Legal and Ethical Behavior / Role of the Nurse Aide
Concepts you must understand
Know your scope of practice: you perform tasks delegated by the licensed nurse, and you are accountable for doing them correctly and reporting. You may not assess, teach about medications, adjust oxygen, change sterile dressings, or perform any task you have not been trained and delegated to do. If asked to do something outside your scope, or something unsafe, say so and report it through the chain of command.
Abuse and neglect are mandatory reporting issues: physical, sexual, verbal or emotional, financial, neglect, involuntary seclusion, and misappropriation of property. Report to the nurse and follow facility policy - never investigate on your own and never promise to keep it secret.
Documentation must be objective, factual, timely, and complete. Chart only care you personally provided. Quote the resident ("Resident stated, 'My stomach hurts'") rather than labeling ("Resident is being difficult"). Errors are corrected with a single line, the correction, your initials, and the date - never erased or written over.
Confidentiality applies to all health information, including confirming whether someone is a resident. Advance directives and DNR orders are followed per facility policy; if a resident with a DNR stops breathing, you call for the nurse rather than starting CPR.
Traps in questions
Answers that have the aide perform nursing tasks, give personal legal or financial advice, witness a will, discuss a resident with a neighbor, hide a mistake, or chart for a coworker.
Rule of thumb
If it isn't delegated, trained, and safe - don't do it; report it.
Worked example: A resident asks you to sign as a witness on a will. The correct response is to politely decline, explain that this is outside your role, and refer the resident to the nurse or social worker.