Certified Nursing Assistant (CNA) Exam Member of the Health Care Team Summary

Never do a task you are not trained for or that is outside your role. Explain this to the nurse respectfully so the task can be reassigned or you can be trained.

Wrong choices

• Do it anyway so the nurse is not upset: Doing a task without training can harm the resident.
• Refuse and leave the unit: Leaving can neglect residents; explain and ask for help instead.
• Ask the resident how to do it: The resident cannot train you to do care safely.

Nurse aides work under the supervision of a licensed nurse (a registered nurse or licensed practical/vocational nurse). Ask the nurse when you have questions about your assignment.

Wrong choices

• Another nurse aide: Nurse aides work under the supervision of licensed nurses.
• The dietitian: The dietitian plans diets but does not supervise nurse aides.
• The resident's family: Family members do not supervise staff.

The care plan is written by the care team and lists each resident's needs and goals. The nurse's assignment tells you what to do on your shift. Follow them and report what you observe.

Wrong choices

• A coworker's memory from last week: Care needs can change; use the current care plan.
• The resident's roommate: The roommate does not decide the resident's care.
• The aide's own guess: Care must follow the plan, not guesses.

A physical therapist helps residents with strength, walking, and moving. Other team members include occupational therapists (daily living skills), speech-language pathologists (speech and swallowing), dietitians, and social workers.

Wrong choices

• Dietitian: A dietitian plans meals and nutrition.
• Speech-language pathologist: A speech-language pathologist helps with speech and swallowing.
• Social worker: A social worker helps with emotional, family, and financial needs.

Good time management starts with the shift report and assignment. Plan your work so urgent needs and scheduled care (such as meals and repositioning) are done on time, and stay flexible for changes.

Wrong choices

• Wait until residents call for help: Waiting means care is late and needs are missed.
• Start with the easiest tasks no matter what: The most urgent needs should come first.
• Do all charting first, then give care: Charting should be done as care is given, not before care.

A speech-language pathologist evaluates and treats problems with speech, language, and swallowing, and may recommend thickened liquids or special feeding methods.

Wrong choices

• Housekeeper: A housekeeper cleans the environment.
• Physical therapist: A physical therapist works on strength and walking.
• Activities director: An activities director plans recreation.

Nurse aides spend a lot of time with residents. Their observations about eating, sleeping, behavior, and abilities help the team make a care plan that fits the resident.

Wrong choices

• The aide makes the final decisions about care: The care team, led by licensed staff, makes decisions.
• The aide decides the resident's diagnosis: Diagnosing is not the aide's role.
• The aide writes the doctor's orders: Doctors and other licensed providers write orders.

Under 42 CFR 483.95, nurse aide in-service training must be at least 12 hours per year, and must include dementia management and resident abuse prevention training.

Wrong choices

• No training is required after certification: Yearly in-service training is required.
• 24 hours: Facilities may give more, but the federal minimum is less than this.
• 4 hours: This is less than the federal minimum.

The chain of command is the order of authority in the facility. If a concern about a resident's safety is not addressed, report it to the next person in charge, such as the charge nurse or director of nursing.

Wrong choices

• Tell the resident's roommate: The roommate cannot address the problem.
• Post about it on social media: This violates confidentiality and does not help the resident.
• Do nothing more, since the nurse was told: If a concern about a resident is not addressed, the aide should take it higher.

Complaining about coworkers in front of residents is unprofessional and can worry residents. Helping others, giving a clear report, and being on time are all part of good teamwork.

Wrong choices

• Helping coworkers when your own work is done: Helping others supports good care.
• Arriving on time for your shift: Being on time means residents are not left without care.
• Giving a clear report to the next shift: A good report keeps care consistent.