ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, December 15, 1996 TAG: 9612160078
SECTION: VIRGINIA PAGE: B-1 EDITION: METRO
SOURCE: SANDRA BROWN KELLY STAFF WRITER
A meeting for registered nurses planned in Roanoke on Monday night has no agenda, but its organizers said they expect that hospitals' increased use of unlicensed workers to care for patients will come up for discussion.
More than 8,000 meeting notices were mailed to registered nurses in central and Western Virginia for the forum on "Protect Your Patients, Protect Your License," said Rebecca Rice of Arlington, president of the Virginia Nurses Association.
Nationally, hospitals and other health facilities have shifted more patient care to unlicensed staff to cut costs. In Tidewater, the shift began some time ago. In October, Carilion Health System began testing a new team approach to patient care that relies on unlicensed staff assuming a greater share of nursing-related duties. Carilion owns both of Roanoke's hospitals and owns or manages 11 others.
Carilion slowed the introduction of the patient care plan, however, after nurses and other workers in Roanoke opened discussions with labor unions.
The trend toward giving unlicensed staff a greater role in patient care is alarming and has concerned the Virginia State Board of Nursing for several years, said Terri Gaffney, board president.
Gaffney, who is from Northern Virginia, will join Rice for the Roanoke session, which is set for 7 to 9 p.m. in Whitman Auditorium at Virginia Western Community College.
Because nurses are responsible for nursing care, no one else can give that care unless assigned that duty by the nurse, Gaffney said. In Virginia, registered nurses can assign duties only to licensed workers such as practical nurses and nurse's aides.
When a hospital puts in a system that uses unlicensed workers, a nurse could be placed in the position of jeopardizing her license if she allows those workers to care for a patient in the wrong circumstance, Gaffney said.
New guidelines developed by the state board should help nurses determine the proper role for a non-nurse and decide when it's legal to assign duties, Teresa Mullin, assistant director of the board, said Friday.
It's not easy to decide what type of worker should give a particular type of care, Mullin said.
"Feeding a patient seems a simple thing," Mullin said. "But what if the patient had just had a stroke? You might not want an untrained person to feed that patient because the patient might choke or aspirate some food."
A nurse would need to assess the patient's physical ability as part of deciding who should help the patient eat, she said.
Three months after the stroke, the situation might be different, Mullin said.
Mullin said the guidelines have not yet been distributed by the state, but soon will be.
She also said the state board has not received any complaints regarding care from unlicensed staff, but she wouldn't expect the board to get those issues because it doesn't have jurisdiction over unlicensed staff.
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