Recognising The Role Of The Specialist Dementia Nurse In The Community
Dr Penny Hibberd, RGN, RMN, DN, PGCLT , talks about her role as a specialist community dementia nurse working for an independent home care organisation.
Dementia continues to make media headlines. Following the G8 Dementia Summit late last year, the Health Secretary pledged to double the Governments research funding for dementia by 2025, to £132m. There have also been calls for more to be done for those living with the condition now.
According to Alzheimers Society statistics , there are currently 800,000 people in the UK living with a diagnosed dementia, two-thirds of whom are living in the community. However, the true figures are probably much higher than this, as it is estimated that less than half of people living with dementia actually have a diagnosis.
Becoming a specialist dementia nurse requires additional post-registration training in the specialism area. The nurse should also, ideally, have at least two years practice experience in dementia care. Usually, people working as a specialist dementia nurse will also hold a registered mental health nursing qualification. Most NHS specialist nursing roles will also demand degree level qualifications, as well as expecting the nurse to be working towards a Masters in their specialism. As a practicing specialist dementia nurse there are so many routes to take, because dementia crosses all fields of medicine.
Clinical Nurse Specialist Employment Outlook & Salary
Clinical nurse specialists have a unique role. They apply their expertise not only to direct patient care but to research and practice improvement projects. They strive to advocate for high-quality care to achieve the best outcomes for patients.
While the Bureau of Labor Statistics does not have statistics specifically for CNSs, the growth for advanced-practice RNs, in general, is expected to rise 31% by the year 2024. This increase is believed to be due to an increase in the demand for healthcare, emphasis on preventive care, and a large population of aging patients.
According to a survey by the U.S. Department of Health and Human Services, there were 59,242 CNSs in the United States, the second largest group of advanced-practice RNs. Additionally, over 90% of CNSs report feeling moderately-to extremely satisfied in their job.
For organizations to remain sustainable during potentially turbulent political times, they can utilize clinical nurse specialists to help maintain the delicate balance of cutting-edge, quality care and cost efficiency. This results in CNSs becoming a highly sought-after resource for employers.
According to salary.com, the median salary of clinical nurse specialists is $99,550 as of June 2017, with a range of $89,999-$109,045. Salary can vary depending on the city/state of employment, additional certifications held, experience level, and the organization.
About Kathy Adkins Dementia Specialist
My Mission
To relieve the daily stress and frustrations that arise from caring for a client or family member with dementia. Recommended by several area physicians, ask your physician about getting this service. CSM approved, should be reimbursed . I am a tiny fraction of cost compared what facility care is. I help families after facility placement too… I monitor care and all aspects of care. Stop worrying about things that do not seem to go right in a care facility. I go by the latest Kansas care standards and make sure your loved one is safe and in great care situations. 20 years as a Legal Nurse Consultant.
My credentials
I am a long-time critical care nurse and nursing professor with specialty certifications and multiple Masters degrees in dementia, nursing education, and health care administration. I am a dedicated dementia research consultant and a nursing professor for several colleges on a variety of subjects, and am licensed to practice in 33 states.
In 2011 I was named “Nursing Educator of the Year” by the WSU School of Nursing. I have critiqued several hundred research documents and digested hundreds of books on the subject of dementia care. The resource links below will be a helpful few.
What I do
Please check out my video’s on You Tube about how NOT to get dementia, well worth your time and attention.
Affiliations
Also Check: Moving A Parent To Memory Care
Dementia: Differential Diagnoses And Treatment
Dementia is not as necessarily clear cut as you may think it is. There are several other mental illnesses the present like dementia but that are not dementia and therefore require an alternative treatment method. A CEU such as this is aimed at helping you identify and treat forms of dementia as well as how to cope with a patient suffering from dementia.
What I Do In My Job As A Nurse Consultant
My Nurse Consultant job description determines that my role is 60% clinical. I have contact with patients every day and consult on complex or challenging cases. I no longer have managerial responsibility for budgets or day to day operations.
The supervision I deliver to Nurses is clinical and I am able to have space with junior Nurses to reflect on Nursing practice and help develop their skills.
I sit on my NHS trusts senior Nursing board and my views and expertise contribute to changing and improving Nursing culture and ultimately patient care.
I have opportunities to network with other Nurse Consultants across the country and deliver teaching on modules at university and various training sessions to both Nurses and other health care professionals.
Recommended Reading: What Is The Difference Between Dementia And Senility
How Long Does It Take To Become A Nurse Consultant
There are three years initial Nursing degree study of course. I then worked as a nurse for over 9 years before I first took a job as a Nurse Consultant.
That included the time spent studying for my MSc and pursuing other courses mentioned elsewhere in this article.
It may be that you will have to progress through the bandings of Nursing via managerial routes or you may have the opportunity to remain clinically focused.
A common progression will be from Staff Nurse to Charge Nurse or Sister where more training and study can be undertaken.
From here Nurses can become Team Leaders, Ward Managers, or Clinical Nurse Specialists.
Band 8a posts can offer opportunities to experience the wider political, strategic and managerial landscape of the NHS.
Whichever career pathway Nurses take it is important to have an awareness of how the whole NHS works and what roles contribute to the running of the system you work in.
What Is A Certified Dementia Practitioner
The Certified Dementia Practitioner ® represents those health care and front line staff who have an in-depth knowledge in dementia care. They have received specific training, met certain requirements, and applied for certification through theNational Council of Certified Dementia Practitioners.
The CDP® is not a license or a requirement to work with those with dementia. Rather it is a certification for those who want to go above and beyond in the care they provide. This credential reflects a commitment to the field by the individual and organizations who support it.
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How Do I Become A Certified Dementia Practitioner
In addition to being one of the eligible professionals listed above, there are requirements you must meet in order to become a CDP®. If you noticed, this credential covers a wide variety of professions. As such, there are four different tracks for individuals pursuing certification.
Regardless of your track you will need to:
- Have at least 1 year of experience in a geriatric health care related field
- Complete a 7-hour seminar through NCCDP
- Complete your application
- Commit to adhering to the Code of Ethics
- Pay the associated fees
Here is a brief breakdown of the tracks- they basically vary by your profession and the work you do.
- 1 Track: Nurses or Health Care Professionals
- 2 Track: Those with a GED or High School Diploma
- 3 Track: Those with a Graduate Degree
- 4 Track: Those with No Licenses or Certifications
The application goes into great detail on what the tracks include. Be sure to review it to make sure you qualify!
Clinical Nurse Specialist Faqs
- Home health agencies
- Mental health facilities
Clinical nurse specialists usually work regular business hours. However, the collaboration between physicians and medical staff may require occasional weekend, evening, and holiday shiftsâespecially considering most CNSs work in the hospital setting.
CNSs often work in direct patient care, but some work in administrative, consulting, research, and supervisory positions where direct patient care is not required.
Clinical nurse specialists may work in high-risk areas that may expose them to workplace violence, blood borne pathogens, and chemicals. However, not all work areas are risky, such as research and education. Regardless of the chosen work area, workplace safety training is mandatory and ongoing, and most organizations strive to protect the safety of its workers.
Also Check: What Is The Difference Between Dementia And Senility
What Is A Clinical Nurse Specialist
A clinical nurse specialist is a graduate-level registered nurse who is certified in a specialty of choice. Obtaining specialty certification demonstrates an advanced level of knowledge as well as advanced clinical skills in a niche area of nursing.
There are differences between a nurse practitioner and CNS. While both are advanced-practice registered nurses, their roles are different.
Nurse Practitioners:
- Diagnose, treat, and manage chronic and acute illnesses
- Often act a primary care provider
- Prescribe medications
Clinical nurse specialists have a different scope of practice. They can prescribe medications if they apply for authority to do so, but this is not always required in their practice. They usually focus on education, research, and consulting.
What Is A Home Care Nurse
A home care nurse is a registered nurse that has chosen touse their skills to work specifically in this area of care. A registered nursehas completed a degree in nursing and is registered with the Nursing and Midwifery Council . Nursesdevelop skills in clinical decision making and learn how to use medicalequipment so they can provide a wide range of care services and treatments.
Home care nurses help to plan and deliver care for patientswith both physical and mental health needs. They often work as part of a teamthrough every stage of a patients healthcare journey, including palliativeand end of life care, which many patients would prefer to receive at home.
All registered nurses choose from four specialisms as part oftheir degree. These are:
- Adult nursing
- Mental health nursing
- Learning disability nursing
After qualifying with a degree, there are other coursesavailable to nurses to help them develop particular skills in areas of medicalcare so they can carry out specific work. This is when a nurse may choose to becomea home care nurse, learning and developing skills in managing carein a home setting, rather than hospital or clinic. Again, this will meanthey can provide a range of services such as cancer and critical care torehabilitation and epilepsy management.
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Studying For A Masters
About 5 years into Nursing I met a Nurse Consultant for PICUs at a conference. He spoke passionately about his role and I bored him senseless with questions about how he got there!
Nurses do not always get the opportunity to get out there and meet other Nurses but if the opportunity arises, take it.
Across the country there are networks, organisations, conferences, seminars and events supporting Nurses to share best practice.
I approached my manager and applied for funding in order to study for a Masters. I studied for a part time masters over two years whilst continuing to work as a Charge Nurse.
Gaining a MSc was a turning point in my career. I was petrified when I began. I felt out of my depth, inadequate and lacked confidence being back in academia.Masters education, I thought, was reserved for those non-clinical Nurses or researchers.
However, I soon became accustomed again to reading research publications and writing essays.
The joy of studying at Masters level is that the chosen topic studied is specific but at a deeper level. My MSc was in Clinical Forensic Psychiatry and as I was fascinated with the subject matter, I was able to engage fully and enjoy every minute. Studying whilst working gave depth to my clinical skills and I noticed my clinical practice and engagement with patients improved greatly.
My practice gained confidence and I was able to share my new knowledge and skills with colleagues
Drug Therapy For Behavioral Psychological & Emotional Symptoms
Behavior problems are a concern with dementia as the disease progresses. Psychosis, depression, and anxiety are three common problems. These symptoms are difficult for those with Alzheimers and can be associated with risk for others as there is at times physical aggression. Non-drug interventions are the first interventions to treat behavioral problems. Keeping a behavioral chart defines the problem and facilitates in the treatment of the undesirable behaviors.
Psychotropics are typically used in conjunction with other non-drug approaches or after attempting non-drug therapies and finding them to be inadequate. They are used at times to treat the behavioral, psychological, and emotional symptoms of Alzheimers. These symptoms can include emotional distress, depression, anxiety, insomnia, hallucinations, and paranoia, as well as some challenging behaviors, so being proactive in identifying and treating them is important.3
The class of psychotropic drugs are antidepressants, anti-anxiety drugs, antipsychotics, mood stabilizers, and drugs for insomnia.3 These drugs can be effective but can also potentially cause significant side effects.
Treatment of depression is important because it improves mental function, lessens confusion, and improves dementia. Depression can be a vexing problem that is difficult to uncover in dementia. SSRI are first line agents in the treatment of depression. SSRIs may be effective for the treatment of psychotic symptoms in dementia
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Impact Of Alzheimer’s Disease On Caregiver
Eighty-three percent of the help provided to older adults in the United States comes from family members, friends or other unpaid caregivers.3 Nearly half of all caregivers who provide help to older adults do so for someone with Alzheimer’s or another dementia.3
- About one in three caregivers is age 65 or older.
- Approximately two-thirds of caregivers are women more specifically, over one-third of dementia caregivers are daughters.
- Approximately one-quarter of dementia caregivers are “sandwich generation” caregivers meaning that they care not only for an aging parent, but also for children under age 18.
Primary and secondary caregivers often times become sick themselves due to the additional stress. This is especially true as the care recipient starts to need more supervision or becomes more unpredictable and possibly violent with frequent hallucinations. Compared with caregivers of people without dementia, twice as many caregivers of those with dementia indicate substantial emotional, financial and physical difficulties.3
Of the total lifetime cost of caring for someone with dementia, 70 percent is borne by families, either through out-of-pocket health and long-term care expenses or from the value of unpaid care.3
Caregiver challenges include:
Caregiver interventions:
What Is It Like Being A Nurse Consultant
Being a Nurse Consultant is a joy, but it is not an easy journey. I have had many late nights working at home whilst studying, balancing being a mum, working full time and trying to gain qualifications.
I have had moments of wondering why I am bothering, I have questioned Nursing as a whole and I have certainly had moments of feeling like I have no idea what I am doing!
But I also feel proud of myself and remain immensely proud of the Nursing profession. I remember my early university days as a student Nurse and the excitement I felt as I embarked on Nursing as a career.
As a Nurse Consultant, I am happy that the excitement remains. I look forward to each new day in my job and the patients I work with.
I hope that as I continue in my career I may inspire other Nurses in the way I have been inspired.
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Communities Where All Caregivers Are Certified Dementia Practitioners
Meeting you where you are, when you are. That is the promise of the Care Services team at Wellmore. At our community, every frontline caregiver is a Certified Dementia Practitioner, which empowers them with the confidence and knowledge to provide quality care.
Wellmore has a unique approach to Memory Care. We understand that individualized care plans have an incredibly positive impact on long-term health. Through our Reflections Memory Care program, our care plans create meaning and purpose for Members and their families. Focusing on individualized care creates a full circle treatment within our community.
Taking A Systematic Approach To All Situations
Alongside my professional development, I have changed personally too. I have changed in my approach to things and recognise there is rarely an urgency to any situation.
I have learnt to be more systematic, measured and reflect on a range of approaches. I have learnt that every role in the NHS is of importance and I am now grateful to those Nurses who chose a managerial path as they are contributing to the machine of the NHS, for which I am only one part.
I can safely say that my current job really is my dream job. It has not been a straight line getting here but I do get moments of feeling like everything up to this point has been worth it.
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The Role Of The Clinical Forensic Examiner
Forensic nurse examiners have a dual role, providing assessment and treatment for the patient and also collecting evidence. They carry out a thorough physical examination and use equipment to find evidence that may not be visible to the eye. They see that a pregnancy test is done and that the patient has medication that may be needed.
The job requires strong people skills. Nurses will need to reassure and offer explanation. They will also need to collaborate with professionals in other disciplines. Oakland University has produced a video depicting a day in the life of a forensic nurse . Among the things she can be seen doing is combing hair: looking for strands that do not belong to the person being examined. She can also be seen interacting with law enforcement after conducting the assessment, she makes sure the evidence is secured.