Communication, Legal, and Ethical Responsibilities
Rights and scope
Know resident rights: dignity, privacy, confidentiality, choice, consent, access to records, freedom from abuse and restraints, and the right to refuse care. CNAs do not give medications, obtain informed consent, or make medical decisions. Follow the chain of command and the care plan. Protect confidentiality: do not discuss residents in halls, elevators, or online.
Reporting and documentation
Abuse, neglect, and misappropriation of property are mandatory reports. Report immediately to the charge nurse and follow facility policy; do not investigate on your own. Document objectively: what you saw, heard, did, and reported-not opinions like 'the resident was rude.' Use exact quotes when possible. Do not erase or alter records. Incident reports are not placed in the medical record.
Ethics and traps
Apply autonomy, beneficence, nonmaleficence, justice, veracity, and fidelity. Traps include promising secrecy, giving personal advice, signing as a witness when not authorized, or accepting gifts that could influence care. Worked example: a resident says, 'Don't tell anyone I fell.' You must report the fall; say, 'I can't keep that secret because I need to keep you safe.' Rule of thumb: when in doubt, report and ask-never guess outside your scope.