THE "NURSE ASSISTANT"

Cathi Pope, RN commented, "Now I'm part of a medical team. I know the patients, learn their symptoms and become familiar with all their needs. I stay during the exam and input data. I see patients on follow-up and realize how the patient is responding to treatment. I'm part of the full circuit of care. It's extremely satisfying."

Joyce Yates, another RN at the practice, agreed that professional life has changed for the better. "Looking back I realize the old way was boring-not challenging. I've learned so much about diseases, symptoms and significant differentiations. This has increased my capability as a nurse, and it makes me happy to hear patients approve. They'll say things like, 'Oh! This is so thorough. I've never been treated so well before!'"
RN Advance 4/10

Family Team Care is a new approach to the traditional office visit in which a well-trained 'nurse assistant' helps the physician accomplish the patient visit. This new practice model is consistent with the 'practice-based care team' component of the Patient Centered Medical Home. This 'practice-based care team' is arguably the most important component needed to build a fully functional Patient Centered Medical Home.

Development of this model occurs through a process of education so that the nurse assistant is capable of fulfilling the following responsibilities:

a. taking a competent initial history
b. completing all documentation of the visit
c. implementing the treatment plan
d. doing patient education

A RN, LPN, or capable MA can fulfill the responsibilities of the nurse assistant, but the more medical education the assistant has, the better. The most important qualifications for this position are character, a willingness to learn, and at least solid medical assistant training.

From a national perspective, the crisis in health care demands this kind of innovation. With the need to expand the capacity of primary care to improve quality and decrease expense, change is mandatory. No other innovation offers so much. Nursing is the untapped resource that can solve our health care crisis.

On the office level, the nurse assistant will work much closer with the physician and the patients. Both will depend on this involvement, making the work more important and meaningful. It is very appropriate to realize this is a significant step up in career aspirations. This material can be self taught but should be reviewed with a physician for sound development of the skill set.

This model must be office nursing at its best.