6 Chapter 1 your own body, mind, and spirit. Holistic caregiving should always include this awareness and sensitivity because it is hard to holistically care for others if you are not aware of your whole self. This textbook will guide you through the essentials of holistic caregiving. Each chapter will point out a different area of the Providing Holistic Care Framework. This information will be identified at the beginning of each chapter and will be your guide to reading the chapter and becoming a holistic nursing assistant. The topics covered in this chapter are highlighted in Figure 1.2. In addition, you are encouraged to reflect and journal about what you have learned in each chapter of your textbook. Creating a reflective journal will give you the chance to write and think about both the knowledge and skills you learned and ways you can use them when you begin working as a holistic nursing assistant. It is only through this self-examination and reflection that you can build the confidence and ability to • be sensitive to special needs and culture • understand diseases, conditions, and disabilities • use your knowledge and skills competently and safely • develop positive and helpful interactions with others and • help empower (give power to) those in your care. All of these factors will impact the way you approach, care for, and communicate with residents. Gaining knowledge and developing your skills will allow you to help them achieve the highest levels of well-being possible. What Are the Responsibilities of a Nursing Assistant? Providing care is the number-one responsibility of nursing assistants, no matter where they work. The amount of work and type of care required are dependent on the specific needs of each resident, the plan of care, and the nursing assistant’s job description (duties, responsibilities, and qualifications). A sample job description is shown in Figure 1.3. The care provided also depends on the nursing assistant’s legal scope of practice, or specific responsibilities, procedures, and actions. Legal scope of practice is determined by each state. While duties may differ depending on the type of healthcare facility in which you work, all nursing assistants have the same basic responsibilities and requirements. It is important to be aware of how care is provided. Care should be holistic so that the physical, mental, and spiritual needs of residents and their families are met. This type of care provides assistance with ADLs, pays attention to any changes in condition, responds to needs and requests, offers appropriate emotional support as needed, shows compassion (the desire to help another person), and demonstrates cultural humility (awareness and sensitivity), among other things. Activities of Daily Living (ADLs) Activities of daily living (ADLs) are actions that people take during a typical day, such as bathing, grooming (combing one’s hair), dressing, eating, toileting (urinary and bowel elimination), and ambulating (moving about or walking). Nursing assistants are responsible for helping residents complete their ADLs. In some cases, nursing assistants provide all of the care, or they may assist more independent residents as needed. Setting up meals, feeding residents, documenting what and how much residents ate, and assisting with toileting are other important responsibilities. Specific information and procedures to assist in performing ADLs can be found in Chapter 19 and Chapter 21. Ambulation, Movement, and Exercise Older residents or those who have illnesses that cause them to be weak or have to stay in bed may need assistance with ambulation. This assistance may include lifting, moving, or transferring residents. Some residents may need assistance with range-of- motion exercises, which help residents maintain or improve their flexibility. Nursing assistants also work with residents who need help gaining body strength or need assistance with physical exercise to maintain effective muscular function and general well-being. You will learn more about ambulation and range-of- motion exercises in Chapter 15. Measurement and Observation Among the most important responsibilities of a nursing assistant are measuring, documenting, and reporting information about a resident. Information Copyright Goodheart-Willcox Co., Inc.