STNA assessing lung sounds?

[Denali_25]

The Scene: You walk into your patient's room/home. After chatting for a bit you pull out your stethoscope and begin to listen to your patient's lungs. Your patient then tells you that her STNA previously informed her that her lung sounds are clear. You ask her how the STNA knew this? Patient tells you that the STNA used her stethoscope to assess the patient before telling the patient that her lungs sound good.

Your Reaction: ???

[Pangea Reunited, ASN, RN]

She didn't say that she refused to let the RN listen, just that the patient said that the STNA/nursing assistant (some states use "state tested nursing assistant" instead of CNA) listened.

OK, then I'd modify it to: "Hey, when I started to assess lung sounds on the patient in 206, she said you had already assessed her lung sounds ...what's up?".

[applesxoranges, BSN, RN]

That's better. I would also point out that she shouldn't be telling them their lungs sound good either.

[I.C.UNurse]

Why does it matter? She can't assess and shouldn't be but in the end it's you that makes the assessment and intervene when needed. I think there is bigger things us nurses have to worry about and fight for than stuff like this. If the STNA continues to do stuff outside scope of practice then they will lose their certificate it's just a matter of time.

[Denali_25]

Thanks for everyone's feedback.

[Here.I.Stand, BSN, RN]

Why does it matter? She can't assess and shouldn't be but in the end it's you that makes the assessment and intervene when needed. I think there is bigger things us nurses have to worry about and fight for than stuff like this. If the STNA continues to do stuff outside scope of practice then they will lose their certificate it's just a matter of time.

Well it undermines the care team as a whole. Pt's lungs actually don't sound good so now the pt has gotten two conflicting reports, and to explain it the RN has to tell the pt that the STNA acted outside of her scope of practice. What does that say to the pt about the hospital in general, if members of the care team are seemingly allowed to act outside their scope?

Also, she* could land in some hot water if she assesses the wrong pt...say, an RN or MD who know that STNAs' scopes do not include nursing/physical assessments.

*ETA: Initially I said "she" referring to the STNA. But after thinking about it, it could look to someone like the RN delegated an inappropriate task.