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~u  
Date 
A DESCRIPTIVE STUDY OF LICENSED PRACTICAL NURSES 
AND NURSES' AIDES IN TWO MONTANA HOSPITALS 
by 
JOAN DABNEY ARCHER 
A professional paper submitted to the Graduate Faculty 
in partial fulfillment of the requirements for the degree 
of 
MASTER OF NURSING 
Approved: 
Head, Major Department 
JL&LA. £-m s 
Chairmalf, Examining Committee 
MONTANA STATE UNIVERSITY 
Bozeman, Montana 
December, 1971 
iii 
ACKNOWLEDGMENT 
The writer wishes to express her sincere appreciation to 
her committee, Dr. Laura C. Walker, Dr. A*Delbert P. Sampson, 
Mrs. Lucille M. Wilson, and in particular to Mrs. Phyllis B. 
Hillard, Chairman of the Committee whose assistance, and sup¬ 
port were invaluable during the preparation and completion of 
the study. 
Special acknowledgment is given to the hospital administra¬ 
tion and nursing service personnel involved in the study whose 
cooperation and support made the study possible. Also apprecia¬ 
tion is extended to the members of her class for their interest 
and helpful suggestions throughout the course of this project. 
/ 
iv 
TABLE OF CONTENTS 
VITA .................. 
ACKNOWLEDGMENT ............. 
LIST OF TABLES . . . . . . . . . . . . . 
ABSTRACT ...... . . . . . . . . . . 
Chapter 
I. INTRODUCTION    . . 
General Information ...... 
Purpose of the Study . . . . . 
Statement of the Problem . . . 
Objectives of the Study . . . 
Assumptions    
Population  
Methodology v . . . 
Limitations ......... 
Definition of Terms ...... 
II. REVIEW OF THE LITERATURE .... 
III. RESEARCH METHODOLOGY  
Procedure  
Structured Interview  
Task List . .  
IV. ANALYSIS OF THE.DATA  
Structured Interview :..... 
Task List ........... 
Page 
ii 
iii 
vi 
vii 
1 
. 1 
3 
3 
4 
4 
4 
4 
4 
5 
8 
15 
15 
15 
17 
18 
19 
25 
V 
Page 
V. SUMMARY 27 
Conclusions 27 
Recommendations 28 
APPENDICES 
A. STRUCTURED INTERVIEW 30 
B. TASK LIST 32 
C. RESULTS OF INTERVIEWS 35 
D. TASK LIST RESULTS 75 
E. JOB DESCRIPTIONS: LPN AND NA 81 
BIBLIOGRAPHY  95 
vi 
LIST OF TABLES 
Table Page 
1. Distribution of the Population . . .   18 
2. Range of Age, Education, and Experience 19 
3. Tasks Corresponding to Task List 25 
vii 
ABSTRACT 
The utilization of nursing personnel is a subject of much 
concern in the health care industry today. The principal objec¬ 
tive of this study was to determine how services of licensed 
practical nurses (LPN's) and nurses* aides (NA*s) were utilized 
in two urban hospitals in Montana. The researcher attempted to 
determine, through the use of taped structured interviews and 
task lists, not only tasks the LPN's and nurses aides were per¬ 
forming but their feelings regarding their ability to perform 
them. The answers received were compared to the job descriptions 
of the hospitals by which the participants were employed. 
Conclusions of the study were that LPN's were under-utilized, 
while NA's worked within the range of their job descriptions. LPN's 
felt that they were not allowed to perform to their capacity, while 
NA's felt that they were working at the level for which they were 
prepared. LPN's and NA's did most of the direct nursing care of 
patients and performed essentially the same tasks. 
The study indicated to the researcher the need to examine 
further the actual tasks performed by LPN's and NA's in an effort 
to clarify roles and define parameters of function and responsibil¬ 
ity. Further examination is also needed as to the types of in- 
service programs given to LPN's and NA's to ascertain if they are 
in fact meeting the needs of this group. 
CHAPTER I 
INTRODUCTION 
General Information 
Nursing today is faced with a multitude of problems, one of the 
greatest of which is the proper utilization of nursing personnel. 
In recent decades, there has been increasing pressure to expand the 
use of ancillary personnel, such as practical nurses and nurses' aides, 
to provide adequate care for hospital patients. The cause of this 
pressure has been threefold: (1) the rapid technological progress 
in the medical field, (2) the demands of an affluent society for 
comprehensive health care, and (3) the increased government interest 
in providing health care for all segments of society. With the tech¬ 
nological advances in medicine, it is now frequently necessary for 
patients to be admitted to a hospital to undergo the complicated diag¬ 
nostic examinations and sophisticated treatment required. The general 
affluence of the society, along with medical insurance plans, has 
given the majority of Americans the ability to demand and pay for 
hospitalization when they are in need of medical care. The govern¬ 
ment has supported the less affluent with medical care plans such 
as Medicare and Childrens' Aid. 
Traditionally, the professional nurse has assumed responsibility 
for the direct nursing care of her patients. However, the expansion 
and diversification of hospital services have increased the number 
and complexity of tasks on the nursing unit enormously, and 
2 
The nurse remaining on the ward has found herself 
essentially 'nursing through others,' directing the ac¬ 
tivities of nurse aides and assistants, while frequently 
performing the necessary, though hardly related, tasks 
of supervision of housecleaning, assessing patient 
charges, trailing nonprofessional employees, and order¬ 
ing supplies. 
Unfortunately, prestige and salary have increased for pro¬ 
fessional nurses in proportion to the distance they have moved 
away from the patient, and bedside nursing has become an insig- 
2 
nificant function with a low salary. In recent years, too, there 
has been an increasing demand for nurses to assume many of the 
duties and responsibilities which have been traditionally medical; 
and the attempt on the part of nurses to meet this demand for ad¬ 
vanced professional skills has created a vacuum below. The quality 
of patient care has been seriously threatened by the fact that the 
void has been filled with large numbers of ancillary personnel who 
are performing many tasks beyond their competence and training. 
"A cursory inspection of large hospitals, and even smaller ones, 
shows that necessary nursing care is being performed primarily by 
aides and practical nurses." Proper instruction and supervision of 
"National Committee for the Study of Nursing and Nursing 
Education: Summary Report and Recommendations," American Journal 
of Nursing, LXX (February, 1970), p. 281. 
2 
Gertrude Cherescavich, "Role of the Clinical Specialist," 
Hospital Topics, XLV (July, 1967), p. 74. 
3 
Genrose Alfano, "Nursing is Vital in Theory but Expendable 
in Practice," in "Nursing in the Decade Ahead," American Journal 
of Nursing, LXX (October, 1970), p. 2116. 
3 
such personnel is essential and the professional nurse, increasingly 
occupied with administrative and medical duties, has been unable to 
4 
provide the teaching and supervision necessary. 
Despite all attempts being made to recruit and train nurses 
to fill present vacancies, there is little doubt that the present 
unfavorable ratios of professional to nonprofessional nurses will 
continue indefintely into the future.”* Today, with society demanding 
more and better delivery of health care, nursing is realizing the 
necessity for re-examination of re-allocation of its manpower resources. 
The lack of clear definitions of nursing roles has resulted in exten¬ 
sive overlapping of responsibility and duplication of effort. 
Purpose of the Study 
The purpose of this study was to obtain a clear picture of the 
actual tasks performed by licensed practical nurses and nurses' aides 
in two urban hospitals in Montana. An attempt was made to relate 
education, background, and experience to the actual tasks they were 
performing, and to determine areas of need where in-service education 
might be of value. 
Statement of the Problem 
The problem was to determine whether or not licensed practical 
nurses (LPN's) and nurses' aides (NA's) function within the realm of 
tasks prescribed by their respective institutions; to identify tasks for 
which LPN's and NA's believe they were either well prepared 
Toward Quality in Nursing, Report of the Surgeon General's Confer¬ 
ence Group on Nursing, Public Health Service Publication No. 992 (Wash¬ 
ington, D. C.: Department of Health, Education, and Welfare, February, 
1963), p. 4 
5Ibid., p. 20 , 
4 
or inadequately prepared to perform; and to make recommendations 
within the limits of the study concerning the use of this information 
in planning in-service programs for LPN’s and NA's. 
Objectives of the Study 
1. To identify specific tasks performed by LPN’s and NA’s and 
relate them to the job descriptions of their employing institutions. 
2. To ascertain the views of LPN’s and NA’s in terms of their 
own abilities to meet the expectations set forth by their respective 
institutions. 
3. To indicate whether or not any relationship exists between 
the types of tasks performed by LPN’s and NA’s and their educational 
background and experience. 
Assumptions 
1. LPN’s and NA's do most of the direct nursing care of patients. 
2. The need for LPN’s and NA's to feel satisfaction in the 
performance of tasks is an important consideration in terms of in¬ 
fluence on patient care. 
Population 
The population for the study included twenty-two licensed 
practical nurses and forty-one nurses’ aides from two urban hospitals 
in Montana. 
Methodology 
The methodology involved the use of a taped structured interview 
and an individual task list. 
Limitations 
The value of the structured interview was limited to some degree 
by the fact that each participant was seen for only one short period 
of time. 
i 
5 
The task list was to be completed in one week*s time. The 
participants were cooperative and did list additional tasks performed, 
but the short time span may have prevented their listing other tasks 
which they would routinely perform but did not happen to perform 
during that particular week. 
An important limitation was the fact that the researcher was 
unable to observe participants in the actual performance of their 
duties to supplement the information submitted on the task lists. 
Another possible limitation was the fact that each hospital sup¬ 
ported training programs for both professional and practical nurses. 
The presence of students who require clinical experience might prevent 
the participants from performing duties which would otherwise be 
routinely theirs. 
Definition of Terms 
Ancillary personnel are those individuals, other than physicians 
and professional nurses, engaged in direct or indirect care of patients 
and including LPN’s, NA's, orderlies, laboratory and X-ray technicians, 
dietary and housekeeping personnel, and ward clerks. 
Direct nursing care encompasses those activities occuring in the 
presence of the patient which involve the provision of care and in¬ 
clude carrying out nursing procedures; giving or assisting the patient 
with personal hygiene; conversing and exchanging pleasantries with the 
patient; observing the physical condition and behavior of the patient; 
escorting the patient; listening to comments, requests, wishes, and 
complaints of the patient; making interpretations to the patient; 
teaching the patient; and assisting physicians with treatments or 
procedures. 
A director of in-service education is a professional nurse re¬ 
sponsible for planning, implementing, and supervising educational activ¬ 
ities for nursing personnel. 
6 
G. E. D. refers to a series of general educational development 
tests, completion of which certifies the equivalent of a high-school 
diploma. 
A head nurse is a professional registered nurse who has full-time 
responsibility for the administration of patient care and general 
management of one nursing unit. 
In-service education includes all educational activities directed 
toward the improvement of personnel performance in caring for patients. 
A job description is a statement of an institution’s policy re¬ 
garding the scope and limitations of a given nursing position, generally 
including an outline of duties and responsiblities and the minimum 
qualifications required for the position. 
A licensed practical nurse is an individual who has graduated 
from an approved practical nurses* school and is licensed by a state 
agency; or an individual who has satisfactorily completed the LPN 
examination according to the waiver clause, Montana State Law 
Number 66-1221, and is licensed by the state of Montana. 
A nurses*s aide is an individual trained on the job to assist the 
professional nursing staff in giving patient care. 
A nursing unit is an area in the hospital where nursing care is 
given to patients. 
0. J. T. is on-the-job training of individuals with no previous 
experience or formal training in the position for which they are 
employed. 
A team leader is a licensed professional nurse who is respon¬ 
sible for all nursing care given to an assigned group of patients. 
Team nursing is the method of providing total nursing care for 
an assigned group of patients by the use of personnel with various 
levels of nursing skill, under the direction of a team leader. 
T. L. C. is tender, loving care. 
7 
Overview of Remainder of the Study 
The remainder of the study includes the following: Chapter II 
a review of pertinent literature, Chapter III an explanation of 
methodology, Chapter IV analysis of data, Chapter V the summary, con¬ 
clusions and recommendation of the study. 
CHAPTER II 
REVIEW OF THE LITERATURE 
A review of the literature indicates that there is much con¬ 
fusion regarding the proper utilization of nursing personnel. Me¬ 
dical professional and administrative literature, as well as nursing 
literature, reflects a great concern about improving the delivery 
of health care services. Medical, administrative, and nursing 
leaders are critically viewing the health manpower supply and put¬ 
ting forth various suggestions for the most effective use of present 
manpower resources. The increasing demand for health services from 
a growing population has imposed heavy responsibilities on the deliv¬ 
erers of health care. 
Relationships between the various members of the health team 
have changed radically and are likely to continue changing in the 
decades ahead. The literature reflects great confusion regarding 
"roles" and lines of authority and responsibility for members 
of the health care team. 
Doctors, in a recent statement of the American 
Medical Association trustees, have undertaken to 
say what the role of the nurse should be, and 
nurses, through the American Nurses* Association*s 
Commission on Nursing Education, have attempted 
to differentiate the 'central focus of the physi¬ 
cian's work,' and neither has paid much attention 
to the many other allied health professionals who 
are getting ready in the wings, soon to be an in¬ 
tegral part of the act. Misinformation, poor 
communication and unilateral actions are the order 
of the day.l 
^"Who is Supposed to be Doing What?" California Medicine, 
CXIII (September, 1970), p. 69. 
9 
New career patterns in the health care field are receiving 
2 3 4 5 
widespread attention. The pediatric nurse practitioner * * * 
6 7 8 
and the physician's assistant0* * are examples of innovations 
and changing patterns at the professional level, and there are 
numerous articles discussing the expansion of the role of the 
2 
L. C. Ford and H. K. Silver, "The Expanded Role of the 
Nurse in Child Care," Nursing Outlook, XV (September, 1967), 
pp, 43-45. 
O 
Nancy Martin, "Freeing the Doctor From Well-Baby Care," 
Medical Economics, XLIV (November 13, 1967), pp. 118-127. 
^Donald W. Schiff, Charles H. Fraser, and Heather L. 
Walters, "The Pediatric Nurse Practitioner in the Office of 
Pediatricians in Private Practice," Pediatrics, XLIV (July, 
1969)_, pp. 62-68. 
^S. G. Stearly, A. Noordenbos, and V. Crouch, "Pediatric 
Nurse Practitioner," American Journal of Nursing, LXVII 
(October, 1967), pp. 2083-2087. 
fl 
Kathleen G..Andreoli and Eugene A. Stead, Jr., "Training 
Physicians' Assistants at Duke," American Journal of Nursing, 
LXVII (July, 1967), pp. 1442-1443. 
^Robert D. Coye and Marc F. Hansen, "The Doctor's 
Assistant: 'A Survey of Physicians' Expectations'," Journal of 
the American Medical Association, CCIX (July 28, 1969), pp. 529- 
533. 
o 
Joseph Kadish and James W. Long, "The Training of Physician 
Assistants: Status and Issues," Journal of the American Medical 
Association, CCXII (May 11, 1970), pp. 1047-1051. 
10 
-M 9, 10, .11, 12 
nurse in other areas as well. 
Changing career patterns are also reflected in the utiliza¬ 
tion of lower-echelon nursing personnel. The role of the licensed 
practical nurse has been greatly expanded during the past few decades, 
largely because of the shortage of registered nurses. In a recent 
study of nursing personnel in four eastern hospitals, Lambertson con¬ 
cluded that "the scope of responsibility of practical nurses increased 
proportionately as the ratio of staff nurses to practical nurses 
13 
decreased." During the day tour of duty, staff nurses assumed 
responsibility for selected procedures, but "during the evening 
and night tours of duty, practical nurses assumed these responsibilities 
for the same patients whose care was assigned during the day to 
registered nurses."14 In another article, Rasmussen points 
^Rose Marie Chioni and Carol Panicucci, "Tomorrow's Nurse 
Practitioners," Nursing Outlook, XVIII (February, 1970), pp. 32- 
35. 
^Josephine A, Cipolla and Gilbeart H. Collings, Jr., 
"Nurse Clinicians in Industry," American Journal of Nursing, 
LXXI (August, 1971), pp. 1530-1534. 
^Dorothy Merenes, "Recent Trends in Expanding Roles of the 
Nurse," Nursing Outlook, XVIII (May, 1970), pp. 30-33. 
12 
Laura L. Simms, "The Clinical Nursing Specialist: An 
Approach to Nursing in the Hospital," Journal of the American 
Medical Association, CXCVIII (November 7, 1966), pp. 675-677. 
13 
Eleanor C. Lambertson, "Availability of RNs Affects Respon¬ 
sibilities of Others," Modern Hospital, CXIV (March, 1970), p. 132.. 
14Ibid., p. 132. 
i 
11 
out that the difference between registered nurses and licensed prac¬ 
tical nurses is a difference in degree of responsibility for a function, 
rather than a difference in the function itself. 
The nurses' aide has also assumed increasing importance in 
the provision of patient care in recent years. These individuals, 
usually trained on the job, are among the lowest paid employees of 
the hospital. Because of the economic advantages, there is a great 
temptation to use these individuals in place of those with profes¬ 
sional and practical nursing skills. Our proposed 'solutions' to 
health manpower shortages typically involve placing more and more 
16 direct patient care in lesser and lesser trained hands. 
The literature of professional health care groups expresses 
a recognition of the need for expanding roles and changing career 
patterns for nursing personnel. The American Medical Association, 
in its position paper of 1970, emphasized the need for experimenta¬ 
tion and innovation in the educational preparation of all levels 
of nursing personnel. According to the statement of the AMA Com¬ 
mittee on Nursing, 
Considerable effort is needed to integrate effec¬ 
tively the present system of nursing education so 
that persons of ability and motivation can more 
readily achieve their highest level of competency 
■^Etta H. Rasmussen, "Changing Organizational Relations," 
Pamphlet W-12: Reprinted from the American Journal of Nursing, 
LXII (October, 1962), pp. 407. 
1 6 
°Marjorie M. Ramphal, "Freedom to Choose What?" American 
Journal of Nursing, LXX (April, 1970), p. 753. 
12 
and status. Credit for related courses, challenge 
examinations, credit for experience, evening edu¬ 
cational resources, and recognition for achieve¬ 
ment in clinical fields are mechanisms which would 
facilitate mobility.^ 
The basic concern of hospital administration is the maximum 
utilization of nursing personnel. As one author puts it, 
The term ’efficiency' might be equated with the term 
'economy,' because efficiency is concerned with ob¬ 
taining economy through the attainment of the great¬ 
est amount of productivity while expending the least 
amount of effort. 
In numerous articles, administrators examine the feasi¬ 
bility of improving the training of the nurses' aide and giving her 
19 20 
more status by opening promotional opportunities. * They contend 
that improving methods of selecting, training, and supervising nurses' 
aides will enable these individuals to assume positions of greater 
responsibility in the nursing unit. 
17
"Medicine and Nursing in the 1970's: A Position Statement," 
Journal of the American Medical Association, CCXIII (September 14, 
1970), p. 1882. 
^John R. Landdeck, "Efficiency and Quality of Patient Care," 
Hospitals, XLIV (September 16, 1970), p. 41. 
"^Charles R. Shuffield, "Upgrading Nursing Aides," Hospitals, 
XLIV (December 16, 1970), pp. 61-64. 
20Patricia Ann Lang, "From Brooms to Blood Pressures," Nursing 
Outlook, XVIII (October, 1970), pp. 25-27. 
13 
Nursing itself has long recognized the need for further edu¬ 
cation of practical nurses and nurses' aides. Practical nurse 
programs have been supported by both the American Nurses' Associa¬ 
tion and the National League for Nursing and have made tremendous 
strides in the past few decades. 
The nursing assistant came into being during World War II 
when the extreme shortage of professional nurses made it 
mandatory that nursing delegate some routine tasks to 
individuals of less preparation. This led to the 
development and subsequent licensure of vocational or 
practical nurses, who function under the direction of 
' the physician or the nurse depending on the setting?! 
The American Nurses' Association recognized in 1965 the need 
for vocational training for nurses' aides and other ancillary per¬ 
sonnel. The Association recommended short, intensive, pre-service 
2: 
programs in vocational institutions, rather than on-the-job training. 
That this concept has not been completely accepted is evidenced by 
the fact that the majority of training of nurses' aides is still being 
done in individual hospitals. 
Nursing literature today emphasized the necessity for career 
21 
Rheba De Tornay, "Expanding the Nurse's Role Does Not Make Her 
a Physician's Assistant," American Journal of Nursing, LXXI (May, 
1971), p. 974. 
22 
"American Nurses' Association's First Position on Education 
for Nursing," American Journal of Nursing, LXV (December, 1965), 
pp. 106-111. 
14 
ladders and upward mobility for all levels of nursing personnel, with 
23 24 23 increasing attention being focused on the non-professional group. * * 
One article described a plan for the upward mobility of nurses’ 
aides and pointed out three advantages of the program: (1) it gives 
the individual upward mobility and status, (2) it provides a pool 
of personnel more highly-qualified to assume responsibility, and (3) 
it provides a guided experience in teaching for the staff nurse, who 
26 is the clinical instructor for the aides in the course. 
Three omissions which became strikingly apparent to the researcher 
in the course of her review of the•literature were: (1) the lack of 
any minimum criteria for the selection of nurses’ aides, (2) the lack 
of any standardized curriculum for their training, and (3) the lack 
of a clear, legal definition of the position. 
23 
May W. Aisen, "Up the Vocational Stairs," American Journal of 
Nursing, LXX (December, 1970), pp. 2614-2617. 
24 
E. Martin Egelston, "Licensure and Career Mobility," Hospitals, 
XLIV (December 1, 1970), pp. 42-46. 
25 
Carol N. D’Onofrio, "Aides — Pain or Panacea?" Public Health 
Reports, LXXXV (September, 1970), pp. 788-801. 
O £ 
Dorothy A. Rehm, "Design for Staff Growth," American Journal 
of Nursing, LXX (September, 1970), pp. 1930-1933. 
CHAPTER III 
RESEARCH METHODOLOGY 
Procedure 
The basic instruments of research were a structured interview 
(Appendix A) and a task list to be completed by each LPN and NA 
included in the study (Appendix B). In addition, interviews were 
conducted with the directors of nursing of each hospital and with 
the head nurses of the units where the population was employed. In 
each hospital, the director of in-service education served as coordin¬ 
ator between the researcher and the study group and assisted in the 
selection of participants. 
Formal interviews were conducted with twenty-two licensed prac¬ 
tical nurses and forty-one nurses’ aides from all nursing service areas 
of each hospital and from all three shifts. Participants were asked 
to complete the task lists given to them and to add any additional 
tasks performed, but not listed on the form. 
Structured Interview 
The taped structured interview was designed to elicit subjective 
rather than objective answers in order to avoid stereotyped replies 
and allow for freedom of expression. The researcher hoped to deter¬ 
mine what differences, if any, existed between the concepts of the 
LPN’s and NA’s regarding their jobs and the concepts as set forth in 
the job descriptions of the nursing service and hospital administra¬ 
tion. The questions were designed to obtain information about the 
educational background and experience of the individuals interviewed 
and to ascertain theif personal feelings regarding the types of tasks 
they performed, the value of the services they provided, their own 
ability to meet the expectations of the nursing service, and the 
amount of personal satisfaction they derived from their work. 
The initial questions pertained to educational background and 
experience. The first question sought: (1) to determine levels 
16 
of formal education of persons who go into.nonprofessional nursing, 
(2) to determine whether or.not there is any relationship between the 
level of formal education and the types of tasks performed, (3) to 
examine the type of nursing training they received, (4) to ascertain 
whether or not their formal education helped them in learning nursing 
tasks and procedures. The second question was designed to bring to 
light any correlation between the length of experience and the types 
of tasks performed, and to determine whether length of experience and/ 
or the amount of formal training were given primary consideration in 
the assignment of tasks to the individual. 
The third, fourth, and fifth questions supplemented one another 
and attempted to discover whether or not there was a relationship be¬ 
tween the adequacy of training and the ability to perform. The third 
question inquired as to whether or not the respondents’ training was 
sufficient to allow them to be comfortable when they started to work — 
to become readily familiar with the routines of the ward, to ask 
pertinent questions when necessary, and to establish rapport with 
patients and members of the staff. Questions four and five were asked 
to determine if they thought they were actually being used at the level 
for which they were prepared. This group of questions asked LPN's and 
NA*s to define the parameters of their jobs as they saw them. 
Questions six and seven were also supplemental to each other,1 the 
former inquiring if the in-service education the hospital offered was 
adequate and meaningful and the latter asking the participants to define 
what they considered good in-service. 
The eighth question sought to determine the priority and importance 
of relationships between participants and the three pivotal groups with 
whom they were involved in their work — physicians, nurses, and 
patients. 
17 
In question nine, interviewees were asked what they thought was 
their own unique contribution to care of the patient; and whether 
they thought this contribution was a team or a personal effort. 
Question ten requested a recall of the tasks performed on one 
specified day. The researcher hoped that the results might provide 
significant additions to the formal task list each was asked to 
submit during the course of the study, and would help prove the 
validity of what they said they did and what they actually did. 
Task List 
The task list set up by the researcher was limited to routine 
technical procedures commonly performed by ancillary personnel. 
References to psychological and emotional support of the patient 
were deliberately omitted. It was hoped that the participants would 
use the blanks provided for additional tasks to list those tasks 
which they themselves performed most frequently and considered the 
most important. 
CHAPTER IV 
ANALYSIS OF THE DATA 
The population for the study was selected from all nursing areas 
of the two hospitals. Individuals from all three shifts were includ¬ 
ed in order to obtain the broadest possible sampling (Table 1). 
TABLE 1 
DISTRIBUTION OF THE POPULATIONa 
Hospital A Hospital B 
LPN . NA LPN NA 
Days 9 10 6 10 
Evenings 3 9 2 5 
Nights 2 5 0 2 
Total 14 24 8 17 
Source: Nursing Services, Hospital A and Hospital B. 
The researcher conducted a personal interview with each parti¬ 
cipant. All personnel involved were cooperative and appeared to be 
interested in contributing to the study. The writer believes that 
the information submitted was carefully considered and is valid. 
Data obtained from the structured interviews and task lists ' 
appear in tabular form in Appendix .C (page 35) and Appendix D 
(page 75). 
19 
Structured Interview-/ 
The first two questions of the interview requested information 
regarding the age, educational background, formal training, and ex¬ 
perience of the individuals involved in the study (Table 2). 
TABLE 2 
RANGE OF AGE, EDUCATION, AND EXPERIENCE^ 
22 LPN’s ! 41 NA’s 
! 
Low Avg High Low Avg High 
Age 24 42 61 
1 
19 35 64 
Education 
1 
GED 12 yrs 12 yrsj 8 yrs 11 yrs 13 yrs 
Training OJT 7 nos 12 mosj 4 hrs 5 wks 10 wks 
Experience 5 mos 10 yrs 18 yrsj 3 mos 5 yrs 15 yrs 
Q 
Source: Nursing Services, Hospital A and Hospital B. 
Since the researcher had no opportunity to observe the partici¬ 
pants in the performance of their jobs, she was unable to make a 
valid judgement regarding relationships between length of training 
and experience and the tasks performed. However, the LPN's with 
waivers indicated that experience was a factor in upgrading positions. 
All of these people were initially nurses’ aides who were given the 
opportunity to take the qualifying examination for licensure as 
practical nurses, using experience in lieu of training. 
20 
Question 3: "Have you found that your training prepared you for 
what is now expected of you on your ward?" 
Yes No Undecided 
LPN 95% 5% 
NA 51% 22% 27% 
Comments from the school-trained LPN*s indicated almost unan¬ 
imous satisfaction with their initial training. One individual, 
however, was uncertain and commented, "I was trained in a small 
hospital and they didn’t do things the same as here." LPN's with 
waivers indicated that they considered experience adequate training. 
NA’s who were satisfied with their initial training made no 
comments as to why. Those in the "no" and "undecided" groups com¬ 
mented primarily on their inability to obtain sufficient information 
in class and on the importance of their experience. They also men¬ 
tioned a lack of experience in such areas as obstetrics, pediatrics, 
and surgery. 
Question 4: "Do you think you could do more than what is asked or 
expected of you?" 
Yes No Undecided 
LPN 59% 27% 14% 
NA 42% • 46% 12% 
The majority of LPN’s felt that they were somewhat limited in 
their work and could do more, particularly in the area of administer 
ing medications. Most of the NA’s felt there was not much more they 
could do, but some felt that they could do more in the area of treat 
ments and two felt they could give medications. 
21 
Question 5: "Do you feel that you are asked or expected to do more 
than you can?" 
Yes No Undecided 
LPN 9% 77% 14% 
NA 12% 68% 20% 
The majority of LPNTs felt that they were rarely asked to do more 
than they could do. They indicated that if they were asked to per¬ 
form some duty they did not feel capable of doing, they could refuse. 
The majority of NA’s shared the feeling of the LPN’s that they 
were seldom asked to perform tasks above the level of their capability 
and they, too, felt they could refuse. 
Question 6: "Do you feel the hospital continues to give you training 
that helps you.keep up with your job?" 
Yes No Undecided 
LPN 86% 9% 5% 
NA 88% 2% 10% 
On the whole, the LPN’s felt that they were receiving adequate 
in-service training. However, their comments indicated a marked 
variation in the numbers and types of classes attended. 
NA's, too, expressed general satisfaction with the in-service 
programs; but like the LPN’s, they were unclear about the numbers 
and types of classes attended. A few expressed doubt as to the value 
and content of the training sessions. 
Question 7: "What are some of the things the hospital and the staff 
do to help you?" 
LPN’s named a variety of classes, and said films were used often. 
Three mentioned the use of ward conferences. As a whole, they had 
22 
difficulty remembering what types of in-service they had had. 
NA’s had difficulty remembering specific classes. They men¬ 
tioned ward conferences given by nursing students on the ward. Some 
expressed negative feelings about the content and instructors of for¬ 
mal in-service classes. Some felt that the instruction was "over 
their heads" and that they were not learning enough about the physical 
and emotional problems of the patients. 'Many felt that the staff was 
not always helpful in answering their questions. One comment which 
seemed particularly significant was, "I don’t like what’s offered. I 
don’t feel that RN’s should teach., They don’t know enough about nurses’ 
aides jobs." 
Although LPN’s and NA’s said that they had adequate in-service 
training, they did not seem to be getting what they wanted from the 
classes. The fact that most of them could not remember what classes 
they had had indicated a lack of real value in the present system of 
in-service. 
Question 8: "How do you see your work as it relates to: Doctor, 
Nurse, Patient?" 
The majority of LPN’s stated that they had little or no contact 
with the doctor. A few said they assisted the doctor with examinations 
and dressing changes. Two assisted the doctor in the delivery room, 
and two made rounds with the doctors "at times." The most common 
comment was "little contact." The majority of NA’s also said they 
had little or no contact with the doctors. Some did say that, at 
times, they held pediatric patients for the doctors, but most felt 
that they had nothing to do with the doctors directly. Their typical 
comments were "nothing," "very little," and "don’t help them directly." 
The majority of LPN's saw themselves as assisting the nurse in 
many areas. They felt their relationship with the UN’s was one of 
co-workers. Typical comments included "report, observe, and assist 
23 
each other," "we are the nurses’ feet," and "chart lots, and we inter¬ 
change work." Although the NA1s felt they assisted the nurse often, 
they did not feel as strongly about what they did for her as did the 
LPN’s. Typical comments were "assist at times," "assist and report 
things," "help with whatever she wants," and "errand girl, help 
with charts." 
LPN’s saw themselves with the patient much of their time, doing 
physical care for the patient's comfort. Some of their comments were 
"complete care and treatment, everything except medications," and 
"keep patients comfortable, most of the work is with patients." The 
majority of NA’s felt they spent their time with the patients, doing 
most of the patient care. Typical comments included "keep them clean, 
cheer them up, most of my time with the patients," "we are the ones 
that are with them most of the time — more than the RN's, make 
them comfortable and meet their needs," "close to the patients — 
spend most of my time listening, talking, and making them comfortable, 
and "mothering them and doing almost everything." 
The researcher felt that the answers to these questions regarding 
relationships to the three groups — doctors, nurses, and patients — 
placed the LPN’s and NA’s with the patients at the bedside. 
Question 9: "What do you think is the most important thing you do as 
a member of the nursing team?" 
The majority of LPN’s saw themselves at the bedside, caring for 
the patients' physical and emotional needs and using their training 
and knowledge giving care and comfort. Typical answers were "help 
care for the patients and help them recover, give them treatments 
based on knowledge," "patient care — the physical things, also 
talk and listen, spend extra time with the patient who is lonely — 
TLC is important," and "go-between for the patient, nurse, and doctor 
have direct contact eight hours a day and you see them more than 
anyone else." 
24 
NA’s, too, saw themselves as caring for both the physical and 
emotional needs of the patient at the bedside. They saw their job 
as doing basic care for the patient and making him as conformable 
as possible, as well as observing and reporting to the nurse. Typical 
answers were "patient care, bath, grooming, and oral hygiene, phy¬ 
sical comfort, visit with them and try to find out their problems — 
for lots of them talking is good, particularly with the older patients," 
"keep the patients as comfortable as possible, give them personal 
care, observe and report to the nurse — we are closer to the patient 
almost all of the time," and "we’re really the middle-man between the 
patient and the nurse." 
The answers to these questions reflect the feelings of the LPN’s 
and NA’s regarding their own importance to the patient, again empha¬ 
sizing that they see themselves with the patient at the bedside. 
Question 10; "Can you tell me in detail what you did today?" 
This question was intended mainly to provide a means of identi¬ 
fying tasks in addition to those contained in the task lists completed 
by the respondents. The participants’ reports of their one day's work 
indicated that they were doing the type of tasks they reported on the 
task lists (Table 3). 
25 
TA3LE 3 
TASKS CORRESPONDING TO TASK LIST2 
Task List 
Number Task LPN NA i 
1 Give bed baths 11 31 j 
3 Feed patient 3 8 1 
5 Give H. S. Care 2 i 
7 Take temperature orally 9 21 ! 
10 Chart pulse and respiration 6 
11 Assist patient in and out of bed 2 4 
13 Transport patient to other areas 2 
14 Do Intake & Output on Patients 2 i 2 
19 Scrub and assist doctor in D. R. 1 i 1 
20 Change sterile dressings 2 1 
21 Change colostomy dressings 1 
26 Catheterize patient to ennty bladder 2 i ! 
27 Chart care, condition, observations 10 5 1 
28 Give cleansing enemas 2 6 
30 Care for patient in isolation 1 1 
31 Set up isolation area 1 
35 Bath for newborns 1 
36 Feed newborns 1 
47 Use suction to clear throat and mouth 1 
50 Admit patients to ward 2 5 
51 Discharge patients 2 
54 Test urine for sugar 2 1 
56 Take blood pressure 5 7 
58 Terminate IV fluids 2 
Source: Task Lists and Structured Interviews. 
Additional tasks listed or mentioned by the participants were re¬ 
lated tasks which would normally be part of the duties of nonprofes¬ 
sional personnel. 
Task List 
The task list was compared with the job descriptions of LPN’s and 
NA's employed by the two hospitals (Appendix E, p. 80). The job 
descriptions for both institutions were similar, listing duties pre¬ 
dominately patient-centered and involving direct nursing care at the 
bedside. One of the hospitals differentiated between school-trained 
26 
and waivered LPN's, giving the former supervisory responsibility, such 
as team leading, and responsibility for the administration of medi¬ 
cations other than fractional dosages. The other institution made no 
differentiation between the two. Both hospitals expected LPN’s to 
assume greater responsibility than the NA’s, although the routine 
duties which each group performed were very similar. 
The job descriptions for the NA’s in both institutions also 
listed duties predominatly patient-centered and involving direct 
nursing care at the bedside. One job description indicated that NA’s 
could do no direct supervision, but could assist with orientation and 
on-the-job training for new ward aides. Job descriptions for LPN's 
and NA’s in both hospitals, in addition to listing specific duties, 
carried a standard phrase, such as "and performs other related duties." 
Comparison of the results of the task list with the job descrip¬ 
tion for both institutions indicated that all tasks listed fell well 
within the limits established. The task lists showed that LPN’s were 
performing at the same level as the NA’s the majority of the time. The 
researcher had hoped that the spaces provided for the listing of ad¬ 
ditional tasks might indicate that LPN’s services were being used in 
the areas of supervising, dispensing medications, and performing spe¬ 
cialized procedures requiring a higher level of competence and judge¬ 
ment. However, the duties they listed were mostly routine tasks 
which could be performed by either NA's or LPN’s. 
The list of additional tasks indicated some interest on the part 
of both LPN's and NA’s in supporting the patient emotionally and 
psychologically. (Appendix D, pp.75-79 ). However, the greatest 
evidence of their concern with this aspect of patient care was found, 
not in additions to the task list, but in the comments elicited by 
interview question 9 (Appendix C, pp. 62-66). Frequent references 
were made regarding the importance of supporting the patient by 
talking to him, listening to him, and reassuring him. 
CHAPTER V 
SUMMARY 
One of the most critical problems facing the health care indus¬ 
try today is proper utilization of ancillary personnel, and there has 
been increasing pressure to expand the use of nursing personnel such 
as LPN’s and NA’s. Three factors contributing to the pressure are: 
(1) rapid medical technological progress, (2) increased public de¬ 
mand for health services, and (3) government interest in providing 
health care to the nation. 
The prinicpal objective of this study was to determine how LPN’s 
and NA’s services were being used in two urban hospitals in Montana. 
Information was obtained from LPN’s and NA’s regarding the actual tasks 
they performed and compared to the job descriptions of the hospitals 
by which they were employed. Information as to how they felt about 
their ability to perform these tasks was also obtained. The resear¬ 
cher attempted to determine if there was any relationship between 
the formal training and experience of these participants and the types 
of tasks they were performing as well as the levels of responsibility 
they were assuming. The researcher assumed that LPN's and NA’s do most 
of the direct nursing care of the patient and that job satisfaction 
is an important factor in terms of influence on patient care. 
A structured interview and a task list were the tools of the study. 
The population included twenty-two LPN’s and forty-one NA’s from the 
two hospitals. Each participant completed a task list and was 
personally interviewed by the researcher. 
The study was limited by lack of time for adequate observation 
of participants’ job performance, by the relatively small population, 
and by the fact that only two hospitals were involved. 
Conclusions 
1. The majority of LPN’s were under-utilized and did not perform 
at the level outlined in their job descriptions; NA’s performed duties 
which fell within the range of their job descriptions. 
28 
2. The majority of LPN’s felt they were not being used to their 
capacity; the majority of NATs felt they were working.at their proper 
level. 
3. Data collected in the study was insufficient to provide con¬ 
clusive evidence of any relationship between the types of tasks per¬ 
formed and education, background and experience. 
4. LPN’s and NA’s did most of the direct nursing care of patients. 
5. LPN’s and NA’s obtained greatest job satisfaction through giv¬ 
ing direct nursing care to patients. 
6. The in-service training presented did not altogether meet the 
needs of LPN’s and NA’s. 
Recommendations 
1. Further studies should be conducted in hospitals of vary¬ 
ing sizes and types to determine whether or not LPN’s and NA’s are 
allowed freedom to function in their capacity. 
2. In addition to the tools used in this paper, future studies 
should include observation of job performance of participants over 
an extended period of time. 
3. Future studies should be conducted with a view to establish¬ 
ing legal certification for the use of NA’s in hospitals. 
4. Further studies should be conducted to establish criteria for 
the selection of NA’s. 
5. Future studies should be conducted with a view to establish¬ 
ing a formal course of study for uniform national certification of 
NA’s. 
6. Future studies should be conducted to determine what type 
of in-service would be most beneficial to LPN's and NA’s. 
7. Future studies should be conducted to determine the views of 
professional registered nurses regarding the types of tasks LPN’s and 
NA’s are capable of performing. 
APPENDICES 
APPENDIX A 
STRUCTURED INTERVIEW 
(CONFIDENTIAL) 
POSITION: LPN NURSES’ AIDE AGE WARD 
1. Education: 
2. Experience: 
! 3. Have you found that your training prepared you for what is now 
j expected of you on your ward? 
Yes  No Undecided   
Comment: 
4. Do you feel that you could do more than what is asked or expected 
of you? 
Yes  No  Undecided  
Comment: 
5. Do you feel that you are asked or expected to do more than you 
can? 
Yes  No  Undecided  
Comment: 
6. Do you feel that the hospital continues to give you training that 
helps you to keep up with your job? 
Yes  No  Undecided   
Comment: 
7. What are some of the things the hospital and staff do to help 
you? 
Comment: 
31 
8. How do you see your work as it relates to: 
1. The Doctor 
2. The Nurse 
3. The Patient 
9. What do you think is the most important thing you do as a member 
of the nursing team? 
10. Can you tell me in detail what you did today? 
APPENDIX B 
TASK LIST 
NAME   TITLE  DATE  
Routinely = any task you consider a part of your present job 
Occasionally = any task which you do when needed, even if it is 
someone else’s regular duty 
Never = task you never do at any time 
Routinely Occasionally Never 
1. Give Bed Baths   _____   
2. Assist Patient to Complete 
B h       
3. Feed Patient   _____   
4. Assist Patient with Feeding 
Himself       
5. Give H. S. Care _   _____ 
6. Give and Remove Bedpan '      
7. Take Temperature Orally       
8. Take Temperature Rectally    _  
9. Take Pulse and Respiration  _____   
10. Chart Pulse and Respiration       
11. Assist Patient In and Out 
of B     _____ 
12. Collect Lab Specimens       
13. Transport Patients to 
Other Areas of Hospital     _____ 
14. Do Intake and Output on 
Patients       
15. Clean and Wrap Sterile 
Packs       
33 
Routinely Occasionally Never 
16. Sterilize Instruments, 
Packs, and Solutions 
17. Prepare Patients for 
Delivery and Surgery 
18. Scrub and Assist Doctor 
in Surgery 
19. Scrub and Assist Doctor 
in Delivery Room 
20. Change Sterile Dressings 
21. Change Colostomy Dressings 
22. Prepare and Give Oral 
Medication 
23. Prepare and Give Hypodermic 
Injection 
24. Prepare and Give IV 
Fluids 
25. Prepare and Give IV 
Medication 
26. Catheterize Patient to 
Empty Bladder 
27. Give Patient Care, Condition, 
and Observations 
28. Give Cleansing Enemas 
29. Give Oil Retention Enemas 
30. Give Care to Patient in 
Isolation 
31. Set up Isolation Area 
34 
Routinely Occasionally Never 
32. Clean Isolation Area After 
Patient Discharge 
33. Give Sitz Bath 
34. Give Sponge Bath for 
Temperature Reduction 
35. Bath for Newborns 
36. Peed Newborns 
37. Prepare and Insert Tube 
for Feeding Newborn or 
Premature 
38. Give Breast Care to "Mother 
Before and After Nursing 
39. Care for Patient Recovering 
from Anesthesia 
40. Insert Retention Catheter 
41. Give First Aid to Patient 
Suffering from Shock 
42. Give First Aid to Patient 
With Fracture 
43. Assist Physician with 
Examination of Patient 
44. Apply Restraints 
45. Set up Mist Tents 
46. Set up 0^ at Proper Setting 
for Mist Tent 
47. Use Suction Machine to Clear 
Throat and Mouth 
48. Use Suction to Clear 
Tracheotomy Tube 
35 
Routinely Occasionally Never 
49. Give IPPB Treatment ' '    
50. Admit Patient to the Ward ' __   
51. Discharge Patients _ ~ ' 
52. Care for Infants in 
Incubator    
53. Take Phone Reports from 
Lab and X-Ray   
54. Test Urine for Sugar     
55. Answer Telephone on Ward ''   
56. Take Blood Pressure   
57. Chart Blood Pressure   
58. Terminate IV Fluids _____     
59. Terminate Blood Transfusions       
Tasks Not Listed That You do Perform 
1.       • 
2.     • • •_ 
3.   '  ___ • 
4.     __    
5.      • ' ' • ' ' 
6.    ' 1 ‘ ’ ' • • • 
7.  • • ___ • • • • • • • • • 
8.           
9.     __ • • • 
10. 
APPENDIX C 
RESULTS OP INTERVIEWS 
EDUCATION AND TRAINING:' LICENSED PRACTICAL NURSES 
Code Age 
Last Grade 
Completed 
LPN School 
w / s* 
Length of 
Training Experience 
1 24. GED X 12 mos 7 yrs 
2 25 12tn X 12 mos 4 yrs 
3 29 12th X 0JT 5 yrs 
U 35 12th X 12 mos 11 yrs 
5 36 12th X 12 mos 4 yrs 
6 37 12th X 12 mos 6 yrs 
1 37 12th X 12 mos 7 yrs 
8 37 12 th X 12 mos 3 yrs 
9 38 3 mos NT** X OJT 9 yrs 
10 39 12th X 12 mos 3 yrs 
n 40 GED X 12 mos 18 yrs 
12 41 12th X 10 wks 5 yrs 
13 42 GED X OJT 13 yrs 
14 46 12th X OJT 18 yrs 
15 46 10th X 12 mos 5 mos 
16 48 12 th X OJT 14 yrs 
iZ 48 30 mos NT X 12 mos 10 yrs 
18 50 12th X 12 mos 13 yrs 
19 50 12 th X 12 mos 4 yrs 
20 56 18 mos NT X OJT 15 yrs 
2_1 60 8 th X OJT 21 yrs 
22 61 12 mos NT X OJT 18 yrs 
*Waiver/LPN School 
**Nurses! Training 
37 
EDUCATION AND EXPERIENCE:/ NURSES’’AIDES 
Last Grade Length of 
Code Age Completed Training Experience 
23. 19 9 th 9 wks 6 mos 
24. 19 12th 8 wks 6 mos 
25. 20 12th 5 wks 3 mos 
26 20 12th 2 wks 18 mos 
27. 20 12th 5 wks 5 mos 
28. 21 . 12th 8 wks 1 yr 
29 21 12th 2 wks 2 yrs 
30. 22 24 mos NT (HSU) 0JT 1 yr 
31. 22 12th 10 wks 
. 18 mos 
32 22 12th 10 wks 2 yrs 
33. 23 12th 1 wk 2 yrs 
34 24 12th 10 wks 3 yrs 
35 24 13th 3 wks 20 mos 
36 24 12th 0JT 31 mos 
37 25 10th 0JT 13 mos 
38 26 8th 9 wks 5 mos 
39 28 12th 10 wks 6 yrs 
40 28 8th 10 wks 30 mos 
41 28 12th 16 hrs 2 yrs 
42 28 10th 9 wks 28 mos 
43 29 12 th 8 wks 4 mos 
44 29 12th OJT 18 mos 
45 30 12th 6 wks 18 mos 
46 32 12th 10 wks 19 mos 
47 36 10th 5 wks 10 yrs 
48 37 12th 2 wks 4 yrs 
49 38 8th OJT 11 yrs 
50. 
51 
52 
53 
54 
55 
56 
57 
_58 
59 
60 
61 
62 
63 
38 
Last Grade .Length ox 
Age • :Completed • Training •Experienc 
40 12th 2 wks 15 yrs 
41 12th ■ 4 hrs 15 yrs 
42 12th 10 wks 7 yrs 
45 12th 7 wks 1 yr 
47 9th OJT 10 yrs 
48 9th 3 wks 10 yrs 
54 9 th 6 wks 7 yrs 
57 12th ' 10 wks 6 yrs 
57 8th 6 wks 7 yrs 
57 8th OJT 12 yrs 
58 8th 16 hrs 15 yrs 
59 12th 9 wks 8 mos 
60 9 th OJT 7 yrs 
64 12 mos NT OJT 14 yrs 
39 
QUESTION 3: LICENSED PRACTICAL NURSES 
Have you found that your training prepared you for what is now 
expected of you on your ward?" 
Code W/S* Yes 
l s X 
2 s X 
3 w X 
4 s 
5 s X 
6 s X 
l s X 
8 s X 
9 w X 
10 s X 
n s X 
12 w X 
13 w X 
14 w X 
15 s X 
16 w X 
11 s X 
18 s X 
19 s X 
20 w X 
21 w X 
22 w X 
Comment 
I was taught in a small hospital 
They didn't do things the same 
as here. 
Definitely well trained. 
Very good instructors. 
Couldn't do it without all the 
training I had. 
All the experience really helped 
Experience was the main thing. 
Experience. 
Very good training. 
*Waiver/LPN School 
Experience and the actual work. 
Experience has been the main 
teacher. 
40 
QUESTION 3: NURSES1 AIDES 
"Have you found that your•training prepared.you for what is now ex 
pected of you on your ward?" 
Code Training Yes No Und 
23 9 wks X 
24 8 wks X 
25 5 wks X 
26 2 wks X 
27 5 wks X 
28 8 wks X 
29 2 wks X 
30 2 yrs NT X 
31 10 wks X 
32 10 wks X 
33 1 wk X 
34 10 wks X 
35 3 wks X 
36 OJT X 
37 OJT X 
38 9 wks X 
39 10 wks X 
40 10 wks X 
41 16 hrs 
Comment 
Not enough for Peds, but OK for 
adult care. 
Basic was good, but still need 
training in Peds. 
Didn’t cover much. Picked up 
most of my work on the floor. 
Some ways yes, some ways no. 
A lot of difference from days 
to nights. 
Started on Peds. OJT was good. 
Doesn't fit this position (OB), 
but OK for others. 
Did not have enough time at the 
hospital. 
They put me right on Peds and 
I had to learn all over again. 
I got a lot out of it. 
It helps, but the experience 
did too. 
Learned to work on the job. 
Didn't want to work in a 
specialty (Peds). 
This is a much bigger hospital 
and everything is different. 
x 
41 
Code Training Yes • No ' Und 
42 . 9 wks X 
43 8 wks X 
44 OJT X 
45 6 wks X 
46 10 wks X 
47 5 wks X 
48 2 wks X 
49 OJT X 
50 2 wks X 
_51 4 hrs X 
52 10 wks X 
53 7 wks X 
54 OJT X 
N 
55 3 wks X 
56 6 wks X 
57 10 wks X 
58 6 wks X 
59 OJT X 
60 16 hrs X 
_61 9 wks X 
62 OJT X 
63 1 yr NT X 
- Comment 
Not enough about surgical pro¬ 
cedures . 
It helps, but it's not enough. 
You can’t get it all in class. 
Would like to have learned more 
about illness, so you could be 
prepared. 
But OJT taught me as I went along. 
Mostly self-taught. 
That’s the way you learn — by 
by experience. 
As far as the baths go, but the 
rest you learn by experience. 
For the most part, good. 
Not given pediatrics. Had to 
learn on the job. 
Experience helped. 
Along with experience. 
Nurses’s aides do more than 
nurses did in those days (1929). 
42 
QUESTION 4: LICENSED PRACTICAL NURSES 
"Do 
of you?" 
you feel that you could do more than what is asked or expected 
Code W/S* Yes No Und U 0-i.Lx*.U.GT"l tl 
_1 s X I could give medications. 
2 s X 
3 w X In another hospital, so many 
more things you could do. I 
gave medications and hypos. 
4 s X Not used to capacity in the 
delivery room. 
_5 s X Could give medications. 
6 s X They don't let me give medica¬ 
tions now. 
2 s X Could give medications. Now 
I’ve forgotten how. 
2 s X Could discontinue IV’s and pass 
medications. We’re not allowed 
to calculate dosages. 
_9 w X Could do some things, but not 
without legal backing. 
10 s X 
n. s X 
12 w X They don’t let me give medica¬ 
tions . 
JL3 w X 
14 w X Feel I am limited. 
15 s X 
16. w X 
17 s X 
18 s X Have.done lots more in the past 
19 s X 
20 w X 
*Waiver/LPN School 
43 
Code 
21 
22 
W/S* Yes ' No "LJnd . Consent 
W x 
w x I could orient new nurses’ 
Aides 
*Waiver/LPN School 
44 
QUESTION 4:- NURSES1 AIDES 
"Do you think you could do more than what is asked or expected 
you?" 
Code Training Yes No Und Comment 
23 9 wlcs X 
24 8 wks X 
25 5 wks X 
26 2 wks X Could chart on patients and 
take blood pressures. 
27. 5 wks X 
28 8 wks X Could pass Aspirin at times 
do dressing reinforcements. 
29 2 wks X 
30 2 yrs NT X 
31 10 wks X 
32 10 wks X 
33 1 wk X Treatments. 
34 10 wks X 
35 3 wks X Could pass medications and 
out IV1s. 
36 OJT X 
37 OJT X 
38 9 wks X 
39 10 wks X Treatments. 
40 10 wks X 
41 16 hrs X Definitely. Have done much 
in the past. 
42 9 wks X 
43 8 wks X 
44 OJT X 
45 6 wks X Change dressings. 
46 
47 
4_8 
49 
50 
51 
52 
53 
54 
55 
56 
57 
58 
59 
60 
11 
11 
11 
45 
Training 
10 wks 
5 wks 
2 wks 
OJT 
2 wks 
4 hrs 
10 wks 
7 wks 
OJT 
3 wks 
6 wks 
10 wks 
6 wks 
OJT 
16 hrs 
9 wks 
OJT 
1 yr NT 
Yes No Und 'Comment 
x 
x 
You do enough. You really do 
more than nurses* aide’s-work. 
x 
x 
x 
x 
x 
X 
X 
I prefer to.do patient care. 
x 
x 
x 
x I think I could do more, 
x I like responsibility, 
x 
x 
x 
x 
46 
QUESTION 5: LICENSED PRACTICAL NURSES 
"Do 
can?" 
you feel that you are asked or expected to.domore than you 
Code W/S* Yes No Und Comment 
1_ s X 
2 s X Doctors sometimes do. 
3 w X 
4 s X 
_5 s X 
6 s X 
s X 
_8 s X Sometimes they do on other floors 
9 w X If they do ask, I refuse. 
10 s X 
11 s X 
12 w X 
13 w X Sometimes they give complete 
responsibility for IV1s. 
14 w X In the past, yes. Not now. 
s X 
11 w X At times, if they show me how, 
I will; but no, if I can’t do it. 
JL7 s X If I can't do it, I don’t do it. 
18 s X 
11 s X* 
20 w X 
21 w X Sometimes I’m not.too sure. 
Will not give medications. 
22 w X 
*Waiver/LPN School 
47 
QUESTION 5: NURSES1 AIDES 
can?" 
"Do you feel that you are asked 
Code Training Yes No Und 
23 9 wks X 
24 8 wks X 
25 5 wks X 
26 2 wks X 
27 5 wks X 
28 8 wks X 
29 2 wks X 
30 2 yrs NT X 
31 10 wks X 
32 10 wks X 
33 1 wk X 
34 10 wks X 
35 3 wks X 
36 OJT X 
37 OJT X 
38 9 wks X 
39 10 wks X 
40 10 wks X 
41 16 hrs X 
42 9 wks X 
43 8 wks X 
44 OJT X 
45 6 wks X 
46 . 10 wks X 
or expected.to.do more than you 
Comment 
Sometimes they do. If I can’t 
do them, I just say "no”. 
Sometimes. 
Nothing I feel I'm not capable 
of doing. 
.48 
Code Training Yes No. : Und .Comment 
47 5 wks X 
48 2 wks X 
49 OJT X 
50 2 wks X 
51 4 hrs 
52 10 wks 
53 7 wks X 
54 OJT X 
55 3 wks X 
56 6 wks 
51 10 wks X 
58 6 wks X 
59 OJT X 
60 16 hrs 
61 9 wks X 
62 OJT X 
63 1 Yr NT 
Sometimes. Dressing changes 
and blood pressures. 
If they're short .of help, they 
sometimes do. 
Sometimes there are things I 
don't think I should do and I 
say "no". 
Once in awhile. 
x 
49 
QUESTION 6: LICENSED PRACTICAL NURSES 
"Do you feel that the hospital continues to give you training that 
helps you to keep up with your job?" 
Code W/S* Yes No Und Comment 
_1 S X Regular classes once a month. 
2 S X About every two months. 
3 W X 
_4 s X They have everything but my 
specialty (OB). 
_5 s X 
jS s X 
2 s X Not much interest is shown by 
employees. 
3 s X Time is inconvenient. 
9_ w X Once a week. 
10 s X Haven’t been to many. 
11 s X Always something. One a month 
12 w X Very much. Once a month. 
13 w X Better than they used to be. 
14 w X Once a month. 
15 s X 
16 w X 
17 s X About once a month. 
18 s X Every month. 
19 s X It’s our own fault if we don’t 
take advantage of.it. 
20 w X 
21 w X One a month. 
22 w X They don’t have too many. 
*Waiver/LPN School 
50 
QUESTION 6: NURSES1 AIDES 
"Do you find that the hospital continues to give you training that 
helps you to keep up with your job? 
Code Training Yes No Und 
23 9 wks X 
24 8 wks X 
25 5 wks X 
26 2 wks X 
27. 5 wks X 
28 8 wks X 
29 2 wks X 
30 2 yrs NT X 
31 10 wks X 
32 10 wks X 
33 1 wk X 
34 10 wks X 
35 3- wks X 
36 OJT X 
37 OJT X 
38 9 wks X 
39 10 wks X 
40 10 wks X 
41 16 hrs X 
42 9 wks X 
43 8 wks X 
44 OJT X 
45 6 wks X 
Comment 
Have them on the ward. 
One a month. 
Not enough. 
One a month. 
Maybe not enough. I don’t think 
there is much interest among the 
employees, though. 
No set time for classes. 
One a month. 
Once a month. 
Two since I’ve been here (6 mos). 
Have them quite often. 
One a month. 
One or two a month. 
Used to have classes once a 
month, but don't now. 
They don’t offer anything inter¬ 
esting. 
Need more classes. 
46 
j47 
48 
49 
50 
51 
52 
53 
54 
55 
56 
57 
58 
59 
60 
61 
62 
63 
•51 
Training Yes ■ No Und Comment 
10 wks X Had them last year, not this 
year. 
5 wks X 
2 wks X They have them sometimes. 
OJT X Off and on. 
2 wks X Every three months. 
4 hrs X 
10 wks X Definitely. 
7 wks X One a week. 
OJT X Have them off and on. 
3 wks X Have them mostly on the ward. 
6 wks X 
10 wks X But I don't get to go very often. 
6 wks X Used to have them more, but no 
so much this year. 
OJT X Not much lately. 
16 hrs X One a month. 
9 wks X 
OJT X Last year we had one a month, 
but not so many this year. 
1 yr NT X 
52 
QUESTION 7:' LICENSED PRACTICAL NURSES 
'e some of the things the hospital and the.staff do.to 
Comment 
Films. Classes on reaction to pain, catheter care, 
suction care, and isolation. 
In-service in all kinds of things. 
Film on "Mrs. Reynolds Needs a Nurse." 
Class on cardiac arrest. 
We've had films. 
Classes on isolation, heart disease, body mechanics, 
toxemia, and insulin reaction. 
Classes reviewing equipment. 
Class on CVAs. 
Classes on colostomy care and isolation. 
Can't think of any classes, but I've been to a few. 
Ward is going to have meetings once a week. We have 
had classes on CVA and isolation. 
Had one class on isolation. Can't remember the rest. 
Classes on isolation and colostomy care. 
Classes on isolation, body mechanics, and general 
review of new equipment. RNs and head nurses tell 
us about patients. 
Classes on cardiac arrest, range of motion, and some 
ward conferences. 
Classes on inhalation therapy. Attended a seminar 
on ICU and CCU. 
Films and talks. 
One class on body positioning and one on isolation. 
Review of new techniques and procedures and a class 
on supplies 
Can't remember the last class. We have ward con¬ 
ferences. 
.53 
Code W/S* Comment 
21. W Refresher course. Review of new equipment. Class 
on inhalation therapy. 
22 W Classes on new equipment. 
*Waiver/LPN School 
54 
QUESTION 7: NURSES * AIDES 
"What are some of the things the.hospital and.the staff do to 
help you?" 
Code Training Comment 
23 9 wks Isolation class. Movies. Some staff conferences. 
24 8 wks Class on mental health. Students give ward con¬ 
ference on patients on the ward. 
25 5 wks Classes on isolation and review of new things. We 
have a manual for new nurses' aides. 
26 2 wks Team conferences by students about patients. Class 
on TUR. 
27 5 wks Just an isolation class. 
28 8 wks Class on traction. General review of new equipment. 
No ward classes. 
29 2 wks Class on body mechanics and one on cancer. 
30 2 yrs NT Classes on body mechanics and isolation. 
31 10 wks Class on isolation. 
32 10 wks Review of new equipment. Some classes regarding 
policies like fire drill. 
33 1 wk Class on isolation and movies. 
34 10 wks Isolation class. Review of everything new. Team 
conferences. 
35 3 wks Isolation classes. 
36 OJT 
>> 
Lectures. Cardiac care class for pediatrics. 
37 OJT No comment. 
38 9 wks Isolation class. 
39 10 wks Class on OB care. 
40 10 wks Films. Classes on isolation and CVA. 
41 16 hrs Isolation class. I don't like what's offered. I 
don't feel that RNs should teach; they don't know 
enough about nurses' aides jobs. 
42 9 wks Classes on emergency disaster plan and mental health. 
55 
Code Training Comment 
43 8 wks Isolation class. 
44 OJT Classes on isolation and body mechanics. RNs 
explain on the wards. 
45 6 wks Resuscitation class. Would like to have some¬ 
thing on new equipment. 
46 10 wks Not much this year. 
47 5 wks Classes on different parts of the body; one on 
isolation; some on depression, crisis, and death. 
I like these very much. 
48 2 wks Have had some programs, one on P.T. Would like 
to know more about patients. Staff doesn't 
always explain. 
49 OJT Films. Ward conferences with students. 
50 2 wks Isolation class and films. 
51 4 hrs Some classes are over my head. Have had classes on 
isolation, CCU, and lots of different things. 
52 10 wks Classes on medical terminology, isolation, and 
about Rh babies. 
53 7 wks Classes on isolation, colostomy care, and review 
of new things. 
54 OJT Classes on isolation and suction technique. 
Staff helps by explaining. 
55 3 wks Films. Class on catheterization. 
56 6 wks Classes on CVA and orthopedic patients. Staff is 
very good about explaining. 
57 10 wks Classes on positioning and turning patients and 
isolation. 
58 6 wks Staff on Pediatrics helps; they give classes. 
Used to have in-service last year. 
59 OJT Class on cardiac arrest. Not very much lately. 
No ward conferences. 
60 16 hrs Not much in-service. Only every once in awhile. 
56 
Code Training Comment 
61 9 wks Colostomy class. OJT. Review oi isolation and 
diabetes. 
62 OJT 
63 1 yr NT 
Not much this year. Some ward classes with students. 
Films. Class on isolation. Not much else. 
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63 
'QUESTION '9:•' LICENSED PRACTICAL NURSES 
"What do you think is the most important thing you do as a 
member of the nursing team?" : 
Code W/S* Comment 
1 S 
2 S 
3 W 
4 S 
5 S 
6 S 
Help care for the patients and help them recoyer. 
Give them treatments based on knowledge. 
Physical care for the patients. 
Caring for patients — their comfort. Meet their 
needs, and all the physical things. 
Help patients in labor. Try to explain what is 
happening. 
Care for patients, their comfort. Keep them clean. 
Give them what they ask for when they ask for it. 
I give them the best possible care I can. 
Patient care. I like it. . 
S 
% 
_8 S 
I 9 W 
I work as an aide’s aide. Also do dressing changes 
and catheterizations, but help aides all the time. 
I'm not doing what I was trained for. 
Care for patients. Physical and emotional support. 
Bedside care. I don’t like charting and desk work, 
but do like patient care. 
S Give treatments and care for patients. 
11 S General bedside nursing. Mostly with patients. 
12. W I work with patients. That's where we are. 
13 W Patient care — the physical things. Also talk 
and listen. Spend extra time with the patient 
who is lonely. TLC is important. 
64 
Code W/S* Comment 
14. W 
15 S 
1_6 W 
17 S 
18 S 
_19 S 
20 W 
21 W 
22 W 
I take care of the patients. I like it the best. 
I'm a go-between for patients, nurse, and doctor. 
I have direct contact eight hours a day. You see 
them more than anybody else. 
Most patient-centered. 
Patient-centered and physical care. 
Most patient care at the bedside. 
I work with all of them — the doctor, the nurse 
and the patient. Most of the time I do treat¬ 
ments. 
Work with the patients. 
Make patients happy and comfortable as 1 can. I 
talk with patients, but not like the students. 
Bedside care with patients. 
65 
' QUESTION 9 : NURSES’ AIDES 
"What do .you think is the most important thing .you .do as a 
member of the nursing team?" 
Code Training Comment 
23 9 wks Taking care of the patient, everything we can. 
24 8 wks Taking care of patients.' 
25 5 wks Keep patients as comfortable as possible. Give 
them personal care. Observe and report to the 
nurse. We’re closer to the patients almost 
all the time. 
26 2 wks Keep patients comfortable. Give basic care, talk, 
and listen. 
27. 5 wks Keep patients comfortable. Mostly at the bedside. 
28 8 wks Patient care. Talk, and give TLC. 
29. 2 wks Feed, change babies. Help mothers with breast and 
bottle babies. 
30 2 yrs NT Help RN do patient-care things. 
31 10 wks Take care of patients. Make them feel at home. 
I talk to them. 
32 10 wks With patients. Talk and listen. 
33 1 wk No comment. v 
34 10 wks Patient care. Bath. Grooming and oral hygiene. 
Physical comfort. Visit with them. Try to find 
out their problems. For lots of them, talking is 
good, particularly the older patients. 
35_ 3 wks Close to patients. Do things for them. Observe 
and tell nurse. 
36 OJT Patient care. Clean, feed, and entertain children 
66 
Code Training Comment 
37 OJT With the patients. Help explain what is being done. 
Prepare them.for surgery. "Mostly physical things. 
38 9 wks Mostly with patients. Physical things — bath: 
temps, etc. 
39 10 wks Work with patients. Keep them comfortable and 
happy. 
40 10 wks Keep patients comfortable. Care for their 
physical comfort. 
41 16 hrs Try to make their stay in the.hospital as com¬ 
fortable as possible. Treat them as friends. If 
they are afraid, like with death, I try to make 
them feel they are not alone. 
42 . 9 wks Give patient care, physical and emotional. 
43 8 wks Patients are most important. Spend my time there. 
44 OJT Care for patients. With them all the time. 
45 6 wks Give patient care. Report condition to the nurse. 
46 10 wks• We are really the middle-man between the patient 
and the nurse. We’re with the patients most of the 
time and care for them, outside of their medicines 
and treatments. I see my job as listening and 
observing. 
47 5 wks Keep patients happy and comfortable. Meet their 
needs. 
48 2 wks Take care of patients. Do most of the things at 
the bedside. 
49 OJT. Service to patients — physical and anything to 
help them. 
50 2 wks Mostly with patients to care for them. Listen to 
them. Some patients are very happy when you just 
listen. 
67 
Code Training : Comment . 
.51. 4 hrs Patient care. ..Help them to get well. 
52 10 wks Help give patients confidence in themselves. 
Support them any way possible. 
53 7 wks At bedside with patients. 
54 OJT Care for patients at the bedside. Listen a lot. 
Talk with them. 
55 3 wks Keep patients in good frame of mind. Give them 
physical care. 
56 6 wks Helping patients with physical care. Try to be 
cheerful. 
5_7 10 wks Give patients care and see to their wants. Give 
bed baths and care for patients. 
58 6 wks Keep little patients comfortable. See to their 
physical comfort. Work with teenagers; they want 
attention. They like to be babied. They always 
say "Thank you." 
59 OJT Taking care of the patients. 
60 16 hrs Take care of patients, their desires and wants. 
61. 9 wks With the patients. Do little things. Pat their 
shoulders and encourage them. 
62 OJT With patients. Keep them cheerful. Encourage them 
to help themselves. Listen a lot. 
63 1 yr NT Caring for the sick. Find great challenge, 
especially with the little folks. 
68 
Code 
_1 
2 
3 
4_ 
1 
6_ 
7 
QUESTION 10:' LICENSED PRACTICAL NURSES 
"Can you. tell me in detail what you did today?" 
W/S* Comment 
S Got report. General treatment nurse. Checked 
Kardex and treatment cards. Took new surgical 
patient’s BP. Answered lights. Changed dressings. 
Irrigated catheter. Filled ice bags and hot packs. 
Discontinued IVs. 
S Got report. Did temps and AM care. Passed and 
picked up trays. Had five patients assigned. One 
complete bath; the rest were partial. Answered 
lights. Gave orange juice to a diabetic. Spent 
a lot of time with my patients. 
W Got report. Did temps. Passed water. Prepared 
patients for supper. Passed and picked up trays. 
Fed one patient. PM care. 
S Got report. Helped restock delivery room. Changed 
syringe boats. Made up charts. Stored linen. 
Scrubbed in delivery room. 
S Two burn patients. Baths, put on cream. Beds. 
Checked IVs. Talked to mother who was concerned 
about child. We use reverse technique on them.. 
Spent most of the day with these patients. 
S Didn't work in my own area. Helped on Peds. Had 
two little boys and one little girl. Checked 
neuro signs on little girl. Did routine care. 
S Treatment nurse. I organized my work so I could 
know what to do. Did BPs, routine treatments, 
checked dressings and drainage from catheters. 
Changed colostomy. Irrigated a catheter. Took 
care of tracheostomy. Gave oral hygiene to a 
patient. 
69 
Code W/S* Comment 
_8 S 
9_ W 
10 S 
11 S 
12 W 
_13 W 
14 W 
15 
Took temps, passed out ward water. Prepared 
patients.for breakfast. Passed out trays. Got 
report. Was assigned four patients. All but 
one were complete baths. Answered lights. 
Made rounds. Put up NPO signs. Check BPs, 
IVs, and dressings. Turned patients. Irrigated 
catheter. Checked diet sheet. Charted. Got 
surgical patients ready. 
Took temps. Did Clinitest on a patient. Passed 
and picked up trays. Helped others with care. Did 
temps, backrubs, and clinitest. Gave an enema. 
Did treatments, BPs, and one catheterization. Turn¬ 
ed, positioned, and assisted patients. Got patient 
up and walked him. Checked IVs and lights. 
Got report. Treatment room nurse. Filled ice 
bags. Did irrigations (NG tube, Emerson and sump 
pumps). Catheterized one patient. Admitted patient 
for surgery. 
Got report. Made rounds. Checked croupettes, ice 
bags, and BPs. Fed babies. Changed beds. Checked 
I & Os. Checked diet slip. 
Worked in the nursery. Took care of baby in 
incubator. Routine care for other infants. Help¬ 
ed with three new-baby examinations, two home 
examinations. Diapered babies; took them to 
breast. Cleaned nursery. 
Took temps. Did AM care. Got report. Helped 
with trays. Assigned four patients. Two com¬ 
plete baths, two showers. Made up four units. 
Started oxygen on one patient. Did treatments 
and dressings. Answered lights. Gave an enema. 
Charted. 
S 
70 
Code W/S* Comment 
16 W 
17 S 
18 S 
19 S 
20 W 
21 W 
22 W 
I float.. Worked in inhalation therapy and assisted 
in emergency room. Checked stock and equipment. 
Not too busy tonight. 
Got report. Took temps. AM care. Had five 
patients assigned. All but one were tub baths. 
Fed one patient. Answered lights. Helped with 
a paraplegic patient. 
Had three patients. Fed babies and children. 
Encouraged parents to feed their own children. 
Took care of treatments for my own patients. 
Stayed with new surgical patient. Specialed cri¬ 
tical patient rest of day. 
Did treatments, BPs. Bed boards for patient. 
Checked new orders. Took care of returned sur¬ 
gical patients. Checked dressings, IVs, draining 
catheters. Took a patient to the examining room. 
Answered lights. Put Levine tube down. 
Got report. Was assigned five patients. Helped 
admit one patient. Had three complete baths, 
two partials. 
Took report. Had five patients assigned. Had 
one infant who was pretty bad. Tried to feet it. 
Reported difficulty to the nurse. Took infant 
to x-ray. Came back and cleaned up one small 
child-tub bath. Had a sixteen-year-old with 
seizures; bathed him. Got one child ready for 
surgery. Charted on patients. Helped with a 
little one in mist. Helped doctor to examine 
an infant. 
Took report. Helped feed patients. Took temps. 
Had five assigned patients. They were light 
patients. Did one clinitest. 
*Waiver/LPN School 
71 
Code 
23 
24 
25 
26 
27 
28 
QUESTION 10: NURSES1 AIDES 
"Can you toll me in detail what you did today?" 
Training 'Comment 
9 wks Five patients assigned. Fed, bathed baby, and 
changed crib. Had two little girls and I took 
care of a thirteen-year-old boy. Patient back 
from OR. Took BP on patient. Helped with trays. 
Played with children. 
8 wks Got report. Five patients assigned. Two one-year- 
olds and three teenagers. Bathed children, talked 
to them. One went to surgery. Charted on own 
patients. 
5 wks Five patients assigned. Two surgicals — didn't 
go until PM. Gave baths to my patients. Made 
beds. Took BP on one patient. Took temps. Fed 
babies. Gave an enema. Talked to doctor about 
little boy — possilbe hydrocephalic. Baby's 
prognosis not good. Answered lights. Helped 
hold patient for shots. 
2 wks Took temps, passed water, and did AM care. Got 
report. Assigned eight patients, students took 
care of two. One went to surgery. Helped with 
trays. One bed bath, rest partials. Fed two 
people. 
5 wks Temps. Passed trays. Straightened beds. Gave 
backrubs and answered lights. Messenger for the 
nurse — patient wanted hypo, pills, etc. Walked 
patient. Helped patient get up. 
8 wks Got report. Made rounds. Passed juices and soft 
drinks. ' Washed patients for supper. Passed 
trays. Fed baby. Fed.year-and-a-half-old 
infant. Checked children. Took temps. Charted 
on patients. 
72 
Code Training Comment 
29 2 wks 
30 2 yrs NT 
31 10 wks 
32 10 wks 
33 1 wk 
34 10 wks 
35 3 wks 
36 OJT 
37 OJT 
Work in 03. Scrubbed. Got report. Bathed 
babies. Cleaned area. Disposed of garbage. Held 
two babies for circumcision. Took babies to 
mothers; brought them back. Refed, if necessary. 
Cleaned nursery for the next shift. 
Made one bed. Admitted two patients. Passed trays 
Answered lights. Emptied urinals. Gave backrubs. 
Had two patients, one eighteen-year-old and one 
sixteen-year-old. Gave both baths. Talked to them 
Answered lights. Helped with trays. Did BPs. I 
used to do all the treatments. 
Made rounds. Assigned five patients. Changed 
babies and beds. Admitted a patient. Got patients 
ready for supper. Passed trays. Fed patients. 
Took temps and BPs. Passed juices. Fed babies. 
Cleaned up. 
Took temps. AM cares. Got report. Helped with 
trays. Had two patients. Talked with patients. 
They were self-baths. Made beds. Gave an enema. 
Answered lights. 
Four patients. One shower. One bed bath. One to 
OR. One partial. Cleaned the room. Walked with 
one patient. Helped student LPNs. 
Took temps. Got report. Assigned seven patients. 
Cleaned beds. Forced fluids. Answered lights. 
Checked IVs. Helped with trays. Checked I & 0 
sheets. Read to patients. Chatted with parents. 
Got report. Five patients assigned. Two went to 
surgery. Gave three baths. Passed juices. 
Entertained children. Took temps. Charted on 
own patients. 
Got report. Made rounds. Checked IVs. Answered 
lights. Gave bedpans. Not too busy a night. 
73 
Code Training Comment 
38 9 wks Got report. Made rounds. Took BPs. Checked 
patients. Answered lights. .Not too busy tonight. 
39 10 wks Had seven patients. Got report. Took temps, BPs. 
Comforted patient. Gave sitz bath and treatments. 
40 10 wks Four patients assigned. Temps, water, AM care. 
Helped with trays. Gave one enema. Three complete 
baths, one tub bath. Answered lights. 
41 16 hrs Assigned six patients. Changed two beds. One 
problem patient; talked and sat with her. Got 
her up. Passed trays. Answered lights. Helped 
position patients. Gave PM care. 
42 9 wks Report. Was just learning the ward, so followed 
someone else around. 
43 8 wks Made beds. Got patient up with a binder. Water 
and pass trays. Admitted two patients. Answered 
lights. One enema. Encouraged patient to get up. 
44 OJT Temps. AM care. Helped pass trays. Got report. 
Got patients started on baths. Assigned ten 
patients but had help. One complete bath on 
time-consuming patient. Walked patient. Finished 
baths. 
45 6 wks Made rounds. Got them ready for supper. Fed child¬ 
ren. Picked up trays. Took temps. Checked patients 
Passed juice and water. Got patients ready for bed. 
46 10 wks Six patients, one surgical. Two went to x-ray. Two 
partials and one complete bath. Answered lights. 
Took temps. Helped with trays. Helped another 
girl get a patient up and make a bed. Much time 
taken up answering lights. It all takes time. 
You listen a lot. Patients need to talk. Wish 
I had more time to spend with them. It makes them 
feel better. 
Training Comment 
5 wks Eight patients assigned. Temps, passed water, 
and gaye AM care. Helped pass trays. Got report. 
Helped patient on cart for x-ray. Made bed. 
Started to work with my patients. Gave an enema. 
Finished patient. Gave another enema. Two patients 
went home. Finished up patients. Answered lights. 
Changed one bed. One surgical patient went to OR. 
Got a lady up. Made a surgical bed. Helped 
admit patients. 
2 wks Trays. AM care. Report. Assignment of five 
patients plus one surgical. Two baths, three 
partials. Put on heat cradle. Patients had lots 
of questions regarding themselves. 
OJT Got report. Five patients assigned. One shower, 
one tub, one complete bath. Two surgical patients. 
Helped with trays. Made beds. Finished patients. 
2 wks Eight patients. Most self-help. One time-con¬ 
suming. Likes to be done last. Changed dressings. 
Helped with trays. Helped with isolation patient. 
4 hrs Had five patients assigned. Passed out water. 
Took temps. AM care. Got report. Had one 
patient for bed bath, four for self-care. Two 
were on bedrest. Had I & 0 on one patient. Help¬ 
ed put a surgical patient back to bed. Gave him 
sips of water. Visited with patients. Patients 
tell you things they don’t tell doctors and nurses. 
10 wks Scrubbed for delivery room. Cleaned delivery 
room. Instructed students in cleaning delivery 
room. Sat with patient in labor and gave her 
moral support. Filled out birth certificates. 
7 wks BPs. Turned patients. Checked patients. 
Answered lights. Asked for sleeping pills for 
pain. Gave bedpans. Did one clinitest. Took 
patient to bathroom. Checked I & Os. Charted 
on patients. 
75 
Code Training Comment * 
54 OJT Six patients assigned. Took temps. Did AM 
care. Got report. Took linen to patients’ 
rooms. Three complete baths, one tub, and 
two partials. Student helped to get patient 
up. Answered lights. Straightened up for 
3-11 shift. 
55 3 wks Temps. Two aides worked together. Gave AM 
care. Got report. Helped with trays. Two aides 
had eleven patients. Two patients went to surgery. 
Did their patients. Checked IV. Had a blind lady. 
Fed her, got her up, combed her hair. 
56 6 wks Five patients. Did temps and AM care. Charted 
temps. One complete, three partial baths. One 
surgical patient. Got report. Answered lights. 
57 10 wks Worked with a team (two aides). Had twelve 
patients. Did temps. Passed water. Gave AM 
care. Got report. Started working. Had 11:30 
temps. Helped with trays. Helped feed. Busy. 
58 6 wks Worked with burn patients. Took their temps, 
changed their beds. Checked IVs. Specialed them. 
59 OJT Got report. Floated to another ward. Did four 
complete baths. Made beds. Was busy. 
60 16 hrs Eight patients. Two full baths. Six beds made. 
Answered lights. Helped get patient to surgery. 
61 9 wks Worked in newborn nursery. Got report. Scrubbed. 
Cared for infants. Stocked supplies. Took babies 
to mothers.• 
62 OJT Got report. Fed and bathed infants. One older 
child (sixteen), complete bath, helped to ambu¬ 
late. Took temps. ' Admitted a patient. Checked 
IV. 
63 1 yr NT Had six patients, one was dismissed. Two eight- 
month babies. Two eighteen-year-olds, one with back 
pain, one with abdominal pain. One went to surgery. 
APPENDIX D 
TASK LIST RESULTS 
ROUTINE OCCASIONAL NEVER 
QUESTIONS LPN . NA LPN ■ NA ' LPN NA 
1.. Give bed baths 14- ' .31 • 6 9 2 1 
2.. Assist patients to complete bath : i3. 28 8 ^ 11 1 2 
3. Feed patient . 14 29 • 7 12 1 0 
4. Assist patient with feeding 
himself 13 31 8 10 1 0 
5. Give H. S. Care 8 18 8 19 6 4 
6. Give and remove bedpan 21 39 1 2 0 0 
7. Take temperature orally 18 40 4 1 0 0 
8. Take temperature rectally 16 37 6 3 0 1 
9. Take pulse and respirations 22 39 0 2 0 0 
10. Chart pulse and respirations .21 23 1 11 0 7 
11. Assist patient in and out of bed .21 39 1 2 0 0 
12.. Collect lab specimens 20 .31 2 9 0 1 
13. Transport patient to other 
areas of hospital 11 25* 11 16 0 0 
14. Do Intake & Output on patient 19 37 3 4 0 0 
15. Clean and wrap sterile packs 4 . 3 5 11 13 27 
16. Sterilize instruments, packs, 
and solutions 0 1 6 2 16 38 
17. Prepare patients for delivery 
and surgery 10 23 7 ' 10 5 8 
18. Scrub and assist doctor in 
surgery 1 0 1 0 20 41 
19. Scrub and assist doctor in 
delivery room 2 1 . 1 0 11 40 
20. Change sterile ^dressings . 10 1 . 9 . 15 3 25 
21. Change colostomy dressings 14. 6 3 . 19- 5 16 
22. Prepare and give oral medication 2 0 6 4 14 37 
23. Prepare and give hypodermic 
injection 2 0 4 0 16 41 
77 
ROUTINE OCCASIONAL NEVER 
QUESTIONS LPN . NA ' -LPN ' NA LPN NA 
24. Prepare and give IV fluids 0 0 0 0 22 41 
25. Prepare and give TV medications 0 0 0 0 22 41 
26. Catheterize patient to empty 
bladder 14 3 7 3 1 35 
27. Chart patient care, condition, 
and observations 22 30 0 10 0 1 
28. Give cleansing enemas 18 35 4 6 0 0 
29. Give oil retention enemas 15 19 7 . 15 0 7 
30. Care for patient in isolation 13 26 9 10 0 5 
31. Set up isolation area 13 19 8 13 1 9 
32. Clean isolation area after 
patient discharge 7 16 8 14 7 11 
33. Give Sitz bath 19 30 3 10 0 1 
34. Give sponge bath for temperature 
reduction 12 17 10 19 0 5 
35. Bath for newborns 5 4 5 12 12 25 
36. Feed newborns 5 9 5 11 12 21 
37. Prepare and insert tube for 
feeding newborn or premature 0 0 0 0 22 41 
38. Give breast care to mother 
before and after nursing 5 3 5 6 12 32 
39. Care for patient recovering 
from anesthesia 9 18 11 15 2 8 
40. Insert retention catheter 11 1 6 1 5 39 
41. Give first aid to patient 
suffering from shock 5 0 8 8 9 33 
42. Give first aid to patient with 
fracture 3 . 1 3 7 16 33 
43. Assist doctor with examination 
of patient ■ 4 6 17 15 1 20 
44. Apply restraints .11 • .21 10 15 1 5 
45. Set up mist" tents 6 10 5 14 'll 17 
78 
• ROUTINE OCCASIONAL NEVER 
QUESTIONS LPN NA. ' LPN . ' NA LPN NA 
46. Set up oxygen at proper setting 
for mist tent 6 11 4 18 12 12 
47. Use suction machine to clear 
throat and mouth 16 6 6 26 0 9 
48. Use suction to clear tracheotomy 
tube 12 4 8 .21 • 2 16 
49. Give IPPB treatment 1 . 0 4 3 17 38 
50. Admit patients to the ward 20 34 2 5 0 2 
51. Discharge patients 19 38 ' 3 2 0 1 
52. Care for infants in incubator 7 10 3 6 12 25 
53. Take phone reports from lab 
and x-ray 1 5 11 13 10 23 
54. Test urine for sugar 20 20 2 16 0 5 
55. Answer telephone on the ward 9 13 10 27 3 1 
56. Take blood pressure 22 34 0 6 0 1 
57. Chart blood pressure 21 24 . 1 8 0 9 
58. Terminate IV fluids 7 9 12 12 3 20 
59. Terminate blood transfusions 5 6 4 7 13 28 
79 
ADDITIONAL TASKS LISTED ON TASK LIST FORMS 
TASK LPN ' NA 
1.: Tube feed * 3 
2. Irrigate naso-gastric tube 6 
3. Irrigate catheter 5 
4. Pass and pick up food trays 5 12 
5. Answer lights 11. 10 
6. Fill ice bags 5 4 
7. Apply heat pads 4 4 
8. Give phisohex scrubs 2 
9. Care for deceased 5 2 
10. Apply eye ointment 3 
11. Apply eye compress 3 
12. Use and care for equipment (Simp 
and Emerson pumps) 9 4 
13. Reassure patients and relatives 
and explain equipment used 6 
14. Special critical patients coming 
from operating room 1 
15. Work with traction patients 3 2 
16. Assist doctors on rounds 1 
17. Check neurological signs 1 2 
18. Work with circle bed 2 2 
19. Measure and fit belts and binders 1 
20. Assist students 2 1 
21. Prep surgical patients 1 
22.. Help and assist mentally confused 
patients . 1 • 
23. Observe and time contractions in 
labor room 3 1 
24. Relieve nurse for lunch and supper 
break . 1 
80 
TASK LPN NA 
25. Give douches . 1 • 
26. Instill medications in bladder . 1 2 
27. Irrigate wounds . 1 
28. Range of motion exercises 2 2 
29. Work with Byrd respirator 3 
30. Work with monitoring equipment : . 1 • 
31. Relieve at switchboard 1 
32. Feed infants with cleft palates 1 
33. Mix infant formula 1 2 
34. Order supplies 3 
35. Take patients histories 2 
36. Clean various areas of the hospital 7 
37. Attend in-service meetings 1 
38. Run errands 4 
39. Float to other floors 7 
40. Assist physician with circumcisions 2 
41. Do peri care • 4 
42. Remove catheter 3 1 
43. Shampoo hair 1 
44. Make phone calls for patients 4 
45. Reassure patient when necessary 3 
46. Apply head and pillow traction . 1 
47. Help patients with P. T. exercises 1 
48. Read to and comfort children 3 
APPENDIX E 
JOB DESCRIPTIONS: LPN AND NA 
LICENSED PRACTICAL NURSE 
General Statement of'Duties’ 
Administers routine nursing procedures in caring Tor patients. 
Supervision Received 
Works under the supervision of a member of unit nursing staff. 
Supervision Exercised 
None. 
EXAMPLES OF DUTIES: (Any one position may not include all the duties 
listed, nor do the listed examples include all tasks found in 
positions of this class.) 
Administers personal hygenic measures: baths, oral hygiene, skin 
care, assists patients in ambulation, feed patients, observes 
isolation measures. 
Administers treatments: enemas, douches, catheterizations, trach 
suctioning. Applies hot and cold compresses and packs. 
Charts and maintains records of treatments performed. 
Attends and participates in nursing care conferences, educational 
programs, workshops, and personal development programs. 
Performs other related duties. 
MINIMUM QUALIFICATIONS: 
Responsibilities, Skills and Effort 
Skill in basic nursing techniques. Must have a desire to serve those 
who are ill or incapacitated. Ability.to work under close super¬ 
vision and to follow orders. Must be able to adjust to diversified 
types of personalities and use tact and judgment in dealing with 
varying situations. 
82 
Education 
Graduation from high.school. Satisfactory•completion of the LPN 
examination according.to waiver clause, .Montana State Law j?66-1221. 
Experience 
Satisfactory performance as patient care aide before taking LPN 
examination. 
Special Requirements 
Current State licensure as a practical nurse. 
83 
LICENSED PRACTICAL NURSE II , 
General Statement of Duties 
Administers routine nursing procedures in caring for patients. 
Supervision Received 
Works under the supervision of a registered nurse. 
Supervision Exercised 
May assist in assessing patient care needs. 
EXAMPLES OF DUTIES: (Any one position may not include all of the duties 
listed, nor do the listed examples include all-tasks found in 
positions of this class.) 
Performs nursing procedures such as: venous pressure monitoring, 
peritoneal dialysis, physical examination, administration of 
medication in accordance with the guidelines of the Montana State 
Board of Nursing. Assist in the operating room and delivery 
room and Coronary Care Unit. 
May act as team leader assisting patient care aides. 
Requisitions supplies and equipment necessary to perform treatments. 
Utilizes and maintains various types of equipment. 
Maintains records of treatments performed. 
Provides for the comfort of patients and participates in patient 
teaching. 
Assist in orienting new personnel to unit. 
Attends and participates in nursing care conferences, educational 
workshops, and personal develpment programs. 
Performs other related work. 
MINIMUM QUALIFICATIONS: 
Responsibilities, Skills and Effort 
Ability to make independent judgments when performing routine 
nursing procedures. Ability to maintain a helpful and sympathe- 
84 
tic attitude toward patients,*and.to.establish and maintain harmon¬ 
ious working relationships. 
Education 
Graduation from high school. Satisfactory completion of approved 
practical nurse training course. Coronary Care Course required if 
assigned to unit. 
Experience 
None. 
Special Requirements 
Current State licensure as practical nurse 
85 
JOB DESCRIPTION: LICENSED PRACTICAL NURSE ' July 1968 
In the Hospital a licensed practical nurse is a person who is 
licensed to practice in the State of/Montana and is trained to 
care for the subacutely and chronically ill and convalescent 
patients under the supervision of a registered professional nurse 
and to assist the registered professional nurse with nursing 
care of the seriously ill patients. 
Those licensed practical nurses who have had in-service training in 
preparation and administration of medications and/or special 
treatments and procedures, and who have demonstrated adequate com¬ 
petency to the satisfaction of the Nursing Service, may prepare 
and administer medications, treatments and procedures. 
Licensed practical nurses may chart those duties and procedures 
they themselves do for the patient. Under no circumstance may the 
licensed practical nurse accept verbal orders from physicians. 
LINE OF AUTHORITY: Directly responsible to the Team Leader. 
DUTIES: The Licensed Practical Nurse is prepared to assume those duties 
of the Nurse Aide plus the following: 
I. Routine Nursing Services: 
A. Assist with physical examinations 
1. Vaginal 
2. Rectal 
3. Proctoscopy 
II. Comfort and Hygiene 
A. Irrigation of functioning and regulated colostomies and 
catheters 
B. Vaginal irrigations 
C. Prepare and give throat irrigation 
D. Prepare and apply sterile and unsterile dressings 
E. Prepare and apply hot packs 
,F. Observe and discontinue IVs as directed by the head nurse 
86 
G. Prepare and administer medications as directed by the head 
nurse or medication nurse. 
1. Order new supply of drugs 
NOTE: Does not include the giving of medications which must be 
prepared by calculation of fractional dosage, or by convert¬ 
ing to or from apothecary or metric system, or any medica¬ 
tion to be given by.IV. 
H. Catheterize patients 
1. Retention catheters 
I. Maintain airway for patient1s immediate comfort: 
1. Oral suction 
2. Nasopharyngeal suction 
3. Tracheal suction 
J. Care of patients recovering from anesthesia 
K. Scrub for minor surgical operations and at 2nd table for 
selected cases of major surgery in the operating room 
L. Scrub in the delivery room 
M. Care of patient, relatives and visitors in emergencies: 
1. Apply tourniquet in emergency 
2. Apply pressure to stop bleeding in an emergency 
3. Give first aid to fainting person 
4. Give first aid to patient or visitor with nosebleed 
87 
TITLE: 
JOB SUMMARY: 
PERFORMANCE 
REQUIREMENTS: 
JOB DESCRIPTION . 
Patient Care Aide 
Under close supervision the aide assists the nurse 
in performing safe, efficient, therapeutic care of the 
patients. These duties require knowledge, judgment, 
manual dexterity. 
Responsibility for: • (Any one position may not include 
all of the duties listed, nor do 
the listed examples include all 
tasks found in positions of this 
class.) 
1. Bed making, bathing, and other 
hygenic measures. 
2. Feeding, recording 1-0. 
3. Positioning and ambulation. 
4. Vital signs. 
5. Safety measures: bed rails 
posey belts. 
6. Simple therapeutic measures: 
skin traction, bed cradles, 
foot boards, warm and cold 
applications, enemas, cathe¬ 
ter care. 
7. Collection of specimens. 
8. Admission, transfer, and dis¬ 
missal of patients. 
9. Aseptic technique. 
. 10. Makes observations and reports 
to nurse in charge. 
.11. Participates in care confer- 
. ence and educational programs. 
. 12. Performs related duties as 
required. 
88 
JOB RELA¬ 
TIONSHIPS : 
WORK PERFORMED: 
Physical Demands: Good physical and mental health. 
Cleanliness and neatness. Ability 
to lift, carry and move moderately 
heavy objects. Walking and stand- 
during a work period. 
Special Demands: Willingness to accept close super¬ 
vision and instructions from im¬ 
mediate supervisor. Willingness 
to work knowing that an error 
may have serious consequences. 
Capacity to safeguard and main¬ 
tain professional secrecy in regard 
to patients, doctors, personnel, 
and events in hospital environment. 
Job Knowledge: Know direct lines of authority. 
Take advantage to teach good health 
habits by word and example. 
Working Environment: Works in a well lighted and ventila¬ 
ted patient care area. May be 
subjected to disagreeable odors. 
May be exposed to communicable 
diseases. 
Supervised by: Head Nurse - directly responsible. 
Workers Supervised: None. 
Assignments are made daily. Estab¬ 
lished procedures have to be follow¬ 
ed. 
QUALIFICATIONS: 
89 
Educational: Preferable, a high school educa- 
. tion and course in patient care 
training. 
Experience: Previous satisfactory experience 
in patient care. 
90 
JOB DESCRIPTION: WARD AIDE January 1969 
Hours of work: 40 hours per week 
In the Hospital a Ward Aide is a person who cares for subacutely and/ 
or chronically ill patients and convalescent patients, under the super- 
vision of registered nurses and/or professional student nurses who are 
in charge of a team. 
LINE OF AUTHORITY: Directly responsible to the team leader. 
A. QUALIFICATIONS: 
Should be a high school graduate. Have no disabilities that will 
prevent performing any duties assigned. Should have a pleasing 
personality and enjoy working with people. Maintains a neat and 
well groomed appearance. 
B. TRAINING: 
Previous ward aide training desirable. Is trained on the job 
through a formal training program. 
C. DUTIES: 
1. Works as a member of the nursing team in giving direct routine 
care to the patient including patient comfort and hygiene as 
directed by the team leader and outlined in the job duties. 
2. Cleans, assembles and maintains equipment, sets up nursing 
units, and maintains patient care areas. 
3. Attends in-service training programs and special orientation 
meetings on new procedures, techniques or equipment demonstrations. 
4. Charts pertinent duties and procedures they themselves do for 
patients. 
5. Works in any area assigned by nursing supervisor. 
♦6. Assists in the on-the-job training of new ward aides. 
91 
D. SUPERVISION: 
Does no direct supervision but nay assist with orientation and on-' 
the-job training of new ward aides. 
JOB DUTIES: WARD AIDE 
92 
January 1969 
I. Routine Nursing Services: 
A. Set up nursing units 
B. Bed making 
1. Make open beds, closed beds, occupied beds, surgical 
beds, closed cribs, occupied cribs and bassinets. 
C. Care of clothing and valuables belonging to the patients 
1. Temporary safekeeping 
2. Hearing aid 
3. Dentures 
4. Prosthesis 
D. Answer call lights and report needs to nurse. 
E. Assist patients into or out of bed, wheel chair; onto and off 
stretcher. 
F. Assist patient in walking and to and from bathroom 
G. Observe Oxygen and Mistogen tents in use: 
1. Read guage 
2. Check ice and fill container if need be 
3. Check and empty water pan if necessary 
H. Take vital signs and record: 
1. Blood pressure 
2. Temperature(rectal, oral, axillary) 
3. Pulse 
4. Respiration . 
I. Observe patients receiving intravenous solutions 
1. Obtain blood from Lab. 
J. Observe character of and measure elimination: 
1. Urine 
2. Vomitus 
3. Sputum 
4. Feces 
5. Drainage from Wangensteen suction 
6. Bile bag 
7. Hemovac 
8. Abdominal drainage systems 
K. Weigh patients - Infant, Child, Adult 
L. Collect specimens: 
1. Accumulative specimen of urine 
2. Voided, single urine specimen 
3. Feces 
4. Vomitus 
5. Sputum 
6. Assist technician in obtaining blood 
M. Test urine for sugar and acetone 
N. Special types of service: 
93 
1. Admission: apply adentiband 
2.. Transfer ' 
3. Dismissal 
4. Preparation for surgical operation: surgical prep 
5. Assist with care of body alter death 
II. Comfort and Hygiene of Patients: 
A. Give baths 
1. Cleansing bed bath 
2. Shower 
3. Sitz 
4. Tub 
5. Water bath for infant 
6. Temperature sponge 
7. Medicated bath 
B. Back rub 
C. Care of mouth and teeth including oral suctioning 
D. Care of hands and feet 
E. Care of scalp and hair 
F. Care of nose 
G. Care of elimination: 
1. Bed pan 
2. Urinal 
3. Commode 
• 4. Catheter drainage 
5. Regulated colostomy 
H. Feed Patients: 
1. Serve trays 
2. Feed helpless patients 
3. Feed infants 
4. Assist mothers with breast feeding 
5. Determine amount of food consumed or refused 
6. Record appetite on special sheet 
7. Record fluid intake on special sheet 
I. Care of patient with cast 
J. Dress and undress patient 
K. Provide for and maintain physical and mental well-being: 
1. Maintain comfort and safety: 
a. Move patient up in bed 
b. Turn patient 
c. Support patient with pillows 
d. Maintain good body alignment 
e. Give passive exercises as directed 
f. Put patient on air ring 
94 
g. Put patient on Decubicare pad 
h. Adjust mechanical bed 
i. Adjust bedclothes 
j. Apply binders - Scultetus, T-binder, Breast binder, 
Pneumonia jackets 
k. Change unsterile dressings 
L. Apply arm, leg and body restraints 
M. Carry out therapeutic procedures: 
1. Enemas: Cleansing, stimulant, carminative, emollient, seda¬ 
tive 
2. Pass flatus tube 
3. Care of pressure sore 
4. Fill and apply hot water bottle 
5. Fill and apply ice cap 
6. Prepare and give steam inhalations 
7. Give perineal care 
8. Apply heat lamp 
9. Give breast care to nursing and non-nursing mothers 
N. Isolation 
III. Maintenance of Patient Areas: 
A. Care of laundry: 
1. Closets 
2. Soiled linen 
B. Clean and arrange bedside table and equipment 
C. Provide and adjust lights 
D. Utility room, diet kitchen and closets: 
1. Clean 
2. Keep in order 
3. Clean IV standards, side rails, etc 
E. C.S.R. Equipment: 
1. Clean and return to utility room 
F. Isolation 
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98 
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CXIII