Role of the Nurse Aide
Scope and chain of command
The nurse aide works under the direction of a licensed nurse. Know your job description and your state's rules: you may perform personal care, ambulation, feeding, vital signs, and basic documentation as taught and delegated. You may not assess, diagnose, give medications, insert tubes or catheters, perform sterile procedures, or change care plans. When unsure, ask the nurse-never guess or take a shortcut.
Delegation and reporting
Delegation flows from RN or LPN to aide. Accept a task only if it is within your training and you have been shown how to do it in that setting. Report changes in condition promptly and factually: what you saw, when, and what you did. Document objectively-'skin reddened over left heel'-not 'resident is fine' or 'probably a bedsore.'
Legal and ethical duties
Protect confidentiality under HIPAA: share information only with the care team. Follow the resident's rights, advance directives, and facility policies. Report abuse, neglect, and misappropriation of property immediately. Know that the nurse aide registry records findings of abuse or neglect. Keep skills current with continuing education and in-service training.
Traps
Test items often tempt you to answer a resident's medical question, accept a task you were not trained for, or document opinions. Another trap is discussing a resident with a friend or on social media.
Worked rule
A resident asks, 'What is this new pill for?' You say, 'I do not give medications, but I will ask your nurse to come explain it.' Refer, do not guess.