Legal and Ethical Aspects and Role of the Nurse Aide
Legal questions test scope of practice - the line between what you may do and what you must hand to the nurse.
Core concepts
- Scope: a CNA provides basic nursing care and observation under a nurse's supervision. You do not assess, diagnose, teach, perform sterile procedures, or obtain informed consent. Medication administration is limited to what the state nurse aide act and facility policy specifically permit. When a task is outside your training, say so and report it.
- Chain of command: charge nurse first, then the supervisor, then the administrator. Never bypass the nurse to take a complaint to the physician.
- Legal terms: negligence (failing to meet the standard of care), malpractice, assault (a threat), battery (unwanted touching), false imprisonment (confining without justification), defamation, invasion of privacy, and abuse, neglect, and misappropriation of property.
- Advance directives and DNR: honor them per policy and the care plan; never begin CPR on a resident with a valid DNR order confirmed by the nurse.
- Ethics: honesty, integrity, confidentiality, respect, and accountability. Report your own errors immediately - never cover up, falsify a record, or chart care that was not given.
Traps
"Fix the mistake before anyone notices," "chart it later from memory," and "ask the family whether the resident wants CPR" are all wrong. Accepting money or gifts from residents, or discussing them off the clock, can constitute exploitation or a privacy violation.
Rule of thumb
When in doubt, ask the nurse - and report every error the moment it happens.
Worked example
You served a resident the wrong meal tray. Correct: check the resident for harm, notify the nurse immediately, document objectively, and complete an incident report per policy. You do not describe the incident report in the chart or blame the dietary aide.