Generations of Change

By Lynn Sywyj - May 11, 2015

Generations of Change

Today is Nurse Assessment Coordination (NAC) Day, and in celebration of NAC Day, we’re highlighting NAC Jennifer LaBay, RN, RAC-MT in our Feature Story Nurses series.

On a cold day in Rhode Island, Jennifer put her newborn daughter down for a nap and then took a few moments to speak to me on the phone about herself, her career path, and how her nana inspired her to become a long-term care nurse.

Jennifer started working in long-term care when she was 17, following the steps of the women in her family. She became a certified nursing assistant in the same local nursing home where her nana had worked as a nurse aid, along with her two aunts and mother. Jennifer’s nana had helped to raise her, and to Jennifer, “She was the most important person in my entire life… she was independent, let us learn and play, and taught us all sorts of things.”

Jennifer worked as a CNA for five years before graduating with her RN degree at 21 and receiving a promotion to charge nurse. When she started working as a nurse in 1995, MDS coordinator wasn’t a specialized position. On one of her first days in her new role, her supervisor threw her an MDS and said, “See what you can do with this,” with no instructions. Two years later at her boss’ instruction, she began to take a “paperwork day” for MDSs once per week.

About a year later, she interviewed for a position as a floor supervisor at a different facility. On the day of her interview, the facility’s MDS coordinator had a traumatic injury. Jennifer was immediately offered a job she wasn’t applying for – MDS coordinator. “The MDS seemed to keep falling into my lap. Luckily, I didn’t fight it, I just went with it.” More than 15 years later, she is a nationally recognized MDS expert.

Jennifer’s experience taught her the importance of the MDS. “When I first started, I didn’t have the buy-in… I made a lot of mistakes along the way and I’m not afraid to admit that.” According to Jennifer now, “The MDS is what drives everything in long-term care… quality of care, payment, all of these things. If you use the tool correctly, it leads to great care for residents, which is the goal. But you really have to understand the nuances of why, and that it’s fun and exciting.”

In her more than twenty years in the field, Jennifer has seen how the MDS has changed the culture and the care of residents. She reminisced:

When I first started as a CNA in ‘90 or ‘91, there were still smoking rooms off of the nurses’ stations and not too long before that, they were still smoking at their desks! When I first started, we tied everyone into their beds and wheelchairs. The goal now is to be restraint free. It was more institutionalized when I first started. We had a group of patients that we had to care for -- they weren’t residents -- and individualized care plans weren’t part of it. The nurses wouldn’t really talk with the staff about what was happening with the patients. The MDS allows all of the staff to understand what is happening with each resident.

The care of residents has been and continues to be transformed as more facilities value the MDS, its purpose, and its potential.

Jennifer’s biggest challenge today as a director of reimbursement is “to get people to understand what you need them to understand and the importance of proper training for MDS coordinators. Too many times people think they can throw someone from the floor into an MDS position, but they need to take the time to train.” Jennifer knows from her own evolution of thinking about the MDS as a “paperwork day” to becoming the epicenter of care, that changing the way long-term care professionals think about the MDS takes time. But it’s changing, and care is improving because of it.

Recently Jennifer welcomed a new baby girl into the world, whom she will love and teach in many of the same ways that her nana loved and taught her.  While change can be generational, the care and wisdom with which we lead change is constant.

From all of us at the Care Connection blog, happy NAC Day!


Lynn is the membership marketing coordinator for AANAC and a guest-contributor to the Care Connection blog.

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