many components to the care the LVN gives in such a facility. They use all the foundations of nursing they learn in school to be a mentor to the certified nurse assistant, the eyes for the RN and doctor that might only see their patients once every 30 days.

Many Nursing students are taking jobs in clinics

Nurses in this environment work to assess, plan and organize patient needs for doctors, Carotenuti said. They might be doing office procedures, scheduling and assisting the patient with preparation for diagnostic testing. They might be providing immunizations, clinical medications and just about anything that is in their scope of practice.

Nursing in schools

Nurses assess schoolchildren for health issues. They prepare medications for students to take while at school. They keep up with students' immunizations, call families of sick children and work independently with the RN charge nurse. Nurses provide first aid to children, assess hearing and vision and scoliosis per protocol of the school board.

Nursing in home health

Carotenuti said LVNs work independently following case managers and orders from the MD to complete patients' needs. Many assignments are to complete wound care, assessment of patient status, observe and teach the family how to take care of their family member.

Nursing in hospice care

These nurses are responsible for assisting clients through the last stages of their lives. They might be making visits or staying with the patient in the home to the end. They work with a case manager, sometimes social worker, chaplain or anyone else that the patient needs to fulfill the patient quality of life. Constant assessment for palliative care and comfort care is a must for this area of nursing.

Nursing in correctional facilities

This job description is mostly to work with the injured and sick in the infirmary and give out medications that are needed to the jail population. Many patients are on psychotropic medications, and there is a potential danger in working with these clients.

Nursing on cruise ships

"One of my students went to work on the cruise lines to work in the infirmary of the ship with a ship doctor," Carotenuti said. "They are required to evaluate any person that becomes ill on the ship, assist the doctor to provide good bedside care and to make sure clients all receive the best care while on board."

"Most calls to the infirmary are for seasickness, but they also have to make house calls to anyone that states there is a medical problem, provide first aid, evaluate if the client will need to be taken to the hospital or what needs to be done for the client."


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