CNA straight cathing and giving suppository?????????

[Stone06]

I recently started a new job and last night was asked to job shadow another aide at a clients residence. The client is on a bowel program that includes giving a suppository and inserting the catheter into his member. I was not taught to do this in my CNA training. I am not really sure how to address this with my employer. I am willing to do both of these things, but I should be fairly compensated. I am sure the employer has never had anyone call them on this, but what should I do something I'm not licensed to do for half the pay. Any suggestions?

[DebblesRN, ASN, BSN, RN]

When I was a CAN/HHA, we were not allowed to do that. There was a Critical Care/Emergency Department Technician program I took at the community college that trained me to do sterile procedures (lab draws, foley insertion, straight caths, and all kinds of dressing changes), but NEVER was I allowed to give meds, even suppositories.

I'd check with your supervisor. I never did home care as a CNA, maybe they let you do that in the home setting if it is an over the counter drug.

[RachH]

In my last CNA job, we were allowed to do many things that CNAs aren't trained to do, including straight catheters and suppositories. I told my nurses that I would be happy to do whatever they required, but asked that they teach me how to do these things first. The nurses weren't surprised that I wasn't trained and were very helpful. They would walk me through doing these skills several times, and wait until I was comfortable before allowing me to do anything on a patient.

[Penelope_Pitstop, BSN, RN]

I don't see a problem with a CNA doing these things as long as the state's Nurse Practice Act allows for them to be delegated.

In PA, for example, CNAs may catheterize (straight cath and Foley, for male and female patients). However, they are properly trained in this procedure.

As for administering meds, there are several "medication aides" who exist, who are not nurses. Administering a suppository is a lot different than, say, IV medicines. Again, though, proper training is needed.

In your case, it's a problem because you don't have this training, not because it's illegal or wrong for a non-nurse to do these things.

[shelbil]

At the CNA job i have we cannot even place a band aid without getting a nurse.

It does seem like that job would pay more

[OgopogoLPN, LPN, RN]

At the LTC facility where I work, the aides can give suppositories (non medicated only for bowels). But not catheters. Ever.

[rosey2007]

I have a nurse delegated but still have to be trained by a RN to insert caths and giving suppositories.

[BrewerRN]

In NC, we have CNA level 2's that can do more that a CNA level 1. Maybe this was the case.

[cjcsoon2bnp, MSN, RN, NP]

Here is my recommendation for when you're asked to do a particular procedure of which you are not familiar.

Step 1: Check your facilities Policy & Procedure Book. If the agency that you work for says that you can't do it, well then don't do it. Easy as that...

Step 2: Check your state's Nurse Practice Act. Make sure that what you are asked to do is within your scope of practice. Use common sense with this one, if your asked as a CNA to take a patient's apical pulse then obviously this is within your scope of practice (even if you personally haven't done it before) but doing a sterile procedure like a dressing change or inserting an catheter is something that you need to check on before you try it.

Step 3: If the task/procedure is within your scope of practice, you must then ask yourself: Have you ever seen this done before? Do you know the proper steps to performing the task? If you do not know the steps or are not comfortable doing the procedure by yourself then seek out the appropriate resource to assist you with the task until you feel that you are competent and comfortable doing said task alone.

I am not familar with your state's Nurse Practice Act but I would be very wary as a CNA doing a sterile procedure like inserting a cath. or giving any sort of medication unless I was absolutely sure that doing so was not illegal and that I am fully aware of how to do the procedure properly and the risks involved. It's better to be safe than sorry, CYA as they say.

!Chris

[tyvin, BSN, RN]

CNA's and the like accept this ever increasing responsibility of patient care. It's done because of cost issues. Employers aren't about to compensate CNA's the way a licensed nurse is. The whole idea is to make the CNA have as much patient care as can be gotten away with because the wage is so low and that way the employer doesn't have to hire as many licensed staff.

The RN is becoming the ever increasing Rare Nurse as states enact practice to allow non-licensed staff to perform specialized nursing skills. Then the procedures become less specialized and pretty soon anyone will be able to get away with practicing nursing.

Don't get me wrong I think everyone should be compensated accordingly but it's just not going to happen. Maybe a little to keep every one in line but not to the point of respectability. I saw this happening years ago the first time a CNA was allowed (in a facility) to do tube feedings. I was astonished and was told they have to have special certification to do that. Really! So I talk with the person and they are a puppet not really realizing the ramification of what they're doing. It made me very uncomfortable because as charge it was on my license so to speak that this person was allowed to "practice."

So as far as the employer compensating you for the extra procedures you CNA's have accepted to do I really don't see it happening. Maybe they might throw you a bone but not to the point of what you should really be getting for the work you're doing.

Good luck.

[NurseLoveJoy88, ASN, RN]

choose all of the above. :)

[4323]

I think at times it is great that CNA's,PCA's and Med Techs help us with our load as they become our assistants and help create a team. I think if the state allows a procedure to be done by a CNA ,PCAor Med tech that then is up to the state . I began working in an ambulatory Dept. and back then there were many nurses in the floor today that same dept is getting rid of LPN'S and RN's and replacing them with PCA'S . The nursing staff(No LPN's at all) is much smaller.The LPN's have been sent up to the nursing home and the RN's are less everyday they too are being sent to the nursing home.Many end up resigning. PCA's are practically doing a nurses job and when anyone nurse says anything administration will tell you they are under the supervision of the M.D. Is there a shortage of nurses or are other health care staff taking our jobs. It is funny in our faciity the PCA's wear white and it has been very difficult for administration to change the color of the uniform. The patient's go around calling the PCA's nurses and the PCA's will not make the correction. I think PCA's are a great part of the team yet they should not be allowed to take the place of a nurse.This is a city facility. They will brag as to the amount of nursing home jobs they have available but dont ask them for amb.care they will tell you they have none available. The idea is tons of PCA's and 1 nurse available in the building.