California CNA scope of practice question

[CaliCNA]

Hello! This is my first post to this website. Unfortunately, it's quite a heavy post. So, here's the story.

My wife is an ICU RN and I'm a CNA in Northern California. 8 weeks ago, she began having sciatica pain issues on her left side. The pain increased over the following weeks. We, both being the types to not go to the doctor or hospital unless we feel it's a true emergency,tried the conservative management route. But after 7 weeks, the pain became unbearable to the point my wife could barely walk. We finally went to see an NP and we were able to get an MRI the same day because of the amazing people at her hospital pulling together for us. Her MRI was read the following day and the NP Gave her Norco and sent her home even though the MRI showed that Her L5/S1 disk was extruded with A free fragment in the left lateral spinal canal with S1 nerve Compression. She obviously had no idea what she was dealing with because when the Neurologist finally got a hold of the MRI image, they called us telling us that we need to come in the very next day.

By then, my wife had been bed ridden for the entire week. Thank you NP lady for basically telling her to walk it off! So, that night, the night before our appointment with the neurologist, my wife could no longer control her bladder/ bowel movements and we decided it was time to call an ambulance.(She could no longer stand, sit, and even lying down was extremely painful. She had to be airlifted that same night to a hospital 3 hours away where a neurologist was on standby for her. She had emergency back surgery 8 hours after our phone call to 911. it was a L4/L5/S1 Lamenectomy and an L5/S1 Discectomy. Turns out she had Cauda Equina syndrome.

Anyways, thats the background. Here's the point. My wife was extremely constipated because of the nerves that were being pinched. During her first day on the med/surg floor she had to beg her RN to digitally disimpact her and when she did this, the nurse literally threw a pair of gloves at my wife and told her to do it. my wife refused because she just spinal surgery hours prior and the nurse sent a CNA in to do it. The CNA attempted for over a half hour with no lidocaine and not being gentle whatsoever. My wife, being extremely desperate to pass a bowel movement, screamed and cried through the entire experience. There was no written order by the doctor or nurse that allows the CNA to perform a disimpaction. Is this legal in California? Can a CNA perform this procedure legally?

Any input would be greatly appreciated.

[sallyrnrrt, ADN, RN]

shame on that nurse,

i am so sorry your wife had to experience this & sincerely hope she is doing better, and that future nurses are far more compassionate.........

[scottaprn]

What is your reason behind the question?

If you are seeking a legal opinion on the scope of practice for a cna please consult an attorney as we can't give legal advice and you agreed not to ask for it in the terms of service.

If you are seeking medical advice concerning the care of your wife you also agreed not to do this per the terms of service you agreed to.

[JustBeachyNurse, LPN]

Since you are a CNA you likely know the answer generally CNAs cannot be delegated to perform an invasive procedure, digital disimpaction or otherwise. Check the state agency that over sees CNAs. Are you sure this was a certified CNA and not a NA or pct? Otherwise we cannot offer medical/legal advice. You always have the option to consult with an attorney

[JustBeachyNurse, LPN]

Per CABRN RNs cannot delegate any invasive procedure to unlicensed assistive personnel (CNAs are not licensed therefor this applies to CNA). Consult with an attorney for legal advice if you feel the need.

http://www.rn.ca.gov/pdfs/regulations/npr-b-16.pdf

[Esme12, ASN, BSN, RN]

I am sorry your wife has had such a difficult time....I send positive energy for her recovery.

As per the terms of Service we cannot offer legal advice.

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Thread closed.