What are you allowed to do?

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I am a CNA in WV and we are extremely limited in our scope of practice. Resident needs Z-guard, call the nurse or risk the legal consequences. I can change your brief, but you'll have to wait 10 mins for the nurse who has 29 other residents, med pass, and paperwork to come put what amounts to grown up desitin on your butt. So what are you allowed to do by your state? I can do adl's, and vitals. Everything else is off limits.

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I can take vitals, do ADLs, transfer with lifts, drain Foley's and colostomy bags, administer enemas, remove and replace ACE wraps, apply most over the counter creams and ointments, start telemetry, collect UA, stool, and sputum specimens, replace disposable colostomy bags, perform colostomy care and Foley care, cover IV sites, and perform CPR. I can also apply and remove TED hose. I also set up O2 equipment like cannulas and extension tubing. There are other things, I'm sure but those are what I can think of currently.

I live in Kansas and work in a hospital.

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It's really going to vary. As a Cna in ltc I could do vitals, adls, ambulation, charting, emptying foleys, changing briefs and applying creams. As a pca in the hospital all of that plus d/c ivs and foleys. Applying telemetry devices, and Bg checks. As a nurse extern all of the above plus insertion of foleys or I/O caths, ng tubes, IVs.

Youll find it really varies on where you are and the administration

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Specializes in ICU Stepdown.

As a CNA in LTC in MN I could do ADLs, ambulate, empty foleys, replace butterflies, check and document I&O, apply cavilon and moisture barrier cream, do vitals, chart, put on TED and compression socks andddd not much else.

As an ED tech in a hospital I can do EKGs, vitals, cardiac monitoring, apply splints and dressings, draw blood, chart, assist with pelvic and rectal exams, assign patients to rooms, transport to other departments, check patients in, support with triage and other things I can't think of.

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Specializes in Long term care.

We can not do anything regarding oxygen beyond putting the tubing to their nose. Cannot turn it on or off.

We can apply any over the counter creams. We are trained in CPR and first aid and the state allows us to do it but the facility (LTC) does not allow us to perform CPR or provide any first aid.

We can change colostomy bags but, again, our facility requires that we be signed off by the RN before we are allowed to do it.

We are also trained in range of motion and walking with a resident (outside of their room), but our facility also does not allow us to do these things without specific training by them.

In home care and assisted living we are allowed and expected to do more things while in a LTC we, as CNA's, are more restricted.

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Specializes in ICU Stepdown.
We can not do anything regarding oxygen beyond putting the tubing to their nose. Cannot turn it on or off.

Oh yeah, that's something I've been able to do in LTC and the hospital.

We can turn them on and off. In LTC we were to keep it at 1 but could set it to 2 based off judgement. In the hospital I just ask what the patient usually has it set on and if they don't usually have oxygen I ask the nurse.

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When I was a CNA at a long term facility I was only able to assist with ADLs, no vitals or anything. When I worked as a nursing assistant in the PACU I was able to obtain a patient's blood glucose, get vitals, obtain specimens, get the meds sent from the pharmacy and give them to the nurses, etc. Now I am a nurse and the CNA's I work with aren't allowed to do vitals but they can put the prescription creams and powders on patients.

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I can take vitals, do ADLs, transfer with lifts, drain Foley's and colostomy bags, administer enemas, remove and replace ACE wraps, apply most over the counter creams and ointments, start telemetry, collect UA, stool, and sputum specimens, replace disposable colostomy bags, perform colostomy care and Foley care, cover IV sites, and perform CPR. I can also apply and remove TED hose. I also set up O2 equipment like cannulas and extension tubing. There are other things, I'm sure but those are what I can think of currently.

I live in Kansas and work in a hospital.

This.

Also blood glucose check, removal of IV. Once upon a time, we could insert Foley catheter at my hospital.

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Im a little curious why the cnas can't do vitals.

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Specializes in ICU Stepdown.
Im a little curious why the cnas can't do vitals.

I'm guessing their facilities prefer the nurses to do it so that it's their responsibility to get accurate numbers.

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I can take vitals, do ADLs, transfer with lifts, drain Foley's and colostomy bags, administer enemas, remove and replace ACE wraps, apply most over the counter creams and ointments, start telemetry, collect UA, stool, and sputum specimens, replace disposable colostomy bags, perform colostomy care and Foley care, cover IV sites, and perform CPR. I can also apply and remove TED hose. I also set up O2 equipment like cannulas and extension tubing. There are other things, I'm sure but those are what I can think of currently.

I live in Kansas and work in a hospital.

Same as above plus BG checks. I work in Florida. In some cases I've started IV's in the ED and preformed Heel sticks for bilirubin level checks on bili babies.

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.
I am a CNA in WV and we are extremely limited in our scope of practice. Resident needs Z-guard, call the nurse or risk the legal consequences. I can change your brief, but you'll have to wait 10 mins for the nurse who has 29 other residents, med pass, and paperwork to come put what amounts to grown up desitin on your butt. So what are you allowed to do by your state? I can do adl's, and vitals. Everything else is off limits.

In my area, CNAs are very limited in our scope. Regarding barrier creams, such as Desitin, when I worked as a CNA, the nurses left it in a med cup at bedside and we had to put it on when changing briefs.

However, when I went through nursing school, I learned that Desitin, A&D, etc were considered meds and that CNAs weren't supposed to apply them (at least not without an MD order that UAPs could apply them)

I don't know what a Z Gard is....?

Sometimes, CNAs (and nurses) are placed on awkward situations in which facility general policy goes against strict, literal laws/policies.

In those cases, you have to make a decision as to whether this is "the hill you wish to die on", eg are you willing to forgo your employment based on your insistence on following the law, vs the facilities protocols.

This can be complicated! And there's also so much heresay r/t the law and facility procedures. Sometimes, what we think is the law is not. And sometimes, facilities will expect you to break laws to do what they need.

I have very little "advice", except to say that you learn which things are the "law" and which are "company policy in writing".

Then you have to decide what amount of common sense you will use up decide if everyone in your facility does things a certain way that you aren't willing to do.

Best wishes!

#itscomplicated

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