Role of the Nurse Aide
Core concepts
The role section tests scope of practice, delegation, ethical and legal behavior, documentation, reporting, confidentiality, and work habits. A CNA performs tasks that are within state law, facility policy, training, and the care plan. The nurse delegates tasks and remains accountable for nursing care; the CNA reports outcomes and changes. Know the chain of command, incident reporting, abuse and neglect reporting, advance directives, the ombudsman role, HIPAA confidentiality, and the importance of objective documentation. In New Mexico, CNAs must maintain current listing on the state Nurse Aide Registry and follow facility policy.
Traps
A CNA cannot delegate to another CNA, diagnose, prescribe, give medications, perform sterile procedures, or sign as a nurse. Do not chart for someone else, chart before care is given, or write opinions such as “resident is lazy.” Do not promise confidentiality you cannot keep, discuss residents in public, or accept an assignment outside your scope just because someone is busy. Report abuse immediately through facility policy and the required state channels. When a nurse delegates a task, the CNA may accept only if trained and legally permitted, then must report the result.
Worked example
A nurse asks you to change a sterile dressing. You have not been trained and it is outside CNA scope. The right response is to decline politely, explain that it is outside your training and scope, and ask the nurse to perform or reassign it. Refusing an out-of-scope task is professional, not insubordinate.
Rule of thumb
When in doubt, don’t-ask the nurse. Document what you did and what you observed, objectively, as soon as possible.