Nursing Assistants

[Bri1231, BSN, RN]

Hi all, from Ireland. I want to ask you all about the role of the nursing assistant in your facility. I have been in nursing now for twenty one years and have worked in Ireland, the US, UK, Spain and now I am back in Northern Ireland. The first notable difference I found when returning here after all these years is the role of the NA. Here in the hospital I work they are not permitted to

Take Vitals

Blood Glucose

Draw Labs

EKGs

Etc Etc

On some wards they are not even permitted to take patient report!!! I know I know, how unsafe is that!

I ask because in every other country NAs at a minimum took Vitals and Accu checks at a minimum and depending on the unit could be trained to do more if that NA was deemed competent and wanted to.

What are CNAs allowed to do and not do these days in the US?

I intend to write a paper about my experiences as a nurse in different countries.

Thanks ?

Bri

[beekee]

Where I work (US), nursing assistants take vitals, check blood glucose levels and do EKGs. They do not draw labs. They can empty foleys, JP drains, etc. They can remove foleys and peripheral IVs, but not place them. They cannot titrate oxygen or touch the IV pumps. They assist with feeding, toileting, ambulation, repositioning and other ADLs.

[Jedrnurse, BSN, RN]

Much of the variance in duties depends on facility policy, not the government agency overseeing CNA certification. That being said, facility policy may not violate the Nursing Practice Act of whatever state we're talking about...

[Bri1231, BSN, RN]

1 hour ago, beekee said:

Where I work (US), nursing assistants take vitals, check blood glucose levels and do EKGs. They do not draw labs. They can empty foleys, JP drains, etc. They can remove foleys and peripheral IVs, but not place them. They cannot titrate oxygen or touch the IV pumps. They assist with feeding, toileting, ambulation, repositioning and other ADLs.

Thank you for the response. So pretty much in line with the UK apart from in some senior roles they can draw labs, place peripheral IV lines and foleys. IV pumps are a no go area for obvious reasons however in a lot of facilities you will find that they will stop an IV and disconnect it if required for a patients basic care needs but they should not restart it. You find a lot of the time they have done so though. Lines have become blurred over recent years!

In Northern Ireland not so much in line with the rest of the UK. The role seems to be very very basic.

[Bri1231, BSN, RN]

1 hour ago, Jedrnurse said:

Much of the variance in duties depends on facility policy, not the government agency overseeing CNA certification. That being said, facility policy may not violate the Nursing Practice Act of whatever state we're talking about...

Thank you. The UK on a whole is like this, it depends on the facility or even the actual unit and, the actual NA. Oh and don't forget the staffing levels. One day I can delegate something to a NA and the very next day on the same unit someone will say sorry, not allowed to do that.

[Jedrnurse, BSN, RN]

12 minutes ago, Bri1231 said:

Thank you. The UK on a whole is like this, it depends on the facility or even the actual unit and, the actual NA. Oh and don't forget the staffing levels. One day I can delegate something to a NA and the very next day on the same unit someone will say sorry, not allowed to do that.

Ah. Fluid, situational, verbal-only policies. I hate those...

[Bri1231, BSN, RN]

12 minutes ago, Jedrnurse said:

Ah. Fluid, situational, verbal-only policies. I hate those...

They are the worst! One day anything goes and the next, totally different rules.

[Swellz]

I have worked in a few different hospitals in the US. It varies by hospital, floor, and whether the ancillary staff is a CNA (certified nurse assistant) vs a PCT (patient care technician).

Where I work now, they get VS, accucheks, perform ADLs, place foleys/straight cath, but don't do labs or EKGs (we have separate staff for these tasks). All ancillary staff have the same role.

Where I first started working, CNAs could not draw labs or do EKGs, but PCTs were allowed to; PCTs could also pull foleys and do trache care/suctioning with additional training, but it was uncommon.

[Golden_RN, MSN]

The answer may vary hospital to hospital. Hospitals do not have to use actual certified CNAs for their assistant/patient care tech/whatever they call them. They can train these people to do more than just vitals/ADLs - EKG, BG & blood draws, for instance.

If the job title is actually "Certified Nursing Assistant," that is most likely in long term care (not hospital), and the job duties do not involve anything invasive - no BG check, no blood draws. The CNA certifications are given out by each state. CNAs mostly stick to vitals and ADLs.

[Zippy83]

In my state in the US there are state guidelines that facilities have to follow.

CNAs can only do non-invasive care, ADLs, range of motion, vitals. They can empty a catheter drainage bag but can’t do anything else with a Foley. Definitely no BG checks or blood draw. Even LVNs here need an additional cert to draw blood or touch an IV.

They can definitely monitor and report changes on their patients, such as signs of skin breakdown, measuring intake and output, etc.

[VivaLasViejas, ASN, RN]

Where I live, there are two classifications of nursing assistants--CNA, and CNA 2. The CNA usually works in LTC and only does VS, ADLs and simple treatments like butt paste and TED hose. There are a few CNA 2's in nursing homes who can do ostomy care and FSBS, but mostly they work in hospitals where they can D/C Foleys and peripheral IVs and do straight caths in addition to fingersticks and of course, ADLs. I was the equivalent of a CNA 2 during nursing school and learned a lot from my experiences in the hospital that helped me a great deal when I became an RN.

[Bri1231, BSN, RN]

Thank you all for the replies. Appreciate it. They have NA one and two here as well but it never works out very well as you might have a NA1 who can do everything then a NA2 who has been hired as a 2 but.....has not completed the training and got lost along the way so the NA1 who was a NA2 somewhere else could only be hired as a 1 because of budget and then they decide lets hire some 2s, in they come and then some train up fast others do not. I always scratch my head at this scenario.