I had a patient who has been trached/pegged at home for 2 years. His 2 CNA's (awesome smart ladies) were taking care of him, doing all suctioning, trach care, tube feeds. I assume theyve been doing a good job because there have been no reported problems, such as infections, aspiration...
When I discharged him, I gave the CNAs written instructions on trach care and tube feeds. I also demonstrated again, had them verbalize and demonstrate safe technique, including emergency interventions.
Now my question is, isnt trach care and PEG care supposed to be done by a RN? Am I allowed to chart that I taught the CNA how to do it. (A home health RN visits the pt. every morning and is available on call)
It seems like what I did was wrong, but then again, I have taught family members trach care before as well!
Instead of using the term "private CNA", I would use the term "private caregiver". That gets around the issue, which isn't an issue, now that we know they are private caregivers.
I wonder if charting "patient's caregiver at bedside...." would be more appropriate. I would assume that the family would be allowed to hire anyone off the street and teach them how to care for their loved one. In this case they were smart and hired people who've worked in the capacity of CNAs.
My take on this is it is a ploy to get people to spend more money to get licenses and certifications they shouldn't need. My state took away CNA certificates from licensed nurses 15 years ago. I expect that probably keeps some people from getting work, and I don't think that would be an unintended consequence.
I'm quite certain you are correct! I'm like "I'm a nurse (LPN) so just go ahead and ASSUME I can take vitals, make beds, calculate I/O, bathe patients, etc". In the end, it's all about the almighty dollar, sigh.
caliotter3
38,333 Posts
Instead of using the term "private CNA", I would use the term "private caregiver". That gets around the issue, which isn't an issue, now that we know they are private caregivers.