Role of the Nurse Aide and Care Coordination
What you must understand
A nurse aide practices under the license and supervision of a registered nurse or practical nurse. You carry out delegated tasks and personal care; the nurse assesses, judges, teaches, medicates, and plans. Tasks outside your scope include sterile procedures, administering medications, resident teaching, accepting verbal or telephone orders, deciding to change the care plan, and any procedure you were not trained and checked off to perform.
The nurse delegates to you. You delegate to no one. If you are asked to do something you were not trained for or that is unsafe, ask for clarification and, if it is still unsafe, decline professionally and report it up the chain of command: charge nurse, then director of nursing, then administrator.
Know your tools: the care plan, the assignment sheet, flow sheets, and incident reports. Incident reports record facts about any event that harmed or could have harmed a resident - a fall, a medication error, a skin tear - and exist for quality improvement rather than punishment. They are generally not part of the medical record; follow your facility's policy on what goes in the chart.
Professional obligations
Arrive on time, know your assignment, ask questions, protect confidentiality, stay within your training, and keep your skills current. Every state, including Michigan, maintains a nurse aide registry with competency evaluation and requires continuing education hours each year to stay active.
Traps
Saying yes to a task you cannot safely perform to be a "team player." Charting someone else's observations. Telling a resident what the doctor said. Discussing an incident report's contents with coworkers.
Rule of thumb
Do what is delegated, report what you observe, and ask when you do not know - the license for assessment and judgment belongs to the nurse, not to you.