Legal and Ethical Considerations for Nurse Aides
What you must understand
A nurse aide works under a licensed nurse's delegation and within state scope of practice. You may not perform skills you were not trained and authorized to do, and you cannot delegate nursing tasks to another aide. If you are asked to do something outside your training, say so and ask the nurse.
The seven categories of abuse are physical, sexual, verbal, emotional or mental, financial exploitation, neglect, and involuntary seclusion; misappropriation of resident property is often grouped with them. Abuse also includes rough handling, threats, and humiliation. Every state requires reporting: tell your supervisor immediately and follow facility and Nebraska reporting procedures. Failure to report is itself a violation, and retaliation against a reporter is prohibited. Never investigate on your own, and never promise to keep abuse secret.
Other legal concepts to know: negligence is failing to provide the standard of care; assault is a threat, battery is unwanted touching; false imprisonment is restraining someone's movement; defamation is damaging someone's reputation; invasion of privacy includes sharing health information (HIPAA). Informed consent belongs to the resident or their legal representative. Advance directives, living wills, and DNR orders are followed exactly - a DNR means do not start CPR.
Traps the exam sets
- Charting care a coworker said they performed but you did not do - falsification.
- Accepting money, gifts, or a bequest from a resident.
- Discussing a resident with friends or on social media.
- "Keep it between us" after a resident discloses abuse.
- Doing a task because you saw someone else do it, without authorization.
Rule of thumb
If you did not see it, do it, or hear it directly, you do not chart it. Worked example: a coworker asks you to sign off a shower you did not give. You decline and tell the nurse; the coworker must document their own care.