CNA - Chain of command/organizational structure question

[semester1kid]

Is there any structure ranks within the employed CNAs of a given facility or does everything come down from the charge nurse? For example, is there such thing as a 'lead CNA/Tech'? Sorry for what may or may not be a silly question:o:)

[yousoldtheworld]

At our facility, we had a "head CNA". She did all the training, inservices, and did things like stocking briefs and wipes, and putting together our books each month. She basically got shoved to do whatever the DON felt needed done that day. She recently switched to laundry because she was sick of all the pressure, haha, so we don't have one.

But most places I've been don't have them.

[SlyckRN]

Unless done within your company, they usually don't have them. The chain of command has to do with the level of your licensure.

[daimere]

Depends on the place. During day shift they have NASR II but the other shifts don't have them. NASR II will do precepting and "take charge."

[KimberlyRN89, BSN, RN]

My first CNA job was at an assisted living facility, and it used to have on each shift, a "senior caregiver". They were the ones who had been there the longest, and were also certified as a med.tech..in a way they were sort of the go-to person for that shift, especially on evening or night shift b/c the nurse left the building at 8 pm. Now that there's a nurse in the building for each shift and they no longer use med techs, the senior caregiver is not as important.

[CNA2day]

we have a CNA supervisor who is below the DON but directly supervises all the CNA's... shes great!

[Bruce_Wayne, ASN, RN]

You can have a CNA that's a "supervisor" but make no mistake that a CNA can ONLY be directly supervised by a licensed nurse. You can't have a CNA directly in charge of another CNA, period. You can't, for example, have an RN delegate responsibilities to a "charge CNA" and then that charge CNA delegates responsibilities to another CNA. An RN must be the one to do the delegation, it's just part of the deal because a CNA license is unusable without an RN supervisor. In short you can't work if there isn't an RN that's responsible for you. If the RN in charge of you tells you that they don't like the way you work and they don't want you working for them, you must stop doing all patient care right then and there until another RN agrees to be responsible for you.

I just wanted to be clear about that. But that doesn't mean you can't have a "lead CNA" that is in some other way your "boss" and can tell you what to do. They just can't give you an assignment, they could make up an assignment and then get the an RN to approve it, that'd be ok. And they can do things like make sure you're working up to the standards of their facility, etc.

[CNA2day]

our Cna supervisor is actually a CMA but she is the CNA supervisor of the facility.