Understand nurse aide’s range of function as a member of the healthcare team. Unit A Nurse Aide Workplace Fundamentals Essential Standard 1.00 Understand

Understand Understand nurse aidenurse aide’’s s range of functionrange of function as a as a member of the member of the healthcare team.healthcare team.

Unit A Nurse Aide Workplace FundamentalsEssential Standard 1.00 Understand the range of function, legal and ethical responsibilities of the nurse aide within the healthcare system. Indicator 1.02 Understand nurse aide’s range of function as a member of the healthcare team.

11.02 Nursing Fundamentals

NURSE AIDE RANGE OF FUNCTIONNURSE AIDE RANGE OF FUNCTION

Nursing Fundamentals 7243 21.02

• Assist the licensed nurse by Assist the licensed nurse by performing performing delegated tasks delegated tasks directly to residents who are directly to residents who are ill and unable to care for ill and unable to care for themselves. themselves.



•Nurse aide tasks Nurse aide tasks are are supervisedsupervised by by the the licensed nurse.licensed nurse.



• Serve as the Serve as the eyes eyes and and earsears for the healthcare for the healthcare teamteam



Make and report/record observations Make and report/record observations accurately regarding accurately regarding 1.1.Resident condition, care, and residentResident condition, care, and resident’’s s response to careresponse to care2.2.ResidentResident’’s environments environment



Measure and report/record:Measure and report/record:1.1.Vital signsVital signs2.2.Height and weightHeight and weight3.3.Intake and outputIntake and output



Help residents with personal needs:Help residents with personal needs:•HygieneHygiene•SafetySafety•NutritionNutrition•ExerciseExercise•EliminationElimination•MobilityMobility



Help residents with personal Help residents with personal needs: needs: (continued)(continued)

•CommunicationCommunication•Socialization activitiesSocialization activities•Comfort measuresComfort measures•Restorative proceduresRestorative procedures



• Assist in resident Assist in resident admission and discharge admission and discharge to the facilityto the facility



Maintains a Maintains a clean and clean and safe safe resident resident environmentenvironment



Assist in the collection of Assist in the collection of various specimensvarious specimens



Answer call signalsAnswer call signals



Call signals/lights Call signals/lights should should NOTNOT be be perceived as perceived as noise and noise and interruptioninterruption



Call signals/lights are Call signals/lights are an an important wayimportant way for for residents to request residents to request assistance!assistance!



Answering call lights in a timely Answering call lights in a timely manner:manner:1.1.helps prevent falls.helps prevent falls.2.2.improves rapport between resident/family improves rapport between resident/family and staff.and staff.3.3.increases resident/family confidence in the increases resident/family confidence in the staffstaff’’s ability to care for the needs of the s ability to care for the needs of the resident.resident.



Assist in the transportation Assist in the transportation of residents within a facilityof residents within a facility



Cleaning and care of Cleaning and care of

equipmentequipment



Comply with infection control and Comply with infection control and safety practices, policies, and safety practices, policies, and procedures…procedures…

Standard PrecautionsStandard PrecautionsFire Drills/PreparednessFire Drills/PreparednessDisaster Drills/PreparednessDisaster Drills/Preparedness



Resident Care Plan and Resident Care Resident Care Plan and Resident Care Conferences: Conferences:

•May attend Resident Care ConferencesMay attend Resident Care Conferences•Assist to develop/revise care plansAssist to develop/revise care plans•Share care suggestionsShare care suggestions•Report observationsReport observations

Ethical ResponsibilitiesEthical Responsibilities of the Nurse Aide of the Nurse Aide


Ethical Responsibilities of the Nurse AideEthical Responsibilities of the Nurse Aide


ETHICSETHICS•Discipline concerned with right or Discipline concerned with right or wrong conductwrong conduct•Guides to moral behaviorGuides to moral behavior•Making choices or judgmentsMaking choices or judgments



•Put residentPut resident’’s needs s needs ahead of your ownahead of your own

• Be sincere, honest and trustworthy Be sincere, honest and trustworthy in performance of dutiesin performance of duties– caring and concernedcaring and concerned– ““golden rulegolden rule””



• Show respect for each resident as an Show respect for each resident as an individualindividual

• Understand the limits of roleUnderstand the limits of role• Perform only acts for which Perform only acts for which

adequately preparedadequately prepared• Perform acts only within legal scope Perform acts only within legal scope

of nurse aideof nurse aide



• Carry out assignments to best of Carry out assignments to best of abilityability

• Be loyal:Be loyal:• Maintain a positive attitude Maintain a positive attitude

toward institution that employs toward institution that employs youyou

• Support co-workersSupport co-workers



• Be responsible citizen at all Be responsible citizen at all times times

• Respect othersRespect others• Respect values that differ Respect values that differ

from yoursfrom yours



• Resident information should be kept confidentialResident information should be kept confidential• Discuss only in appropriate placesDiscuss only in appropriate places• Resident information should be kept confidentialResident information should be kept confidential

– Discuss only in appropriate placesDiscuss only in appropriate places– Discuss only with proper peopleDiscuss only with proper people– Refer questions from residents about their condition Refer questions from residents about their condition

to supervisorto supervisor• Discuss only with proper peopleDiscuss only with proper people• Refer questions from residents about their condition to Refer questions from residents about their condition to

supervisorsupervisor



• Respect privacy of others:Respect privacy of others:– while dressingwhile dressing– while performing personal hygienewhile performing personal hygiene– during examination or treatmentduring examination or treatment– during visits with clergyduring visits with clergy– during visits with spouse or during visits with spouse or

significant othersignificant other



• Do not accept monetary tipsDo not accept monetary tips– Residents are paying for serviceResidents are paying for service– You are paid to provide serviceYou are paid to provide service– Do not discriminate regardless of Do not discriminate regardless of

race, creed, color, age, financial race, creed, color, age, financial resourcesresources

– Provide care based on needProvide care based on need



• Do not accept monetary tips Do not accept monetary tips (continued)(continued)

– Display tactful and courteous Display tactful and courteous refusal of tipsrefusal of tips

– Display continued desire to be Display continued desire to be helpful helpful

Legal Parameters of Legal Parameters of Nurse Aide WorkNurse Aide Work


Legal Parameters of Nurse Aide WorkLegal Parameters of Nurse Aide Work


• BON does not recognize the term BON does not recognize the term ““practicepractice”” for nurse aides. BON states the for nurse aides. BON states the phrase phrase ““practicepractice”” is reserved for the is reserved for the professional nurse.professional nurse.

• NCDHSR will use the phrase NCDHSR will use the phrase ““range of range of functionfunction”” to enumerate what the nurse to enumerate what the nurse aide can and cannot do.aide can and cannot do.

• NCDPI will use the phrase NCDPI will use the phrase ““range of range of functionfunction”” to be consistent with NCDHSR to be consistent with NCDHSR



• Nurse aides do not do sterile procedures.Nurse aides do not do sterile procedures.• Nurse aides do not give information Nurse aides do not give information

about the diagnosis or treatment plans to about the diagnosis or treatment plans to the resident or his/her family.the resident or his/her family.

• Nurse aides do not give medications.Nurse aides do not give medications.• Nurse aides do not insert or remove tubes Nurse aides do not insert or remove tubes

from the residentfrom the resident’’s body.s body.



• Nurse aides do not take oral or Nurse aides do not take oral or telephone orders from a physiciantelephone orders from a physician

• Nurse aides do not diagnose or Nurse aides do not diagnose or prescribe treatments or medications prescribe treatments or medications for residents.for residents.

• Nurse aides do not supervise the Nurse aides do not supervise the work of other nurse aides.work of other nurse aides.



Nurse aides do not agree to Nurse aides do not agree to do something beyond the do something beyond the nurse aidenurse aide’’s range of s range of function as defined by the function as defined by the North Carolina Board of North Carolina Board of Nursing.Nursing.



Legal issues related to nurse aide work Legal issues related to nurse aide work and all of healthcare are legislatedand all of healthcare are legislatedby state and federal governments. by state and federal governments.



Healthcare legal issues are based Healthcare legal issues are based on one of two types of law:on one of two types of law:

Civil – Fines are imposedCivil – Fines are imposed

Criminal – You can go to prisonCriminal – You can go to prison



Healthcare legal Healthcare legal issues typically issues typically

involve involve CIVIL LAWCIVIL LAW



Malpractice:Malpractice:•Giving care for which you are not Giving care for which you are not legally allowed to dolegally allowed to do

•Providing improper or Providing improper or ““BADBAD”” carecare



Negligence:Negligence:•Unintentional wrongUnintentional wrong

•Failure to provide goods and services Failure to provide goods and services (patient care) necessary and normally (patient care) necessary and normally expected to avoid physical harm, expected to avoid physical harm, mental anguish, or mental illness.mental anguish, or mental illness.



Assault and Battery:Assault and Battery:These terms are closely These terms are closely related and often used related and often used together.together.



Assault and Battery:Assault and Battery:•AssaultAssault – threatening or attempting to – threatening or attempting to touch a person without his consent, touch a person without his consent, causing that person to fear bodily causing that person to fear bodily harmharm



Assault and Battery:Assault and Battery:

•Battery Battery – touching of – touching of another without consentanother without consent



A B U S EA B U S E



ABUSE:ABUSE:Willful infliction of injury, Willful infliction of injury, unreasonable confinement, unreasonable confinement, intimidation or punishment intimidation or punishment with resulting physical harm, with resulting physical harm, pain or mental anguish.pain or mental anguish.



Types of Abuse:Types of Abuse:•Physical Physical •VerbalVerbal•PsychologicalPsychological•SexualSexual•Others Others http://www.preventelderabuse.org/elderabuse/http://www.preventelderabuse.org/elderabuse/

1.02 Nursing Fundamentals 7243 46



Signs of Signs of Abuse:Abuse:Unexplained Unexplained bruises, bruises, fractures, fractures, burns, or burns, or injuries.injuries.



Signs of Signs of Abuse:Abuse:Signs of Signs of neglect such neglect such as poor as poor hygienehygiene



Signs of Signs of Abuse:Abuse:Irrational fears Irrational fears or change in or change in personalitypersonality



Signs of Signs of Abuse:Abuse:Aggressive, Aggressive, withdrawn, or withdrawn, or paranoid paranoid behaviorbehavior



Signs of Signs of Abuse:Abuse:Resident Resident statements statements that indicate that indicate abuse or abuse or neglectneglect





FINANCIAL

PHYSICAL

SELF-N

EGLE

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EMTOTIO

NAL

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NEGLECT

PSYCHOLO

GICAL

Abuse Abuse MUSTMUST be reported!!!! be reported!!!!


Elder AbuseDisabled adults of any age are protected in North Carolina under State law (N.C. General Statute 108A-102), which mandates that "any person having reasonable cause to believe that a disabled adult is in need of protective services shall report such information." The county departments of social services provide adult protective services under the supervision of the State Division of Aging and Adult Services.

Abuse Abuse MUSTMUST be reported!!!! be reported!!!!


If observed in the resident care facility, stop If observed in the resident care facility, stop abuse and report IMMEDIATELY to supervisor abuse and report IMMEDIATELY to supervisor if at work.if at work.

If observed or have reasonable suspicion of If observed or have reasonable suspicion of abuse in private life, call the county abuse in private life, call the county Department of Social Services where the Department of Social Services where the abuse occurred. abuse occurred.

Not reporting is aiding and abetting!



Residents at risk of being Residents at risk of being abused:abused:•Noisy residentsNoisy residents•Residents who wanderResidents who wander•Philandering residentsPhilandering residents•Socially or logistically isolated residentsSocially or logistically isolated residents•Residents with a history of aggressive Residents with a history of aggressive behavior are at risk to abuse other residentsbehavior are at risk to abuse other residents



PerpetratorPerpetrator’’s Actions Action……•May be cause for immediate dismissalMay be cause for immediate dismissal•If abuse is proven, perpetratorIf abuse is proven, perpetrator’’s name is s name is posted on the posted on the NC Healthcare Personnel NC Healthcare Personnel RegistryRegistry AND AND The National Practitioner Data The National Practitioner Data Bank-Healthcare Integrity and Protection Bank-Healthcare Integrity and Protection Data BankData Bank•May be cause for civil or criminal chargesMay be cause for civil or criminal charges



Invasion of PrivacyInvasion of Privacy::

Unnecessary exposure of an Unnecessary exposure of an Individual Individual

Revealing personal informationRevealing personal informationwithout consentwithout consent

The Bottom Line


““Do not expose Do not expose their their bodybodyor their or their businessbusiness!!””



Invasion of PrivacyInvasion of Privacy: examples: examples

•Exposing the entire body when Exposing the entire body when only a body part should be only a body part should be exposed.exposed.•Leaving a door or curtain open Leaving a door or curtain open during a procedure. during a procedure.



Invasion of PrivacyInvasion of Privacy: examples: examples

•Leaving resident information in Leaving resident information in plain viewplain view•Discussing residents in public Discussing residents in public areasareas



False imprisonmentFalse imprisonment::

•Restraining an individualRestraining an individual•Restricting residents freedomRestricting residents freedom•Confining an individual against Confining an individual against his/her willhis/her will



DefamationDefamation::False statements that cause a False statements that cause a resident to be ridiculed or cause resident to be ridiculed or cause damage to their reputationdamage to their reputation•SSpoken – poken – SSlanderlander•Written – Written – LLiable (iable (LLetter)etter)



FraudFraud::•Intentional deception or misrepresentation Intentional deception or misrepresentation by a person with knowledge that deception by a person with knowledge that deception could result in some unauthorized benefit to could result in some unauthorized benefit to himself or some other personhimself or some other person•Includes any act that constitutes fraud under Includes any act that constitutes fraud under applicable Federal or State lawapplicable Federal or State law



WillWillLegal document giving direction on how Legal document giving direction on how resident wants property distributed after resident wants property distributed after death.death.Refer requests to prepare will to supervisorRefer requests to prepare will to supervisorNurse aide may witness signing of willNurse aide may witness signing of will•Check facility of policyCheck facility of policy•Discuss with supervisorDiscuss with supervisor

Nurse Aide Qualities Nurse Aide Qualities and Characteristicsand Characteristics


Characteristics of Nurse AideCharacteristics of Nurse Aide


• CheerfulCheerful• EnthusiasticEnthusiastic• ResponsibleResponsible• ConsiderateConsiderate• CourteousCourteous• CooperativeCooperative



• Willing to learnWilling to learn• TactfulTactful• CompetentCompetent• Committed to Committed to

jobjob• PunctualPunctual• Self-awareSelf-aware



• DependableDependable• EmpatheticEmpathetic• HonestHonest• PatientPatient• RespectfulRespectful• TrustworthyTrustworthy

Nurse Aide Personal Nurse Aide Personal Hygiene and HealthHygiene and Health


Personal Hygiene PracticesPersonal Hygiene Practices


• Taking a daily bath or showerTaking a daily bath or shower• Using Using

deodorants/antiperspirantsdeodorants/antiperspirants• Brushing teeth and using Brushing teeth and using

mouthwashmouthwash• Keeping hair clean and neatly Keeping hair clean and neatly

styledstyled• Cleaning and maintaining short, Cleaning and maintaining short,

smooth nailssmooth nails

Personal Hygiene PracticesPersonal Hygiene Practices


• Washing hands after using Washing hands after using bathroombathroom

• Wearing clean underwear, socks Wearing clean underwear, socks or stockings and uniform dailyor stockings and uniform daily

• Do not use products having Do not use products having odors that might be offensive to odors that might be offensive to residentsresidents

Factors that Promotes Good HealthFactors that Promotes Good Health


• Rest and sleepRest and sleep• DietDiet• ExerciseExercise• Good posture and body Good posture and body

mechanicsmechanics• Eye examinationsEye examinations• Dental careDental care• No use of drugs, alcohol or No use of drugs, alcohol or

cigarettescigarettes

Professional DressProfessional Dress


• Uniform clean, pressedUniform clean, pressed• Shoes polished and Shoes polished and

comfortablecomfortable• Shoe laces cleanShoe laces clean• Stockings without Stockings without

holes/runsholes/runs• Jewelry limited to watch Jewelry limited to watch

and wedding ringand wedding ring

Nurse Aide Nurse Aide Work AssignmentWork Assignment


Nurse Aide Work AssignmentNurse Aide Work Assignment


• Made by a licensed nurseMade by a licensed nurse• Based on needs of residents Based on needs of residents

and availability of staffand availability of staff• Allows staff to work as teamAllows staff to work as team• Includes being cooperative Includes being cooperative

and helping others when and helping others when askedasked



• Includes Includes never never ignoring a resident ignoring a resident that needs helpthat needs help, is , is uncomfortable or in uncomfortable or in dangerdanger



• Includes notifying the Includes notifying the supervisor of unfinished supervisor of unfinished assignmentsassignments

• Includes answering call Includes answering call signals even though not signals even though not assigned to the residentassigned to the resident

Nurse Aide Work Plan ConsiderationsNurse Aide Work Plan Considerations


• WorkloadWorkload• Resident conditionResident condition• TimeTime• Support services assignedSupport services assigned

Establishing Priorities for Resident CareEstablishing Priorities for Resident Care


• Activities of daily livingActivities of daily living• Meeting hygiene needsMeeting hygiene needs• Positioning and providing for Positioning and providing for

exerciseexercise• Maintaining proper nutritionMaintaining proper nutrition• Providing for elimination of Providing for elimination of

wasteswastes



Special procedures: Special procedures: •Taking vital signs Taking vital signs •Measuring urineMeasuring urine



• Support servicesSupport services• Providing drinking waterProviding drinking water• Delivering and picking up meal Delivering and picking up meal

traystrays• Providing clean linen and Providing clean linen and

making bedsmaking beds• Cleaning and caring for Cleaning and caring for

equipmentequipment



• Documentation/ Documentation/ reportingreporting

• Presenting oral Presenting oral reports to supervisorreports to supervisor

• Writing on record if Writing on record if directed to do sodirected to do so

Healthcare Team Healthcare Team Member PracticesMember Practices


Identification of Team MembersIdentification of Team Members


Nurse Aide MUST wear Nurse Aide MUST wear name tag or photo ID!name tag or photo ID!North Carolina G.S. 90-640 reads as written: North Carolina G.S. 90-640 reads as written: § 90-640. Identification badges required. § 90-640. Identification badges required.

Working with Others - GuidelinesWorking with Others - Guidelines


• Know the responsibilities, functions Know the responsibilities, functions and role expectations listed in job and role expectations listed in job descriptiondescription

• Display qualities and characteristics Display qualities and characteristics befitting a nurse aidebefitting a nurse aide

• Be prompt in reporting to workBe prompt in reporting to work



• Notify facility of absence ASAPNotify facility of absence ASAP• Display good health and hygiene Display good health and hygiene

practicespractices• Follow facility dress code policyFollow facility dress code policy• Practice ethical & legal actionsPractice ethical & legal actions• Direct questions about things you donDirect questions about things you don’’t t

understand to supervisorunderstand to supervisor



• Follow instructions and directions of Follow instructions and directions of supervisor supervisor

• Display pride in appearance Display pride in appearance • Promptly report unusual Promptly report unusual

observations to the supervisorobservations to the supervisor• Make supervisor aware of family and Make supervisor aware of family and

resident complaintsresident complaints



• Perform duties in spirit of cooperationPerform duties in spirit of cooperation• Do not waste supplies and equipmentDo not waste supplies and equipment• Follow facility rules and regulationsFollow facility rules and regulations• Be accurate in measuring, recording Be accurate in measuring, recording

and reportingand reporting• Notify supervisor when leaving and Notify supervisor when leaving and

returning to unit returning to unit



• Assist other healthcare workers Assist other healthcare workers willingly willingly

• Never use supplies or Never use supplies or equipment belonging to the equipment belonging to the facility or residentfacility or resident

• Never discuss personal Never discuss personal problems with the residentsproblems with the residents

Documents

Understand nurse aide’s range of function as a member of the healthcare team. Unit A Nurse Aide Workplace Fundamentals Essential Standard 1.00 Understand