Role of the Nurse Aide: Scope, Ethics, and Reporting
What this domain tests
This domain covers who you are on the care team: what you may and may not do, to whom you report, how you document, and the legal and ethical rules that protect residents.
Core concepts
- Scope of practice. You perform the tasks in your job description and the care plan. Nursing judgment, assessments, sterile procedures, and medications are outside your role unless you hold an additional credential and are authorized.
- Chain of command. Report to the licensed nurse in charge of your resident's care. Report changes in condition, refusals, injuries, and anything you cannot resolve yourself.
- Abuse, neglect, and misappropriation. Physical, sexual, verbal, and emotional abuse, involuntary seclusion, neglect, and theft of resident property are all reportable. In Washington, nurse aides are mandatory reporters and must report suspected abuse to the nurse and to the state agency promptly.
- Documentation. Chart only what you did and observed, at the time it happened, using objective facts. Never chart in advance, never chart for a coworker, never use correction fluid, and sign and date every entry.
- Resident rights and confidentiality. Knock, protect privacy, share information only with the care team, and never discuss a resident in public areas.
- Ethics. Do not accept gifts, tips, or money from residents or families, and do not become financially involved.
Traps
Watch for answers that have you accept a gift or loan, chart care before performing it, give personal advice, or "handle it yourself" instead of reporting. Another trap is taking a resident's request to a family member before telling the nurse.
Worked example
A resident asks you to give her the "leftover pill" in her drawer because she is in pain. You cannot give medication. You also do not ignore the pain. You refuse kindly, tell the nurse promptly, and comfort the resident while waiting.