What can a RN delegate to a CNA?

DusktilDawn · May 19, 2006

Not to play devil's advocate here: but aren't accuchecks assessing? For the record- I was an STNA in Ohio for 10 years before I became an LPN. My comment is in no way a slam to anyone.

Actually all aspects of care could be seen from an assessment perspective.

VS and blood glucose would be considered "data collection" with the nurse assessing and interpreting the results. Same with toileting and feeding (I & O). Are we not relying on NA to assess when performing bathing/hygiene, oral care, and ambulation? Actually we are, so in essence I don't think it is accurate to say that all assessments are left entirely up to the nurses and that anything involving assessment cannot be done by an NA. For instance, they know to recognize the signs of skin breakdown and to report that, is that not an assessment on their part?

Bala Shark · May 19, 2006

I think it is better if CNAs are already assigned duties so that is what they have to do during the whole day ..I always hate to ask for their cooperation in helping me have an extra hand..Some dont help, some do help..I think they should be assigned bed baths, vital signs, poop, etc and that is their duty to do for their patients..

tookewlandy · May 19, 2006

I just finished my first year of the ASN program and I just finished an interview today for a pt care tech job at the hospital affiliated with my school. I decided that I was going to work as an aid so i can better understand the scope of nursing. But, at the hospital, they like to have student nurses, but you don't have to be certified as a CNA to work there. Yet, at nursing homes in the area, you do have to be. So, even though I've been in school for a year, I had to go and take that stupid test that cost $100 dollars to take so i could work as a CNA since I wasn't getting interviews at the hospital. AND I DIDN'T EVEN PASS THE FIRST TIME! I had to take the CNA test twice. They don't go over CNA skills very well in the first semester of nursing because we're not going to school to be CNA's, and really I had more experience the other people there taking that stupid test. Anyhoo, I thought an interesting note to put on here, was that some nursing schools require you to be a CNA before admit into the program. I personally think that it will be a very good experience to be a CNA before a RN. I will get to see and I know that the nurses will trust me to be involved in more things because I am a nursing student and they know i will be a RN in a year.

You said that in nursing school they do not teach you the CNA skills very well, but then you said that you had more experience then the people who were also there with you to take the CNA certification exam. If they were in CNA training programs then you don't have more experience than them in the CNA training aspect, you said it your self they did not teach you that many CNA skills at your NS. Really if you went to take the test with people who had gotten trained at a CNA program them you did not have more experienced skills than the others maybe the same but no more since you did not go into it that much and thats what the test tests CNA knowledge and sklls.

RNOTODAY, BSN, RN · May 19, 2006

I remember, when reviewing for NCLEX, we were told that delagating VS to an aid would be wrong, because it IS actually assessing, even though we see it done every day and it probably will always be done that way. We were all so surprised by that one... and sure enough, it was a question on the NCLEX, for me anyway........ We were always told that real life nursing is not NCLEX nursing.... lol

daisey_may · May 19, 2006

You said that in nursing school they do not teach you the CNA skills very well, but then you said that you had more experience then the people who were also there with you to take the CNA certification exam. If they were in CNA training programs then you don't have more experience than them in the CNA training aspect, you said it your self they did not teach you that many CNA skills at your NS. Really if you went to take the test with people who had gotten trained at a CNA program them you did not have more experienced skills than the others maybe the same but no more since you did not go into it that much and thats what the test tests CNA knowledge and sklls.

True, but I didn't mean more experience as CNA skills. I meant that I have been taught to assess, to do ng tubes, foleys, IVs, drains, etc. and I meant that as more experience. I have done bed baths and transfers, but I had never done ROM exercises or feeding a pt. before that test.

RN and Mommy · May 19, 2006

I remember, when reviewing for NCLEX, we were told that delagating VS to an aid would be wrong, because it IS actually assessing, even though we see it done every day and it probably will always be done that way. We were all so surprised by that one... and sure enough, it was a question on the NCLEX, for me anyway........ We were always told that real life nursing is not NCLEX nursing.... lol

That's strange because I see taking VS as data collection, then giving that information to the RN to assess the information given. If the CNA also told the nurse that the pulse is "irregular" or whatever that would be the RN's job to assess that situation as well. But then again...they didn't ask my opinion when writing the NCLEX!:)

Jo Dirt · May 20, 2006

Wow tweety! I want to work where you are. The CNA's here can't even do fingersticks!

It sounds like Tweety is describing chores that would be delegated to LPN's. Here in Tennessee, CNA's are not supposed to do accuchecks and are not supposed to even touch IV's, let alone D/C them.

Basically, CNA's provide assistance with ADL's and take VS here in Tennessee. Some facilities are doing the med tech thing, but this is a scene I would avoid.

PANurseRN1 · May 20, 2006

I would never let a CNA d/c an IV. How am I supposed to document that the cathlon was intact (or not) and that the site was healthy (or not)?

As far as aides who want more responsibility, it's quite simple: go back to school. Aides are essential in keeping a unit running smoothly, but teaching aides to do skills that should clearly be done by a licensed nurse is not the answer to the shortage of nurses.

hersunflower · Oct 25, 2006

I worked as CNA for about 7 years but left to join the army. I am ready to go back to school for LPN. This means I will probably have to work as CNA again to support myself and my son. But when I did worked as a CNA I loved every bit of it except for the fact when they begged for relief when they were in pain and or dying and I new I could not do anything for them other than to try to make them feel as comfortable as possible. Til this day I think about those dying patients.

Tweety, BSN, RN · Oct 25, 2006

It sounds like Tweety is describing chores that would be delegated to LPN's. Here in Tennessee, CNA's are not supposed to do accuchecks and are not supposed to even touch IV's, let alone D/C them.
Basically, CNA's provide assistance with ADL's and take VS here in Tennessee. Some facilities are doing the med tech thing, but this is a scene I would avoid.

It's interesting they don't let techs do an accucheck but will train them to pass meds?? :lol2:

banditrn · Oct 26, 2006

Where I've worked in Iowa, the CNA's didn't do foleys or accuchecks. When I was in the hospital in Illinois, they did my accucheck.

In the LTC where I work, they can do colostomy care, and empty foleys, and do VS. I don't require the CNA on my shift to do vitals, because she is the only aide at nite for 35 to 40 patients, and she has enough to do trying to keep them all dry.

pagandeva2000, LPN · Oct 26, 2006

So, what can a RN delegate to a CNA? ;) ;) ;) ;)

You have to look at the job descriptions of your respective facility to know what you can delegate them to do.