PCA / PCT Scope of Practice

U.S.A. Tennessee

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Anyone that has worked in any part of the nation outside of Tennessee has experience a type of care that is somewhat advanced and is generally being considered "normal." Some of us have experienced the phenominon of Patient Care Assistants and Patient Care Techs. Now, I know several facilities in Tennessee use these position titles, but they really don't use PCAs / PCTs to the extent that other states do. In some states, Ohio for example, PCAs are almost exactly CNAs with a different title. PCTs have a slightly higher level of training and responsibility that are provided by their respective hospitals as part of their orientation and competency checklists. Some of these tasks include: chemsticks, discontinuing IVs and foley catheters, clean and minor sterile dressing changes, trach care, and the list goes on.

Through a position description review at my facility and having called the state office that issues state certifications for NAs, I was dishearted at the lack of structure and forward thinking in our state.

We have no state standard or scope of practice for CNAs in Tennessee. Tennessee follows the federal guidelines for CNAs as it relates to their practice in nursing homes. Contrast that with the Colorado State Board of Nursing website that has an entire section devoted to CNA scope of practice, policy and the like.

As we continue down the road of this nursing shortage, our CNAs (PCTs or PCAs) can be some of our greatest non-licensed allies in providing exceptional care. While there are a great many things that you cannot substitute a RN's training for, these staff members can help with some of the more mundane tasks.

I believe it would behoove us to look into expanding the role and practice of CNAs in Tennessee to that of PCTs from other states. I'm not exactly sure what it would take for a change like this to come about, but if we need legislation, then let's get it! We need to get Tennessee out of this seemingly 10 year old time warp and catch up with the rest of the modern nation.

Any experiences or thoughts to share about this?

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I think for this to happen would call for a formalized education program and a requirement for certification and continuing education. On the other hand many of the CNAs/PCT/PCAs (or whatever your facility calls them) tend to not be reliable and easily delegated to.

Trach Care is not something I would delegate to a CNA/PCA/PCT. That's your airway.

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I think for this to happen would call for a formalized education program and a requirement for certification and continuing education. On the other hand many of the CNAs/PCT/PCAs (or whatever your facility calls them) tend to not be reliable and easily delegated to.

Trach Care is not something I would delegate to a CNA/PCA/PCT. That's your airway.

This thread may be old but I was looking up this topic and felt I needed to respond.

Yes, trach care is the airway and I do think that a trained PCT could take care of it if the qualifications I have have seem for PCT's are true. While in nursing school, I did trach care first ion the lab and then in the hospital. It was my first semester of clinicals actually.

Also, while I was a CNA/LNA 9 years ago I did home health. I took care of trachs all the time and it was a part of my job description to clean them and make sure there was no infection around the insertion site.

Now, from what I gather, the qualifications for a CPT are at least a semester of clinical if you are a nursing student and if you are a cna then at least 6 months to a year of working as a cna.

With this in mind, I have to say that it would be OK to do trach care if you were a PCT. :twocents:

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I agree that Tennessee is certainly in a 10 year timewarp. I have been a RN for over 30 years, and remember when nursing aides (that is what they use to be called) did actually do simple dressing changes, BS, insert foleys, remove IVs, etc. Let's give credit to the CNAs that are capable of performing certain tasks after demonstrating competency. There are some CNAs that I would trust with certain tasks, and some that I would never trust to do the job right. I work with a few techs that have been doing the same job for years, and should be doing more than they are doing now. They would demonstrate competency without any difficulty. They are great at what they do, and extending their scope of practice would make them even better. I worked in Georgia for years where they do utilize their PCTs and PCAs--there is a difference in a PCT and a PCA--to lighten the load of the nurse. Tennessee needs to catch up with the rest of the nation. You know, nurses are not the only ones with BRAINS--techs have brains, too!!!!

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NCMC3132: I dont think the problem is with trust that some could perform the task, I think its with the consistency of the CNAs out there. There is no formal education that is given to support the safety of the patients when performing said tasks. I just could not sacrifice patient safety by trusting some tasks to CNAs. I dont care if they have been there 30 years, and they are brilliant, I just couldnt delegate any invasive task due to it being improper. Im all for lessening the load on nurses, but safely doing so. There is NEVER an excuse to sacrifice quality (safety).

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