Scope of practise?

  1. Last week the charge nurse asked me to do a couple of tasks that I'm not sure were within my scope of practise.

    1. Handing me her keys (including the one for the med cart / narc drawer) and requesting that I fetch a few items from the treatment cart.

    2. Asking me to: a) check the treatment book for the names of a resident's prescription skin creams, and b) administer said creams.

    I did both because, at the time, I didn't think it would be a problem; the nurse is a new grad (just passed NCLEX) and is still getting used to her job. This has been niggling at me for a few days...
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  2. 1 Comments

  3. by   jb2u
    Ms. Sara,

    The best thing that you can do is to "know what you are allowed to do." Read the Nurse Practice Act for your state. This will also list what the Nurse can delegate. Second, some states will list "what a CNA is allowed to do." This will tell you more directly what to do.

    Never go outside your "scope of practice." Remember, the Nurse retains accountability for any task that she/he delegates to you, BUT you still have responsibility. So, if you go outside of your "SoP" you can not just say, "well, I was told by the Nurse to do it!" Never be afraid to question or say no! The "Nurse in question" may be unaware (doughtful) or may just see it as no big deal, however, if things go wrong, such as an allergic reaction to a cream that you put on the patient, the Nurse can always say, "I NEVER told the CNA to put that cream on the patient." You do not want to be in that situation. Assuming that you are in CA as your profile states I have provided several helpful links for you.

    From the CA BON website...What unlicensed personel may do.

    As I stated, CNA's are still responsible for their actions.
    From Title 16, California Code of Regulations.....
    "1435.3. Citations for Unlicensed Individual.

    The Executive Officer of the board or his/her designee may issue citations, in accordance with Section 148 of the Code, against any individual (as defined in section 302(e) of the Code) who is performing or who has performed services for which licensure is required under the Nursing Practice Act or regulations adopted pursuant thereto."

    From CA DHS's website.....
    "In California, State requirements prohibit a CNA from performing any nursing functions that must be performed by a licensed health care professional. Some examples of procedures that a CNA may not perform are:
    * Invasive procedures
    * Pass/administer medications or give injections (This includes the administration of any medication associated with treatment of eyes, ears, nose, mouth, or genitourinary tract.)
    * Colostomy care or apply wafer to skin
    * Insert, irrigate, or replace catheters
    * Suctioning
    * Sterile procedures (dressing changes, debridement, and tracheotomy care)
    * Administering gastrostomy or naso-gastric feedings
    * Administer oxygen"

    I hope this has been helpful. If you have any further questions it would probably be best to speak with your NM to clarify your role. I will now close this thread due to your question being answered and to prevent it from turning into a potential "legal advice" thread. If you have any other questions, please feel free to start a new thread.

    Sincerely,
    Jay

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