A Family Request Outside the Aide's Role
Mrs. P is 70 and has type 2 diabetes. Her daughter brings a bottle of herbal capsules and says, 'The nurse is busy-just give these with breakfast; they lower sugar.' Breakfast tray is at bedside, and the resident's pre-meal blood glucose is 210 mg/dL. You are a CNA and have not been trained to give medications or supplements. Later, you see another aide leave a room after emptying a urinary catheter bag and go directly to the dining room without washing her hands.
1. How do you respond to the daughter's request?
Read the worked answer
Do not give the capsules.
- Say plainly: 'I'm not able to give any medication or supplement. That has to go through the nurse.'
- Do not open, mix, or place the capsules on the tray. Do not accept them into your pocket or keep them for later.
- Notify the nurse now that the daughter brought an herbal supplement and asked you to give it with breakfast.
- Tell the nurse the pre-meal glucose is 210 mg/dL and that breakfast is at the bedside.
- Document the request, your response, and that the supplement was not given.
Reasoning: Herbal products can interact with diabetes medicines and are not automatically safe because they are 'natural.' A CNA's scope does not include administering medications, supplements, or deciding whether they are appropriate.
2. What should you do about the coworker's hand hygiene?
Read the worked answer
Hand hygiene is not optional, even when the coworker is a peer.
- If it is safe, speak directly and privately: 'I saw you come from emptying the catheter bag and go to the dining room without washing. Please wash before you serve or touch anything else.'
- If you are not comfortable or the coworker dismisses it, report to the charge nurse or nurse manager right away.
- Do not ignore it because the dining room is a high-risk area for spreading germs.
- Wash your own hands and clean your stethoscope or equipment as needed.
Reasoning: Catheter bag contents are contaminated. The CNA's duty is to protect residents; reporting poor infection control is part of that duty, not tattling.
3. What is the CNA's role in reporting and follow-up?
Read the worked answer
Use the chain of command and keep the report factual.
- Report the supplement request to the nurse immediately; if the nurse is unavailable, go to the charge nurse.
- Report the hand hygiene breach to the charge nurse; if nothing changes and residents are at risk, follow facility policy for further reporting.
- Document only what you saw and did: time, what the daughter asked, what you said, who was notified; and the coworker's action without speculation about intent.
- Never give the supplement, and never chart that it was given.
Reasoning: The CNA is a mandated reporter for unsafe care within the facility's system. Prompt, factual reporting protects residents and keeps the aide within scope.