CNA scope

[Mkw2018]

I have a question about CNA scope of practice... I am currently working in an assisted living facility where most residents are completely independent and only require medication reminders. The DON is trying to delegate "wellness checks" to the CNAs that including assessing for appetite, bowel control, GI upset symptoms and weakness. Is this in the CNA scope of practice to do or is it something the nurses should be doing?

[VivaLasViejas, ASN, RN]

No, the nurse should be doing assessments. You can help by reporting your observations, but otherwise it's up to the nurse as it's her/his responsibility according to the nurse practice act.

Welcome to Allnurses!

[verene, MSN]

A CNAs are great for noticing potential issues, and may receive information in the course of conversation about hunger or pain or what not, but noticing is not assessing. This information should be reported to the nurse (e.g. "When I got Mrs. Wilson up to the toilet I noticed her left leg seems a bit weak today. She says her ankle on that side is sore." or "Mr. Smith didn't eat lunch today and says he isn't hungry at all." ) Assessment should be done by the RN.

If you can track down the scope for CNA practice in your state and bring to your DON that could help you back up your case that this is our of your scope.

[Have Nurse, ADN, RN]

I have a question about CNA scope of practice... I am currently working in an assisted living facility where most residents are completely independent and only require medication reminders. The DON is trying to delegate "wellness checks" to the CNAs that including assessing for appetite, bowel control, GI upset symptoms and weakness. Is this in the CNA scope of practice to do or is it something the nurses should be doing?

No. That is a nursing duty.

[kbrn2002, ADN, RN]

Appetite, bowel functions, ADL abilities, skin condition are things I 100% rely on the CNA's to observe but observing is not the same as assessing. Is the DON requesting that you observe any changes and report them to the nurse or is the DON expecting you to act on your findings independently? That's the difference.

[sheneeg]

CNAs can observe and report but they can not assess. For example, a CNA can observe the skin and tell you that during their shower Mrs. X had something abnormal on her bottom, but a nurse must assess the skin and determine if there is a wound, rash, etc.