Maryland Delegating Nurse

Hi everyone. Lets start by saying thank you in advance for your positive comments!

Currently I am a RN that is looking to start working as a delegating nurse in the state of Maryland. I have fulfilled the requirements of the state to do so. But of course I have a problem. I am seeking four clients for my first job assignment. The assisted living manager that I am working with does not have any healthcare/nursing experience. On the other hand he has fulfilled all requirements of the state as well. He gets calls everyday from clients seeking placement. The problem is that many of these people have mental illnesses. Am I wrong for not wanting to place them due to the ALM lack of experience? Also the ALM does not understand the selecting client process which I have explained multiple clients. For example, he called me saying that a 37 y/o male with Bipolar and a 87 y/o male with severe dementia is looking for placement. Both require care but need to be cared for differently. Any suggestions? This is my first time doing delegating nurse position and his first time starting assisted living. Am I making this complicated?

Helpppppp
I guess I really don't know what you're asking us, but that might be because I don't know what a delegating nurse is. I also don't understand the relationship that you're describing with the assisted living manager.

Maybe this will helpDelegating nurse- The registered nurse who serves as the case manager/ delegating nurse (RN, CM/DN) must complete the Maryland Board of Nursing and OHCQ approved case manager/delegating nurse curriculum offered by a community college and other approved educational sites prior to serving as a delegating nurse. The RN, CM/DN may: 1. Teach the medication administration training program; 2. Serve as the case manager/delegating nurse in Assisted LivingThis responsibility includes: a. perform an initial and 45 day assessment during the site visit to the home. The follow-up site visit must occur at a minimum of every forty-five (45) days b. assessing the clinical status of the client every 45 days. c. assessing the competency of the medication assistant administering medication at the same time as the 45 day site visit. d. assessing the task to be delegated included complexity. e. assessing the environment in which the task is to be performed. f. determining the instruction and frequency of supervision required to monitor the caregiver.

It sounds like you need a psychological type of service. Med-Options offers on site services and can be contacted for official assessments etc. They came to the LTC facility where I worked and would consult for older dementia as well as younger pts who had a psychiatric diagnosis. They are a psychological counseling service only and make referrals to the psychiatrist for any recommended medications. I would not put the elderly dementia patient and the young bipolar patient together as each has a different need and the age difference may impact their life styles. It sounds like the manager is just looking to fill up the open beds, and does not quite understand the acuity levels involved with nursing care etc. Not sure how you can remedy this. If you have any nurses with psych background I would recommend them for any of the psychological type pts. You can pretty much bet on the dementia and bipolar patients requiring more nursing care/interventions.