Nurses Could Delegate to Paid Care Workers

By Hollie Deese

When one of his nurses left his medication on a shelf just out of reach, state Rep. Darren Jernigan realized the frustration caused by state laws governing care.

A paid care worker was legally prohibited from handing the pills to Jernigan, who has used a wheelchair since a 1990 automobile accident in which he was a passenger.

“I had someone come in to give me some assistance in the morning and she could not hand me the meds,” said Jernigan, 47, a Democrat from Old Hickory. “I said, ‘Are you kidding me?’ If you’re in that position it doesn’t make sense.”

In 2016, Jernigan cosponsored the Nursing Delegation Act for Home and Community Living, which would allow a registered nurse to delegate health maintenance tasks to a paid care worker. It died in committee.

“To me it was a practical piece of legislation,” Jernigan said. “It is commonsense legislation and one that is definitely going to be needed in the future.

“There are 10,000 people turning 65 a day for the next 19 years. You’re not going to have a nurse in every single home. If you don’t have a nurse to delegate to someone to simply get some meds that person has been taking for 20 years, it won’t work. Really, you could say we’re being more proactive.”

Legislative priorities
Changing state law to allow registered nurses to delegate some health maintenance tasks to a paid care worker is one of AARP Tennessee’s top legislative priorities for 2017.

Many health maintenance tasks can be performed without professional training. They include insulin shots, blood sugar testing, dispensing eye or ear drops, and nebulizer treatments.

“By allowing a nurse to delegate those tasks to a direct care worker, it allows for families to have someone come into the home and do those things instead of the family member trying to rush back home at lunch to do these things,” said Shelley Courington, AARP Tennessee advocacy director.

Allowing nurses to delegate some responsibilities could also make the difference in whether a person is able to receive safe and cost-effective care at home or has to move to a facility, she said.

“We know that a lot of family caregivers leave the workforce to be able to do the care,” Courington said.

“If you are able to, more cost-effectively, provide safe care in the home, we anticipate that caregivers are going to feel a relief,” she said. “It will give them the ability to have some of these tasks done without having to pay a nurse.”

According to a 2015 AARP survey, 60 percent of registered voters 45 and older in Tennessee are providing or have provided unpaid care to an adult who is ill, frail or elderly, or has a physical or mental disability.

Of those caregivers, nearly 7 in 10 are helping or have helped with complex care like medication management and other nursing and medical tasks.

The survey showed that more than 4 in 5 respondents would support allowing registered nurses to delegate some of their responsibilities to other health care workers as long as they were trained to do so.

Sharon Adkins, executive director of the Tennessee Nurses Association, said the group supports the delegation of “appropriate tasks” after a nurse’s evaluation of the patient and paid caregiver.

Other key issues for 2017 include:

• Property tax relief for low-income elderly or disabled persons and disabled veterans.
• Expanding broadband offerings to rural areas so everyone in Tennessee has access to high-speed internet at a reasonable price.
• Improving livability and transportation options in cities so it is easier to age in place.

Hollie Deese is a writer living in Gallatin, Tenn.