Roles, Responsibilities, and Scope of Practice of the Nurse Aide
What you must know
The nurse aide provides direct care delegated by a licensed nurse and works under that nurse's supervision. You perform personal care, vital signs, intake and output, specimen collection, simple treatments permitted by facility policy, ambulation, and observation - and you report what you see. You do not assess, diagnose, plan care, evaluate outcomes, teach residents or families, or administer medications. Those belong to the licensed nurse.
Know the chain of command: aide, then charge nurse, then director of nursing, then administrator. Report changes in condition to the nurse - not to the family, not to the physician, not to other aides.
If you are asked to do something outside your scope, or something for which you have not been trained, say so politely, ask that the nurse perform it or supervise you, and tell your supervisor. Doing it anyway to be helpful is the wrong answer on any exam and unsafe in any building.
Also part of the role: knowing your job description, following the care plan, completing required in-service education, arriving on time, keeping resident information confidential, not accepting gifts or money, never working while impaired, and never performing a task you are not competent to do because the unit is short-staffed.
Traps
- 'The nurse is busy, so she asked you to give Mr. B his pills' - refuse and report.
- 'The family asks you to explain the lab results' - refer them to the nurse.
- Being asked to use equipment or perform a technique you have not been checked off on is a reason to ask, not to improvise.
Worked example
A nurse hands you a tube of ointment and says, 'Put this on room 12's rash.' You have not been trained or checked off. The answer: 'I haven't been trained on that. Can you show me and sign me off, or apply it yourself?' Then tell your supervisor if it is pressed on you.