2.50
Hdl Handle:
http://hdl.handle.net/10755/158255
Type:
Presentation
Title:
Community care gerontologic nursing: An independent role for nurses
Abstract:
Community care gerontologic nursing: An independent role for nurses
Conference Sponsor:Western Institute of Nursing
Conference Year:2002
Author:Caffrey, Rosalie, PhD
P.I. Institution Name:Oregon Health & Sciences University
Title:Professor
Contact Address:School of Nursing, Ashland Campus, 1250 Siskiyou Boulevard, Ashland, OR, 97520, USA
Contact Telephone:541.552.6706
An innovative group of nurses are developing a new type of independent community care nursing practice to provide care to chronically ill elderly in rural community-based settings. This focused ethnographic research sought to understand this practice from both the nurses' and clients' perspectives. Seven nurses from Southern and Central Oregon and six clients were interviewed. Five of the clients interviewed were foster care providers and one client was an elderly female living in her own home. Observational visits were also conducted with the seven nurses. Briefly, the results from the nurses' interviews found that these were very experienced nurses who saw the need for community-based care to the elderly and wanted to work independently. Five of the seven had also worked as private nurse contractors with Senior Services' Medicaid clients. For four of these five, their primary paying clients were foster care providers who were contracting independently with the nurses to oversee their private pay residents along with their Medicaid residents. One nurse contracted through her hospital with Foster Care Providers serving only private pay residents. Two nurses had cared for or were still caring for private elderly clients living in their own homes in the community. Physicians, families, or the courts had referred these clients requesting that the nurses oversee health care needs. Nurses identified this group of elderly as a more difficult clientele to access than foster care providers. The most difficult aspect of the role change to nurse entrepreneur described by the nurses was developing business acumen. Marketing, reimbursement, financial uncertainty including lack of access to benefits, confusion by other health care providers about their role, legal concerns, and time management were a few of the difficulties encountered. However, the benefits of practicing nursing as they believed it was meant to be practiced, gave a great deal of satisfaction to these nurses. The practice role identified by these nurses included holistic assessment, care planning, teaching, delegation and assignment, monitoring, networking, advocacy, guardianship, caregiver support, and documentation. Delegation and assignment were discussed as posing particularly difficult legal issues for these nurses. Overall, the nurses felt that there is a need for this independent role serving community-based elders with chronic care needs and that it needs to be further developed. Nursing services described as most valued by the clients were: providing information and assisting with problem solving for difficult situations, intervening with physicians and other health care providers, and helping foster care providers meet State licensure requirements. Clients perceived the nurses as being available when needed, providing assurance and support to themselves, to their residents and families, providing continuity of care and being a friend. All agreed that it was money well spent. Further research needs to be done on this role including the potential role for nurses with foster care providers beyond those nurses contracting to see only Medicaid clients, evaluation of the delegation rules and regulations and their impact on nurses' legal concerns as well as client outcomes, and the impact on health outcomes of chronically ill elderly being seen in their homes by privately contracted nurses in rural communities.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCommunity care gerontologic nursing: An independent role for nursesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158255-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Community care gerontologic nursing: An independent role for nurses</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Caffrey, Rosalie, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Sciences University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">School of Nursing, Ashland Campus, 1250 Siskiyou Boulevard, Ashland, OR, 97520, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">541.552.6706</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">caffreyr@ohsu.edu</td></tr><tr><td colspan="2" class="item-abstract">An innovative group of nurses are developing a new type of independent community care nursing practice to provide care to chronically ill elderly in rural community-based settings. This focused ethnographic research sought to understand this practice from both the nurses' and clients' perspectives. Seven nurses from Southern and Central Oregon and six clients were interviewed. Five of the clients interviewed were foster care providers and one client was an elderly female living in her own home. Observational visits were also conducted with the seven nurses. Briefly, the results from the nurses' interviews found that these were very experienced nurses who saw the need for community-based care to the elderly and wanted to work independently. Five of the seven had also worked as private nurse contractors with Senior Services' Medicaid clients. For four of these five, their primary paying clients were foster care providers who were contracting independently with the nurses to oversee their private pay residents along with their Medicaid residents. One nurse contracted through her hospital with Foster Care Providers serving only private pay residents. Two nurses had cared for or were still caring for private elderly clients living in their own homes in the community. Physicians, families, or the courts had referred these clients requesting that the nurses oversee health care needs. Nurses identified this group of elderly as a more difficult clientele to access than foster care providers. The most difficult aspect of the role change to nurse entrepreneur described by the nurses was developing business acumen. Marketing, reimbursement, financial uncertainty including lack of access to benefits, confusion by other health care providers about their role, legal concerns, and time management were a few of the difficulties encountered. However, the benefits of practicing nursing as they believed it was meant to be practiced, gave a great deal of satisfaction to these nurses. The practice role identified by these nurses included holistic assessment, care planning, teaching, delegation and assignment, monitoring, networking, advocacy, guardianship, caregiver support, and documentation. Delegation and assignment were discussed as posing particularly difficult legal issues for these nurses. Overall, the nurses felt that there is a need for this independent role serving community-based elders with chronic care needs and that it needs to be further developed. Nursing services described as most valued by the clients were: providing information and assisting with problem solving for difficult situations, intervening with physicians and other health care providers, and helping foster care providers meet State licensure requirements. Clients perceived the nurses as being available when needed, providing assurance and support to themselves, to their residents and families, providing continuity of care and being a friend. All agreed that it was money well spent. Further research needs to be done on this role including the potential role for nurses with foster care providers beyond those nurses contracting to see only Medicaid clients, evaluation of the delegation rules and regulations and their impact on nurses' legal concerns as well as client outcomes, and the impact on health outcomes of chronically ill elderly being seen in their homes by privately contracted nurses in rural communities.</td></tr></table>en_GB
dc.date.available2011-10-26T20:39:51Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:39:51Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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