Role of the Nurse Aide
Core concepts
The nurse aide works under the supervision of a licensed nurse (RN or LPN) and follows the facility job description and the state nurse practice act. Know the chain of command: report to the charge nurse or supervisor, and know how to escalate unsafe situations. Scope-of-practice limits matter: CNAs observe and report; they do not assess, diagnose, teach, give medications, or delegate nursing tasks. Delegation flows from the nurse to the aide; if asked to perform something you were not trained for, ask the nurse. Documentation must be timely, objective, factual, and legible-record what you saw, did, and reported, not opinions or diagnoses. Correct errors per facility policy; never erase, alter, or chart for someone else. Confidentiality is legal and ethical: share information only with the care team on a need-to-know basis. Mandatory reporting covers abuse, neglect, and exploitation. Professionalism includes punctuality, proper uniform, teamwork, continuing education, and managing stress without taking it out on residents.
Traps
Questions often blur reporting and deciding. 'The resident's condition changes' means notify the nurse, not adjust treatment. Incident reports document facts for the facility-they are not punishment and are generally not placed in the medical chart. Never accept money or gifts, and never keep a secret that involves harm. Do not perform tasks outside your training even if a coworker says it is fine.
Worked example
A resident reports chest pain. Stay with the resident, call the nurse immediately, and follow instructions; do not tell the resident it is 'just gas' or give anything by mouth unless directed.
Rule of thumb
Observe, report, document-do not assess or decide.