CNA scope of practice

Nurses Safety

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I was looking at one of my pt charts (paper charting) the other day and noticed one of the CNAs had charted a pain assessment on the flowsheet where they usually chart the vitals. There is a space for this allowing a numerical value. The CNA had charted 0/10. I thought about it later and started to get a bit worked up about it.

From what I remember in school CNAs can not assess pts. What do you all think? How would you approach this without making the person feel too bad?

We are required to ask about pain at least every time we do the vital signs. There is a box for it on the sheet that we are required to fill in fully. We rate it 0-10. For patients who can not verbalise pain, there is an additional flow sheet that the RN is supposed to do every 2 hours, checking for non-verbal signs of pain.

Specializes in ER CCU ICU L&D MED/SUG MILITARY.

I have been an EMT/CNA for almost 20 years and I have never been able to record pain in any written form, but is required to report it to a liscensed professional such as LVN/RN. I feel that as a CNA that unless there is more education added to the training we recieve we should not have to "document" things like pain due to the liability to asses what needs to be done next as far as medication or possible x-rays/lab draws/treatments. I feel that the liscensed nurses need to deal with this type of thing.

Specializes in Nursing Education, CVICU, Float Pool.

I agree with many of the intial posters. I've beea CNA in NC for almost a year and in my CNA ass in high school we were taught that Pain was the "extra" vital sign. At the hospital I work at we do every- other-hour rounding between the RN and CNA so when we g in we are supposed to ask if they need anything or if they are having any pain and where at. If we, as CNAs, find they do have pain the hour we round on them we report it to the RN and then chart what was said and did, in case anything concerning the legal stuff comes up.

Specializes in Hospital Education Coordinator.

reporting to the nurse is appropriate, just like taking blood sugar. What would not be appropriate is asking questions to determine the cause, intensity of the pain (assessment).

BTW: CNA's do not have a scope of practice because they are not licensed. They have certificates and are delegated tasks by licensed individuals. Your state's health dept outlines their education and your facility SHOULD have a policy about what the CNA may do that falls within that frame of education.

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