Is it legal for a a nursing assistant to do vitals/outputs in an ICU?

[meghan91]

HI everyone, im currently a nursing student and a nursing assistant at my local hospital in the ICU. To make a long story short in the ICU that I work at aides never did vitals or outputs because they felt that those were critical and should be watched by the nurse that has that patient. Currently some nurses feel that the aides dont do enough and we shoudl start doing all the vitals (everything on the monitor in an ICU), all their outputs (drains, chest tubes, foleys etc), one touches (which we already do), set up of rooms, helping nurses, stocking, etc etc etc. One nurse told me it is illegal for an aide to be charting an ICU patients vitals outputs etc. Is that true and do you think one person should be responsiable for up to 26 patients vitals and outputs and everything else in an ICU?

Thanks everyone =)

[mamaxmaria]

I worked as an ICU tech for 4 years before switching to ER. Since all pts were on monitors the nurses documented their vitals (they were still paper charting. Only switched to electronic recently) we only went around and did temps. Accuchecks. And urine output. The techs documented these things on their own board..then the nurse would check the board for their pt. I dont know about it being illegal for us to document vitals...i currently document vitals on critical pts in the ER but i can see why an RN would prefer to do it themselves.

[roser13, ASN, RN]

Never worked ICU, but I can't imagine why it would be illegal for the RN to delegate any of those tasks to the nursing assistant. Just because someone else does the documentation doesn't mean that the RN won't be closely monitoring the vitals/outputs, etc.

[KelRN215, BSN, RN]

Doing VS and recording I/O is within CNA's scope of practice, why would it be illegal for them to practice within their scope in the ICU?

The nurses have always done it because that's how they've chosen to run the unit. I believe when I worked in the hospital, the nurses mostly did their own VS in the ICU- especially if they were 1:1-ing a patient but a CNA certainly can do the VS. If you can do it, it is certainly legal and appropriate for you to document it.

Every facility/floor has different tasks they allow their CNAs to complete. When I was an aide in a community hospital, we did all finger-sticks and were allowed to empty JP drains. When I was a nurse in a different hospital, the aides were not allowed to do either. I remember spending a day in the NICU while in school and an aide placed an NG tube- definitely would be a no-no at the hospital that I worked at although I know in the NICU at that same hospital, the aides set up NG feedings. When I worked in the hospital, our aides did VS, recorded I&O and escorted stable patients to tests if you could track them down to do it.

[i_love_patient_care]

Hi I'm a CNA, and came across this thread. I worked only once in an ICU and the nurses had the CNAs only as sitters or restocking the supplies. We would help with turning, but the nurses had to be there. In our certification we are trained to take vitals and document, I/Os as well. All other parts of the hospital we did both and documented it. I'm assuming it is the responsibility of the unit's nurse manager to determine our role. But, yes we can and do :)

[rumwynnieRN]

No -- my mom is an aide at a big hospital, and she does what all the other aides do -- take vitals, I/Os, etc.

Maybe on some floors, the nurse is required to do it, but no, it's not illegal.

[ktliz]

Sure, an aide could do all those things, but not when there is only 1 aide for 26 patients... that would be intense!

[hodgieRN]

In the ICU, all pts are on monitors, so the BP would be covered. There is nothing wrong with a CNA emptying a foley and reporting the output. The hourly I/O should be monitored be the nurse though. That should not fall on the tech for the whole shift. Charting is different among hospitals. Our techs don't chart anything. They help more with task oriented stuff. I wouldn't say charting would be illegal, but the nurse needs to be the one officially monitoring it and signing off on it Everything in the unit is basically monitored hourly. Input, output, vitals, etc. If a nurse wasn't monitoring vitals or any ouput, that would be more of the nurse's fault.

[Esme12, ASN, BSN, RN]

What the ICU nurses prefer to do is one thing...but CNA a CNA take vitals and I/O? Yes.....the nurse is still responsible for that patient if anything is wrong and if she inappropriately delegates an unstable's patients vitals to the aide then shame on her.

[Nurse_]

Can a CNA input/take the vitals and I/O? YES. Those are raw data. It's the nurse's responsibility to assess the patient, to see if those data means anything.

If I'm on a regular floor and have a CNA, they always give me the vitals to input. If I see a vital that's not concurrent with the patient, I check it myself.

Bottom line is the CNAs have the training to TAKE vitals. They do not have the training to give them meaning/interpret them... that's a RNs job.