Nurse Assisting
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Chapter 8 Expanded Skills
Click on the skills to review expanded skills discussed in this chapter.
Starting-Up Steps
- Knock before entering, identify the client, and introduce yourself.
- Complete hand hygiene.
- Provide for privacy.
- Explain to the client what you will be doing before you start doing it.
- Assemble your supplies.
- Ensure that the bed is at a good working height and is locked; or, if the bed is not in use, you are in an ergonomically correct position to assist the client.
Using a Fire Extinguisher
When: In case of a fire.
Why: A small fire can become a larger, more dangerous fire quickly. If a small fire can be extinguished using a fire extinguisher, it can save lives.
What: Supplies needed for this skill include
- Fire extinguisher—ABC preferably
How:
- Pull the pin on the fire extinguisher.
- Aim the nozzle at the base of the fire.
- Squeeze the handle of the extinguisher.
- Sweep the nozzle from side to side at the base of the fire until extinguished or until the canister is empty.
Responding to a Fire Alarm
When: In case of a fire alarm at your facility.
Why: To limit injuries and/or casualties due to a fire.
What: Supplies needed for this skill include
- Fire extinguisher—ABC preferably
How:
- Identify that a fire emergency exists.
- Remove all clients who are in the area of the fire.
- All clients should be moved behind the fire doors.
- If the fire is institution-wide, evacuate the clients to the outside designated area per facility evacuation policy.
- Activate the alarm per facility policy if it has not been activated already. This may be a wall-mounted pull alarm or use of the intercom system.
- Confine the fire by closing the door to the fire area.
- If the fire is small, remove the ABC fire extinguisher from the nearest wall mount and extinguish the fire.
- If the fire is large, continue to evacuate the building.
- Update the nurse on the event and complete any special directives from the nurse.
Handling Oxygen Safely
When: Oxygen should be handled cautiously at all times to avoid accidents. During a fire, oxygen tanks can be particularly dangerous as oxygen is a flammable substance.
Why: To limit injuries and/or casualties due to oxygen exposure or fire.
How:
- Do not allow clients, staff, or visitors to smoke near oxygen tanks.
- Keep any flammable liquids away from oxygen tanks and be sure tanks are away from any heat source.
- Be sure all areas where oxygen is in use or stored are well ventilated.
- Handle oxygen tanks with care. Do not drag, drop, or hit the tanks.
- “Oxygen in Use” signage should be used per facility policy.
- Empty oxygen tanks must be marked as empty and kept separate from full or partially used tanks. Follow facility policy on where and how to store empty tanks.
Responding to a Natural Disaster
When: In case of a natural disaster.
Why: To limit injuries and/or casualties due to a natural disaster.
What: Supplies needed for this skill include
- Blankets
- Flashlights
- Emergency radios
How:
- Identify that an emergency exists.
- Transport all clients to the designated safe area of the building per facility disaster policy. Typically this is a hallway with no windows.
- Keep bed-bound clients in their beds; move the entire bed to the designated safe area.
- Cover clients with blankets to shield them from debris and to keep them warm.
- Complete a census of clients to ensure that everyone is accounted for.
- Assemble emergency supplies such as radios and flashlights.
- Reassure the clients that they are safe and well cared for.
- Stay with the clients and meet client needs throughout the event.
- Complete any special directives from the nurse.
- Once the threat has passed, return the clients to their desired location or activity.
Responding to a Bomb Threat
When: In case of a bomb threat at your facility.
Why: To limit injuries and/or casualties due to a bomb threat.
What: Supplies needed for this skill include
- Notepad and pen
How:
- Identify that the facility is threatened with a bomb.
- This is usually in the form of a note found or a telephone call received.
- If the bomb threat is called in, keep the caller on the line as long as possible to get as much information as possible. Ask the caller the following questions:
- When is the bomb going to explode?
- Where is it right now?
- What does it look like?
- What kind of bomb is it?
- What will cause it to explode?
- Did you place the bomb?
- Why?
- What is your address?
- What is your name?
- While on the telephone with the caller, alert another staff member to call 911 and to alert facility management immediately.
- While on the telephone with the caller, write down the answers to the questions you have asked. Also write down other information such as:
- If the caller is male or female
- If there are any sounds in the background
- If there are any identifying qualities to the person’s voice, such as an accent or a stutter
- If a note was found, immediately take the note to the facility management or your supervising nurse.
- Follow the directives of the supervising nurse, management staff, and authorities for evacuation. Follow your facility evacuation policy.
*Retrieved August 2, 2010, from https://www.fema.gov/hazard/terrorism/exp/exp_threat.shtm
Finishing-Up Steps
- Ensure that all of the client’s needs have been met and that the client is positioned as desired.
- See to safety. Replace any alarms or positioning devices, as indicated on the care plan or individual service plan. The bed is in the low position and is locked.
- Place the call light within easy reach.
- Clean and replace equipment, and return supplies to the designated place in the client’s room or facility storage area.
- Leave the room clean and in order. Ensure that the bed is made. Remove trash and dirty linens from the room.
- Complete hand hygiene.
- Report and document, as required by your facility.