SCOPE of practice ??

Nurses General Nursing

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I work for a Veterans Hospital, I am a NURSING ASSISTANT... my dilemma is.... i started working in a department where the Nursing assistants draw blood, and insert Foley's.... I have always understood that this was not something a NA does... I inquired about it but they said they teach NA's to do more in this department over any other. I also do Accuchecks. Im not sure if this is ok because im being trained and this is a VA hospital and its part of the US Government or what????

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VA hospitals are federal institutions that are not required to follow state mandates. Non-licensed personnel can perform duties outside the scope of non-federal institutions. Licensed personnel must still follow state regulations except at military hospitals. PS. the VA will pay for your education. Good Luck!

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Specializes in med/surg, telemetry, IV therapy, mgmt.

I think I can answer your question for you. I worked for the V.A. for 5 years. We were taught to suture! That was definitely not something the state nursing law allows. The reason you are doing these things is because it is a federal government facility. The rules and policies of a federal facility take precedence over the laws of the state you are in and that includes the nursing law. Now, they do have to use some prudence and properly train people to do those things. I assume you have had that training, right? You will also find, if you check around, that there are probably nurses working there who do not have a license to practice nursing in the state your facility is located. We had a couple of nurses who were licensed in other states that worked at our V.A. The V.A. recognizes them all as being valid. Working for the federal government is a whole different ball game. Every time you set foot in the door of the V.A. you are stepping onto United States Government land. It can be a nice feeling. Believe me, you are very protected there by our government. That's a nice way of telling you not to worry about getting sued for doing something that only a licensed nurse is supposed to do. Uncle Sam will step forward and take the flak, if there even is any. When you get to nursing school you are going to be an expert at drawing blood, inserting foleys and taking Accuchecks. Think of it as 3 procedures you won't be having anxiety about in nursing school. :chuckle

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Im supposed to be taking my CNA licensure exam on January 3rd. Is that going to cause a problem, or should i not take it at all?

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Specializes in med/surg, telemetry, IV therapy, mgmt.

Don't know how it could be a problem.

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Specializes in LDRP.

I'm in a hospital, and our NA's can do Foleys if htey have extra certification and take some extra classes and be NA 2's. (like a clinical ladder)

the NA's can all do accuchecks. NA 2's can put in foleys, take out foleys, take out staples, take out iv's, etc

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i took out a couple IV's and attempted to draw blood but the guys vein "rolled" on me so the RN said.... whatever that means.... see what i mean i dont even know what that means GRR and I have done the Accuchecks and EKG's... the only thing left is putting in a foley... that hasnt come up yet....

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Specializes in Hospice.

Don't get discouraged because the vein "rolled" when you went to do a blood draw! Learn from the experience (maybe try a little more tension) and get feedback from your preceptor (ask them also to tell you what you did right too, not just what you could do better:) Like any new skill it takes practice and sometimes even experienced people encounter an uncooperative vein. Ooops, I seem to be drifting off topic... so let me take this opportunity to add that any extra skills obtained will also be an asset in future educational opportunities. It shows you are willing and able to learn new skills. Good luck!

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I don't work at a VA hosptial. The NAs where I work also draw blood (except a T&C), take VS, and do accucheks. They are also allowed to do EKGs.

At one time, they were allowed to insert/remove foleys, do trach care, insert/remove NGs, and simple drsg changes. One reason they are no longer allowed to do these things was that infection rates increased when they were allowed to these tasks.

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i took out a couple IV's and attempted to draw blood but the guys vein "rolled" on me so the RN said.... whatever that means.... see what i mean i dont even know what that means GRR and I have done the Accuchecks and EKG's... the only thing left is putting in a foley... that hasnt come up yet....

Drawing blood is fun! Especially when they are a hard stick. I love a good challenge.

The more you draw blood the better you will get at it. After your 1,000,000 stick, you'll likely be very good at those rolling veins! :)

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Specializes in LTC.

I know that in MN what a NA can do depends on the facility, training, and sometimes the title that they work under. For NAs there are little clauses that say a NA/HHA can do what a facility trains them to do. As I work as a HHA, I've been baddly trained to pass pre-setup meds, some minor dressing changeand do a couple of other thinags that CNAs normally wouldn't do.

A lot of our hospitals will train their NAs as PCAs and they can do a lot more things as well.

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Specializes in ICU, Research, Corrections.
I think I can answer your question for you. I worked for the V.A. for 5 years. We were taught to suture! That was definitely not something the state nursing law allows. The reason you are doing these things is because it is a federal government facility. The rules and policies of a federal facility take precedence over the laws of the state you are in and that includes the nursing law. Now, they do have to use some prudence and properly train people to do those things. I assume you have had that training, right? You will also find, if you check around, that there are probably nurses working there who do not have a license to practice nursing in the state your facility is located. We had a couple of nurses who were licensed in other states that worked at our V.A. The V.A. recognizes them all as being valid. Working for the federal government is a whole different ball game. Every time you set foot in the door of the V.A. you are stepping onto United States Government land. It can be a nice feeling. Believe me, you are very protected there by our government. That's a nice way of telling you not to worry about getting sued for doing something that only a licensed nurse is supposed to do. Uncle Sam will step forward and take the flak, if there even is any. When you get to nursing school you are going to be an expert at drawing blood, inserting foleys and taking Accuchecks. Think of it as 3 procedures you won't be having anxiety about in nursing school. :chuckle

Very informative post, thanks. I just accepted a job for an RN Thursday at the VA! Holy smokes, I am a new grad and you have me thinking I am going to insert central lines and Swann-Ganz catheters :wink2:

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