New Jersey considers allowing nurses to delegate some duties to home health aides

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    The Christie administration is considering a health care rule change that would allow registered nurses in New Jersey to delegate some of their duties to a home health aide.

     

    Susan Reinhard, senior vice president with the AARP Public Policy Institute, said the change could improve long-term care for older adults.

    Reinhard faced that situation many years ago when she was working as a visiting registered nurse.

    “I wanted to be able to teach the nurse’s aide how to give the pain medication before I left that day, and my supervisor said I wasn’t legally allowed to do that,” she said. “Therefore, the daughter had to decide whether to come home and not attend a meeting she had to do, or let her mother be in pain.”

    Most people want to manage their health at home, and giving aides additional care duties improves the chances, she said.

    A small New Jersey pilot program found that health aides can help patients with feeding tubes, pain medication and wound cleaning — and continue to provide good care.

    “It’s precisely the kinds of things that home health aides and nurses do, that can prevent people from being readmitted to the hospital,” said Joel Cantor, director of the Center for State Health Policy at Rutgers University.

    Cantor said it’s not clear if the move would save money, but in an opinion piece for the NJSpotlight, he supports shifting of certain nurse duties.

    The level of oversight would be up to the supervising registered nurse.

    “Typically you are there on site, you show the person how to do it, you write down the instructions, you have that person — that aide — show you that they know how to do it,” Reinhard said. “And you determine how often you need to come back and watch them do it.”

    New Jersey’s State Board of Nursing has approved the rule change; next, the Christie administration has to legally vet the modification.

    If the proposed rule change isn’t approved in February, it may take several years to restart the process in New Jersey.

    In the last count in mid-2015, nine states allowed nurses to delegate a wide array of tasks including administering medication, Reinhard said.

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