1. Role of the Nursing Assistant

2. Interdisciplinary Team
A group of professionals from different health care disciplines who each contribute their expertise to the care of a single patient

3. Interdisciplinary Team
Members
Physicians make a diagnosis and prescribe medication
RN’s plan and direct the nursing care ordered by the physician
CNA’s provide direct patient care under the supervision of an RN or LPN
Aides, therapists, and support persons all contribute to this team

4. The Nursing Team RN Licensed-pass a state board exam
Assess, plan, evaluate and coordinate aspects of patient care
Educate patients and their families
Provide nursing care and supervise duties they delegate to others
May specialize in any specific area of nursing practice
HS-NE-10b

5. The Nursing Team LPN/LVN Licensed-passed state board exam
Works under the supervision of a RN, MD or Dentist
Provides most of the care when patient’s nursing needs are not complex
Assists the RN in more complicated situations
HS-NE-10b

6. The Nursing Team
CNA
Trained to assist in the care of patients under the supervision of RN or LPN
May be called:
Patient care attendant
Nurse’s aide
Clinical support associate
Nursing assistant
Health care aide
Patient care technician
Personal care assistant
HS-NE-10b

7. Patient Focused Care
Emphasizes the needs of the patient above the convenience of other departments involved with patient care
Limits the # of people involved in the care
Contains cost
Meet patients’ needs efficiently
Cross-trained workers are utilized

8. What can the CNA do to be an effective member of the team?
Recognize the importance of all team members
Appreciate each others’ contributions to the team
Learn as much as you can about your patient’s and their families to better understand their feelings and concerns
Attend care plan conferences and give your observations/ideas
Attend in-service training sessions
Become cross-trained
Cooperate with other team members to provide patient focused care
HS-NE-10a

9. Regulation of Nursing Assistant Practice
1987-Omnibus Budget Reconciliation Act
Regulates CNA education and certification
Includes statements from the Dept of Health and Human Services and the Center for Medicare and Medicaid Services (states the minimum requirements for CNA training)
Nurse Aide Competency Evaluation Program was started to guide individual programs to meet the requirements of OBRA
Georgia Medical Care Foundation is Georgia’s regulatory agency and must meet federal standards
HS-NE-6c

10. Certified Nursing Assistant Training
Students must complete 85 hrs of classroom/lab time plus clinical experience
Clinical skills must include
Basic nursing skills
Basic restorative skills
Mental health and social service needs
Personal care skills
Resident rights
Safety and emergency care

11. Certified Nursing Assistant Training
You are given 3 opportunities to meet the requirements of testing
You must work at least 8 hours for pay in a LTCF within 24 months time
You must receive 12 hours of continuing education every year
You must meet all requirements to renew every 2 yrs

12. Line of Authority
Health care facilities all have different lines of authority or chain of command
LTCF’s
CNA, LPN, RN Charge Nurse, Director of Nursing, Administration
Hospitals
CNA, Nurse (RN, LPN), Charge Nurse, Nurse or Unit Manager, Director of Nursing, Administration
As a SNA, your teacher or the person designated as your supervisor (CNA) is your immediate authority

13. Line of Authority Know your facility’s organizational structure
Physician
Registered
Nurse
Charge Nurse RN
Team Leader
RN or LPN
CNA
The Patient

14. Guidelines to Follow
Work with your line of authority when solving problems
Always begin with your immediate supervisor and work your way up if you hit a roadblock
Only perform the tasks that you have been trained to do!!
Always ask for help, even if it is related to a skill you have been trained to do.
HS-NE-6b

15. Guidelines to Follow Remain within your scope of practice.
Politely refuse and explain why
CNA’s do not take orders from physicians or discuss the patient’s status, medical record or results of any tests or vital signs
Always be willing to learn new skills that are within your scope of practice

16. CNA Role and Responsibility
Works directly with the patient, giving physical care and emotional support
CNA’s are interested in others and take pride in their work
CNA’s are willing to learn new skills to care for those who are ill
CNA’s can contribute much to the patient’s safety and comfort

17. CNA Role and Responsibility
CNA’s see the patient more than any other member of the nursing team
CNA’s make observations that can give valuable insight into the patient’s illness and attitude
Patient’s may make more “bonds” with you than other members of the health care team and share with you “minor complaints” they may not tell their physician or nurse

18. Personal Adjustments Accept constructive criticism
Follow rules and orders promptly
Show dependability and accuracy be being on time and completing your assignments
Respect your coworkers and the role you share on the health care team
Be empathetic (not sympathetic), patient and tactful with others (patients and coworkers)

19. Personal Adjustments Develop good interpersonal relationships
Be warm and pleasant to others
Your attitude is the most important characteristic you bring to your job
Caring, courtesy, cooperation
Emotional control, tact, patience
EMPATHY or UNDERSTANDING

20. Personal Adjustments Develop good relationships with your patients
Show empathy for the patient by being eager to serve and by using a gentle touch
You may have patients with different problems or concerns, but to a patient, his/her own problems are the most important

21. Personal Adjustments
Not all patient responses are about YOU or your job performance
Patients may become irritable, complaining or uncooperative because of
Fear about their diagnosis, disability or death
Pain
Worries about family or the future
Loss or lack of social support systems
Dependence on others
Financial concerns
A gentle touch and reassurance can help
Report these concerns to the nurse

22. Personal Adjustments You must also meet the family’s needs
They may also be uncooperative and demanding because they are worried about their loved one
Patience and tact are most useful here
Just listening can help
Watch body language as it may give you clues as to the family’s feelings

23. Personal Adjustments
You are part of a team whose goal is to help the patient
Remember your role
Do not overstep your authority
Listen to instructions carefully
Watch your tone of voice and body language
Promptly carry out orders and report unfinished work
Offer to help others and accept help when you need it
Have a positive attitude

24. Personal Adjustments
You are part of a team whose goal is to help the patient
Extend common courtesy and dignity to staff
Keep the common goal in mind and recognize coworkers as integral parts of the team
Understand and follow facility policies and procedures*
Treat all with respect
Practice good hygiene, nutrition and stress reduction
HS-NE-6d

25. Personal Hygiene Bathe daily Use deodorant Good oral hygiene
Clean hair, pulled back
Short, clean natural nails-clear polish only
Only stud earrings, wedding band and watch are allowed
Clean socks or stockings
Well fitting shoes

26. Uniforms LCCS requires white with white shoes Clean, wrinkle free
Repair torn hems and missing buttons
Not worn when not on duty
Remove inside out
ID badge required
Keep in mind that your appearance says a lot about you in a patient’s eyes
A well-groomed appearance says you have pride in yourself and your work

27. Stress, Stress, Stress Avoid burnout by reducing stress
Sufficient rest
Good nutrition
Leisure activities
Stress reduction
Group discussion
Stress management
Exercise programs
Personal Stress Reduction
Go for a walk
Devote time to hobbies
Herbal tea
Relaxation exercises
Quiet music
Warm, relaxing bath
There are many ways to reduce stress other than relying on drugs or alcohol to change your mood. Don’t get into a situation you can’t get out of because of stress