PCTs scope of practice in Texas . . .

[Queen Tiye, CNA]

hello,

i'm wondering if pcts perform any of these duties at our hospitals here in texas. please give your input, so far i've heard from to baylor employees that they don't.

"clinical job duties of the patient care assistant may include: discontinuation of iv's, clean and irrigate lacerations set up rapid infusor, heptafiler setup. answer phones locate equipment and transport non critical patients and assist with critical patients. foley catheters dressing changes and feed patients assist with comfort measures / safety measures. attend to the psyche patients and escort patients to treatment areas, clean rooms, collect specimens, chest tube setups relieve mr's, clinitech documentation and collection change sharp boxes and o2. decontamination procedures ekg's, assist with o2 delivery clean instruments and post-mortem care. copy charts for admissions splint assistance, suction, crutch walking instructions and adjustments take vital signs and assist with pelvic exams perform phlebotomy.

the pct provides basic nursing care on assigned patients as delegated by the rn ,lvn or lpn and completes other duties as required."

[Mashira]

all answers based on my own experience, and not definite, just what i have seen.

"clinical job duties of the patient care assistant may include: discontinuation of iv's yes

clean and irrigate lacerations no, requires nursing assessment and skills

set up rapid infusor, heptafiler setup. honestly not sure

answer phones locate equipment and transport non critical patients and assist with critical patients yes

foley catheters dressing changes no! sterile procedure.

and feed patients assist with comfort measures / safety measures. yes

attend to the psyche patients and escort patients to treatment areas, clean rooms, yes

collect specimens, chest tube setups relieve mr's, no

clinitech documentation and collection change sharp boxes and o2. yes

decontamination procedures yes

ekg's, doing what with ekg's? or is this together with decontamination?

assist with o2 delivery i don't see where there would be need for assistance. however, you can, in theory 'assist', however you cannot administer it yourself.

clean instruments yes

and post-mortem care. i've never seen this. the rn/lvn has always done this when it has happened.

copy charts for admissions yes

splint assistance, yes

suction, no!

crutch walking instructions no! teaching is a nursing responsibility. you can reinforce teaching, but you cannot do the initial teaching.

and adjustments take vital signs and assist with pelvic exams yes

perform phlebotomy. omg no!! where on earth is this place?! are you licenced? is there a pct training program in place? are there different levels of pct i don't know about? if not, no no no!

the pct provides basic nursing care no, that's what the nurse does.

on assigned patients as delegated by the rn ,lvn or lpn and completes other duties as required."

i would seriously question this institution, if not report them if/when i saw a uap doing half of these things.

[classicdame, MSN, EdD]

non-licensed personnel do not have a scope of practice. That is why they have to work under a licensed person's supervision. Unlicensed assistive personnel are certified through the Department of Health.

[Queen Tiye, CNA]

thank you for you replies. in the pct forum, there are several who perform all of these tasks . . . i was wondering where i would be able to also . . . in texas . . . perhaps i should ask them in what department.

many of the pcts on this site have phlebotomy certification.

[classicdame, MSN, EdD]

The State department of health would be your source, not other PCT's. Not everyone is aware of rules affecting them and you might get bad information. It is my understanding that patient care techs are trained by their employer while CNA's are certified thru the health dept. This might affect job mobility. But I am not certain about that statement so go to the source:

try www.DADS.state.tx.us for more information.

[all4ofus, ASN, RN]

At my hospital, there are two levels of PCA. If you are at level I, you can take vital signs and do basic patient care (bath, feed, etc.). You can apply a nasal cannuli if someone is supposed to be on O2 but took it off. You can do mouth suction if someone needs it, but you can't do any other kind of suctioning like nasopharynx or trach suctioning. You can get certain urine samples and poo samples. If you are at a level II, you can take out Foleys and IV's and do blood draws. We don't see chest tubes or EKGs or critical patients on my unit, so I'm not sure about those. You do help transfer patients between units or to radiology, etc., and you do have to decontaminate the areas that your patient spills bodily fluids, and always decontaminate the shower room between patients. You do change sharp boxes. You don't do dressing changes.

[Queen Tiye, CNA]

all answers based on my own experience, and not definite, just what i have seen.

"clinical job duties of the patient care assistant may include: discontinuation of iv's yes

clean and irrigate lacerations no, requires nursing assessment and skills

set up rapid infusor, heptafiler setup. honestly not sure

answer phones locate equipment and transport non critical patients and assist with critical patients yes

foley catheters dressing changes no! sterile procedure.

and feed patients assist with comfort measures / safety measures. yes

attend to the psyche patients and escort patients to treatment areas, clean rooms, yes

collect specimens, chest tube setups relieve mr's, no

clinitech documentation and collection change sharp boxes and o2. yes

decontamination procedures yes

ekg's, doing what with ekg's? or is this together with decontamination?

assist with o2 delivery i don't see where there would be need for assistance. however, you can, in theory 'assist', however you cannot administer it yourself.

clean instruments yes

and post-mortem care. i've never seen this. the rn/lvn has always done this when it has happened.

copy charts for admissions yes

splint assistance, yes

suction, no!

crutch walking instructions no! teaching is a nursing responsibility. you can reinforce teaching, but you cannot do the initial teaching.

and adjustments take vital signs and assist with pelvic exams yes

perform phlebotomy. omg no!! where on earth is this place?! are you licenced? is there a pct training program in place? are there different levels of pct i don't know about? if not, no no no!

the pct provides basic nursing care no, that's what the nurse does.

on assigned patients as delegated by the rn ,lvn or lpn and completes other duties as required."

i would seriously question this institution, if not report them if/when i saw a uap doing half of these things.

thanks for taking the time to respond in such detail mashira.

"doing what with ekg's? or is this together with decontamination?"

not exactly sure but this ekg education is part of what differentiates a pct from a cna.

" i've never seen this. the rn/lvn has always done this when it has happened."

i've read several posts on the cna forum here that cnaa often perform post mortem care, i.e: bathing, making the deceased presentable to be viewed by family, handling seapage, removing jewelry, gathering belongings, etc. my cna book also explains how we should perform post mortem care if it will be required of us in our future facilities.

"no!" regarding suctioning, i've also read posts by pct's who were taught at their hospitals to do this.

"omg no!! where on earth is this place?! are you licenced? is there a pct training program in place? are there different levels of pct i don't know about? if not, no no no!"

there are phlebotomy courses offered, i'm excited about enrolling in one that is 150 hours of instruction.

"no, that's what the nurse does."

regarding basic nursing care, as student cnas, we are taught to assist nurses in providing basic care for patients, working under the supervision of nurses. vitals, keeping patients clean and comfortable, toileting, recording input and output, taking specimens, supporting patients in fulfilling their physical and psychosocial needs, building self-esteem, providing restoritive care, encouraging activity and assisting with exercise, encouraging family participation in care, guarantee of patient safety and more. . . . i don't know enough about pcts to speak on the level of care they provide.

more replies are most welcome.

[Queen Tiye, CNA]

thanks classicdame . . . i'll check it out.

thank you all4ofus . . . that gives me better understanding.

[TJobs]

I worked as a PCT for over a year in a hospital in North Texas and I did all of those things regularly except setting up a heptafilter and crutch teaching.

[Miss Kisha]

I don't want to be a stinker but here it goes, if we want to be compliant with the lisc orgs that keep hospitals open, follow the nurse practice act. Too many folks forget to protect their liscence and delegate when we shouldn't. CYA

[Queen Tiye, CNA]

tjobs, are there positions for pcts or cnas in trauma units?

[General E. Speaking, RN, RN]

Our floor techs help with baths/ADLs, etc. The ER techs start IVs, draw blood, put in Foleys. I think maybe there were EMTs before being techs in ER? Not sure