* Unless otherwise noted all entries are from the Medicare Glossary
A | B | C | D | E | F | G | H | I | J | K | L | M
N | O | P | Q | R | S | T | U | V | W | X | Y | Z
NEGLECT - When care takers do not give a person they care for the goods or services needed to avoid harm or illness.
NETWORK - A group of doctors, hospitals, pharmacies, and other health care experts hired by a health plan to take care of
NO-FAULT INSURANCE - No-fault insurance is insurance that pays for health care services resulting from injury to you or
damage to your property regardless of who is at fault for causing the accident.
NURSE PRACTITIONER - A nurse who has 2 or more years of advanced training and has passed a special exam. A nurse practitioner
often works with a doctor and can do some of the same things a doctor does. (See REGISTERED NURSES.)
NURSING FACILITY - A facility which primarily provides skilled nursing care and related
services for the rehabilitation of injured, disabled, or sick persons, or on a regular basis, health related care services above the level of
custodial care to other than mentally retarded individuals.
NURSING HOME - A residence that provides a room, meals, and help with activities of daily living and recreation. Generally,
nursing home residents have physical or mental problems that keep them from living on their own. They usually require daily assistance.
NURSING, PSYCHIATRIC, AND HOME HEALTH AIDES*
Significant Points - Most jobs are in nursing and residential care facilities, hospitals, and home healthcare services. Modest entry
requirements, low pay, high physical and emotional demands, and lack of advancement opportunities characterize this occupation. Numerous job
openings and excellent job opportunities are expected.
Nature of the Work - Nursing and psychiatric aides help care for physically or mentally ill, injured, disabled, or infirm individuals confined
to hospitals, nursing care facilities, and mental health settings. Home health aides’ duties are similar, but they work in patients’ homes or residential
Nursing aides, also known as nursing assistants, geriatric aides, unlicensed assistive personnel, or hospital attendants, perform routine tasks under
the supervision of nursing and medical staff. They answer patients’ call lights, deliver messages, serve meals, make beds, and help patients eat, dress,
and bathe. Aides also may provide skin care to patients; take their temperatures, pulse rate, respiration rate, and blood pressure; and help patients
get in and out of bed and walk. They also may escort patients to operating and examining rooms, keep patients’ rooms neat, set up equipment, store and
move supplies, or assist with some procedures. Aides observe patients’ physical, mental, and emotional conditions and report any change to the nursing
or medical staff.
Nursing aides employed in nursing care facilities often are the principal caregivers, having far more contact with residents than other members of the
staff. Because some residents may stay in a nursing care facility for months or even years, aides develop ongoing relationships with them and interact
with them in a positive, caring way.
Home health aides help elderly, convalescent, or disabled persons live in their own homes instead of in a health facility. Under the direction of
nursing or medical staff, they provide health-related services, such as administering oral medications. (Personal and home care aides, who provide
mainly housekeeping and routine personal care services, are discussed elsewhere in the Handbook.) Like nursing aides, home health aides may check
patients’ pulse rates, temperatures, and respiration rates; help with simple prescribed exercises; keep patients’ rooms neat; and help patients move
from bed, bathe, dress, and groom. Occasionally, they change nonsterile dressings, give massages and alcohol rubs, or assist with braces and artificial
limbs. Experienced home health aides also may assist with medical equipment such as ventilators, which help patients breathe.
Most home health aides work with elderly or disabled persons who need more extensive care than family or friends can provide. Some help discharged
hospital patients who have relatively short-term needs.
In home health agencies, a registered nurse, physical therapist, or social worker usually assigns specific duties and supervises home health aides, who
keep records of the services they perform and record patients’ condition and progress. They report changes in patients’ conditions to the supervisor or
Psychiatric aides, also known as mental health assistants or psychiatric nursing assistants, care for mentally impaired or emotionally disturbed
individuals. They work under a team that may include psychiatrists, psychologists, psychiatric nurses, social workers, and therapists. In addition to
helping patients dress, bathe, groom, and eat, psychiatric aides socialize with them and lead them in educational and recreational activities.
Psychiatric aides may play games such as cards with the patients, watch television with them, or participate in group activities, such as sports or
field trips. They observe patients and report any physical or behavioral signs that might be important for the professional staff to know. They
accompany patients to and from examinations and treatment. Because they have such close contact with patients, psychiatric aides can have a great deal
of influence on their patients’ outlook and treatment.
Training, Other Qualifications, and Advancement - In many cases, neither a high school diploma nor previous work experience is necessary for
a job as a nursing, psychiatric, or home health aide. A few employers, however, require some training or experience. Hospitals may require experience
as a nursing aide or home health aide. Nursing care facilities often hire inexperienced workers who must complete a minimum of 75 hours of mandatory
training and pass a competency evaluation program within 4 months of their employment. Aides who complete the program are certified and placed on the
State registry of nursing aides. Some States require psychiatric aides to complete a formal training program.
The Federal Government has guidelines for home health aides whose employers receive reimbursement from Medicare. Federal law requires home health aides
to pass a competency test covering 12 areas: Communication skills; documentation of patient status and care provided; reading and recording vital signs;
basic infection control procedures; basic body functions; maintenance of a healthy environment; emergency procedures; physical, emotional, and
developmental characteristics of patients; personal hygiene and grooming; safe transfer techniques; normal range of motion and positioning; and basic
A home health aide may receive training before taking the competency test. Federal law suggests at least 75 hours of classroom and practical training,
supervised by a registered nurse. Training and testing programs may be offered by the employing agency, but must meet the standards of the Center for
Medicare and Medicaid Services. Training programs vary with State regulations.
The National Association for Home Care offers national certification for home health aides. The certification is a voluntary demonstration that the
individual has met industry standards.
Nursing aide training is offered in high schools, vocational-technical centers, some nursing care facilities, and some community colleges. Courses
cover body mechanics, nutrition, anatomy and physiology, infection control, communication skills, and resident rights. Personal care skills, such as
how to help patients bathe, eat, and groom, also are taught.
Some employers other than nursing care facilities provide classroom instruction for newly hired aides, while others rely exclusively on informal
on-the-job instruction from a licensed nurse or an experienced aide. Such training may last several days to a few months. From time to time, aides
also may attend lectures, workshops, and inservice training.
These occupations can offer individuals an entry into the world of work. The flexibility of night and weekend hours also provides high school and
college students a chance to work during the school year.
Applicants should be tactful, patient, understanding, emotionally stable, and dependable and should have a desire to help people. They also should
be able to work as part of a team, have good communication skills, and be willing to perform repetitive, routine tasks. Home health aides should be
honest and discreet, because they work in private homes.
Aides must be in good health. A physical examination, including State-regulated tests such as those for tuberculosis, may be required.
Opportunities for advancement within these occupations are limited. To enter other health occupations, aides generally need additional formal
training. Some employers and unions provide opportunities by simplifying the educational paths to advancement. Experience as an aide also can help
individuals decide whether to pursue a career in the health-care field.
* U.S. Department of Labor
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