The Role of Nurses in a Nursing Home

A nurse in a nursing home facility has many responsibilities. They have the task of not only caring for the elderly residents, they are also in charge of other employees and have to make sure the operation runs smoothly. Caring for the elderly in a nursing home is a huge responsibility as many of the residents need some type of medical attention. Just like any other business, there are various levels of responsibility among the employees.

Overview of Nurse Types

There are basically three types of nurses in a nursing facility: Registered Nurse (RN), Licensed Practical Nurse (LPN), and Certified Nursing Assistant (CNA), and sometimes a Nurse Practioner (NP). Also, an RN who takes specialized graduate courses in geriatric care and obtains a certificate or degree are designated as a Gerontological Nurse.

Depending on the level of care rendered to its residents, the nursing home may employ all three nursing types or sometimes just CNA’s and one or two registered nurses. In any case, each type of nurse has their own job description and different level of responsibility.

Description of Each Nurse Role

The Registered Nurse usually has more training and education than other nurses. These are the nurses who are the supervisors and they work under the direct supervision of the medical doctor. Their professional title is usually Head Nurse. They are responsible for overseeing the LPN’s and CNA’s by designating the nursing assignments and are also responsible for making up the working schedules.

Aside from their supervisory role, RN’s have specific jobs to do. They are also responsible for the total care of the residents by initiating treatment plans and administering medicine. They also prepare IVs, draw blood, give injections, and taking vital signs. Their nursing responsibilities go even further as they are required to monitor the health of their patients and to make sure they are getting the proper care. In addition, an RN is responsible for interacting with the patient’s family by reporting any changes in the patients health or living situation.

The LPN’s role in a nursing home is direct bedside care. Under the supervision of the Head RN, LPNs carry out the routine care for their patients. Basically, they are responsible for the patient’s personal hygiene and day to day care. LPNs have a very physically demanding job as they may be responsible for getting the patient out of bed or moving the patient into a more comfortable position. They may work right along side of an RN or work independently.

LPNs are responsible for taking the vital signs of the patient such as blood pressure, temperature, heart rate, oxygen level, and respiration. They also give enemas, may initiate medicine, apply bandages and dressings, insert catheters, and monitor the IVs. Also, they may feed the patients and record any changes in the patient’s health or vital signs. Basically, they are responsible for doing any tasks that need to be done for the sake of the patient’s comfort. If a problem arises, the LPN always reports back to the RN in charge.

The CNA’s role in a nursing home is to assist the LPNs, and they are also required to be state certified. Many community colleges have programs for CNAs. Essentially, a CNA does some of the tasks that an LPN does but there are some things a CNA cannot do. For instance, a CNA cannot administer medicine or supply IV medicines. Also, a CNA cannot start an IV where an LPN can.

Some of the basic tasks a CNA might do are: changes bed sheets, bathe patients, change bed pans, feed patients, walk the patient, helps with personal hygiene, transport patients, and any other tasks that are designated by the LPN or RN.


As you can see, being an RN, LPN, or CNA in a nursing home is a big responsibility as both the patient’s health and well being are the prime concern. Some of these patients cannot care for themselves and they are totally dependent on the staff for their care. A nursing-home nurse not only needs the proper education and degree for the job, they also need to be totally dedicated as their job can be a very demanding one.

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