Unit A
Nurse Aide Workplace Fundamentals
Essential 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.
Understand nurse aide’s
range of function as a
member of the
healthcare team.
1.02
Nursing Fundamentals
1
NURSE AIDE RANGE OF FUNCTION
• Assist the licensed nurse by
performing delegated tasks
directly to residents who are
ill and unable to care for
themselves.
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NURSE AIDE RANGE OF FUNCTION
•Nurse aide tasks
are supervised by
the licensed nurse.
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NURSE AIDE RANGE OF FUNCTION
•Serve as the eyes and
ears for the healthcare
team
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NURSE AIDE RANGE OF FUNCTION
Make and report/record observations
accurately regarding
1.Resident condition, care, and resident’s
response to care
2.Resident’s environment
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NURSE AIDE RANGE OF FUNCTION
Measure and report/record:
1. Vital signs
2. Height and weight
3. Intake and output
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NURSE AIDE RANGE OF FUNCTION
Help residents with personal needs:
• Hygiene
•
•
•
•
•
1.02
Safety
Nutrition
Exercise
Elimination
Mobility
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NURSE AIDE RANGE OF FUNCTION
Help residents with personal
needs: (continued)
•
•
•
•
1.02
Communication
Socialization activities
Comfort measures
Restorative procedures
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NURSE AIDE RANGE OF FUNCTION
• Assist in resident
admission and discharge
to the facility
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NURSE AIDE RANGE OF FUNCTION
Maintains a
clean and
safe resident
environment
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NURSE AIDE RANGE OF FUNCTION
Assist in the collection of
various specimens
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NURSE AIDE RANGE OF FUNCTION
Answer call signals
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NURSE AIDE RANGE OF FUNCTION
Call signals/lights
should NOT be
perceived as noise and
interruption
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NURSE AIDE RANGE OF FUNCTION
Call signals/lights are
an important way for
residents to request
assistance!
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NURSE AIDE RANGE OF FUNCTION
Answering call lights in a timely
manner:
1.helps prevent falls.
2.improves rapport between resident/family
and staff.
3.increases resident/family confidence in the
staff’s ability to care for the needs of the
resident.
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NURSE AIDE RANGE OF FUNCTION
Assist in the transportation
of residents within a facility
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NURSE AIDE RANGE OF FUNCTION
Cleaning and care of
equipment
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NURSE AIDE RANGE OF FUNCTION
Comply with infection control and
safety practices, policies, and
procedures…
Standard Precautions
Fire Drills/Preparedness
Disaster Drills/Preparedness
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NURSE AIDE RANGE OF FUNCTION
Resident Care Plan and Resident Care
Conferences:
•
•
•
•
1.02
May attend Resident Care Conferences
Assist to develop/revise care plans
Share care suggestions
Report observations
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Ethical Responsibilities
of the Nurse Aide
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Ethical Responsibilities of the Nurse Aide
ETHICS
• Discipline concerned with right
or wrong conduct
• Guides to moral behavior
• Making choices or judgments
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Ethical Responsibilities of the Nurse Aide
•Put resident’s
needs ahead of your
own
• Be sincere, honest and trustworthy
in performance of duties
– caring and concerned
– “golden rule”
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Ethical Responsibilities of the Nurse Aide
• Show respect for each resident as an
individual
• Understand the limits of role
• Perform only acts for which
adequately prepared
• Perform acts only within legal scope
of nurse aide
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Ethical Responsibilities of the Nurse Aide
• Carry out assignments to best of
ability
• Be loyal:
• Maintain a positive attitude
toward institution that employs
you
• Support co-workers
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Ethical Responsibilities of the Nurse Aide
• Be responsible citizen at all
times
• Respect others
• Respect values that differ
from yours
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Ethical Responsibilities of the Nurse Aide
• Resident information should be kept confidential
• Discuss only in appropriate places
• Resident information should be kept confidential
– Discuss only in appropriate places
– Discuss only with proper people
– Refer questions from residents about their condition
to supervisor
• Discuss only with proper people
• Refer questions from residents about their condition to
supervisor
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Ethical Responsibilities of the Nurse Aide
• Respect privacy of others:
– while dressing
– while performing personal hygiene
– during examination or treatment
– during visits with clergy
– during visits with spouse or
significant other
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Ethical Responsibilities of the Nurse Aide
• Do not accept monetary tips
– Residents are paying for service
– You are paid to provide service
– Do not discriminate regardless of
race, creed, color, age, financial
resources
– Provide care based on need
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Ethical Responsibilities of the Nurse Aide
• Do not accept monetary tips
(continued)
– Display tactful and courteous
refusal of tips
– Display continued desire to be
helpful
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Legal Parameters of
Nurse Aide Work
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Legal Parameters of Nurse Aide Work
• BON does not recognize the term
“practice” for nurse aides. BON states
the phrase “practice” is reserved for the
professional nurse.
• NCDHSR will use the phrase “range of
function” to enumerate what the nurse
aide can and cannot do.
• NCDPI will use the phrase “range of
function” to be consistent with NCDHSR
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Legal Parameters of Nurse Aide Work
• Nurse aides do not do sterile procedures.
• Nurse aides do not give information
about the diagnosis or treatment plans to
the resident or his/her family.
• Nurse aides do not give medications.
• Nurse aides do not insert or remove tubes
from the resident’s body.
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Legal Parameters of Nurse Aide Work
• Nurse aides do not take oral or
telephone orders from a physician
• Nurse aides do not diagnose or
prescribe treatments or medications
for residents.
• Nurse aides do not supervise the
work of other nurse aides.
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Legal Parameters of Nurse Aide Work
Nurse aides do not agree to
do something beyond the
nurse aide’s range of
function as defined by the
North Carolina Board of
Nursing.
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Legal Parameters of Nurse Aide Work
Legal issues related to nurse aide work
and all of healthcare are legislated
by state and federal governments.
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Legal Parameters of Nurse Aide Work
Healthcare legal issues are based
on one of two types of law:
Civil – Fines are imposed
Criminal – You can go to prison
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Legal Parameters of Nurse Aide Work
Healthcare legal
issues typically
involve
CIVIL LAW
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Legal Parameters of Nurse Aide Work
Malpractice:
•Giving care for which you are not
legally allowed to do
•Providing improper or “BAD”
care
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Legal Parameters of Nurse Aide Work
Negligence:
•
Unintentional wrong
•
Failure to provide goods and
services (patient care) necessary
and normally expected to avoid
physical harm, mental anguish, or
mental illness.
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Legal Parameters of Nurse Aide Work
Assault and Battery:
These terms are closely
related and often used
together.
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Legal Parameters of Nurse Aide Work
Assault and Battery:
•Assault – threatening or attempting to
touch a person without his consent,
causing that person to fear bodily
harm
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Legal Parameters of Nurse Aide Work
Assault and Battery:
•Battery – touching of
another without consent
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Legal Parameters of Nurse Aide Work
A B U S E
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Legal Parameters of Nurse Aide Work
ABUSE:
Willful infliction of injury,
unreasonable confinement,
intimidation or punishment
with resulting physical harm,
pain or mental anguish.
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Legal Parameters of Nurse Aide Work
Types of Abuse:
•Physical
•Verbal
•Psychological
•Sexual
•Others
http://www.preventelderabuse.org/elderabuse/
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Legal Parameters of Nurse Aide Work
Signs of
Abuse:
Unexplained
bruises,
fractures,
burns, or
injuries.
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Legal Parameters of Nurse Aide Work
Signs of
Abuse:
Signs of
neglect such
as poor
hygiene
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Legal Parameters of Nurse Aide Work
Signs of
Abuse:
Irrational fears
or change in
personality
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Legal Parameters of Nurse Aide Work
Signs of
Abuse:
Aggressive,
withdrawn, or
paranoid
behavior
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Legal Parameters of Nurse Aide Work
Signs of
Abuse:
Resident
statements
that indicate
abuse or
neglect
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Legal Parameters of Nurse Aide Work
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Legal Parameters of Nurse Aide Work
PHYSICAL
VERBAL
SEXUAL
NEGLECT
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Abuse MUST be reported!!!!
Elder Abuse
Disabled 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.
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Abuse MUST be reported!!!!
If observed in the resident care facility, stop
abuse and report IMMEDIATELY to supervisor
if at work.
If observed or have reasonable suspicion of
abuse in private life, call the county
Department of Social Services where the
abuse occurred.
Not reporting is aiding and abetting!
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Legal Parameters of Nurse Aide Work
Residents at risk of being
abused:
•Noisy residents
•Residents who wander
•Philandering residents
•Socially or logistically isolated residents
•Residents with a history of aggressive
behavior are at risk to abuse other residents
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Legal Parameters of Nurse Aide Work
Perpetrator’s Action…
•May be cause for immediate dismissal
•If abuse is proven, perpetrator’s name is
posted on the NC Healthcare Personnel
Registry AND The National Practitioner Data
Bank-Healthcare Integrity and Protection
Data Bank
•May be cause for civil or criminal charges
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Legal Parameters of Nurse Aide Work
Invasion of Privacy:
Unnecessary exposure of an
Individual
Revealing personal information
without consent
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The
Bottom
Line
“Do not expose
their body
or their
business!”
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Legal Parameters of Nurse Aide Work
Invasion of Privacy: examples
•Exposing the entire body when
only a body part should be
exposed.
•Leaving a door or curtain open
during a procedure.
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Legal Parameters of Nurse Aide Work
Invasion of Privacy: examples
• Leaving resident information
in plain view
• Discussing residents in
public areas
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Legal Parameters of Nurse Aide Work
False imprisonment:
• Restraining an individual
• Restricting residents freedom
• Confining an individual
against his/her will
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Legal Parameters of Nurse Aide Work
Defamation:
False statements that cause a
resident to be ridiculed or cause
damage to their reputation
•Spoken – Slander
•Written – Liable (Letter)
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Legal Parameters of Nurse Aide Work
Fraud:
• Intentional deception or misrepresentation
by a person with knowledge that deception
could result in some unauthorized benefit
to himself or some other person
• Includes any act that constitutes fraud
under applicable Federal or State law
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Legal Parameters of Nurse Aide Work
Will
Legal document giving direction on how
resident wants property distributed after
death.
Refer requests to prepare will to supervisor
Nurse aide may witness signing of will
• Check facility of policy
• Discuss with supervisor
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Nurse Aide Qualities
and Characteristics
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Characteristics of Nurse Aide
•
•
•
•
•
•
1.02
Cheerful
Enthusiastic
Responsible
Considerate
Courteous
Cooperative
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Characteristics of Nurse Aide
•
•
•
•
Willing to learn
Tactful
Competent
Committed to
job
• Punctual
• Self-aware
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Characteristics of Nurse Aide
•
•
•
•
•
•
1.02
Dependable
Empathetic
Honest
Patient
Respectful
Trustworthy
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Nurse Aide Personal
Hygiene and Health
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Personal Hygiene Practices
• Taking a daily bath or shower
• Using
deodorants/antiperspirants
• Brushing teeth and using
mouthwash
• Keeping hair clean and neatly
styled
• Cleaning and maintaining short,
smooth nails
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Personal Hygiene Practices
• Washing hands after using
bathroom
• Wearing clean underwear, socks
or stockings and uniform daily
• Do not use products having
odors that might be offensive to
residents
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Factors that Promotes Good Health
•
•
•
•
Rest and sleep
Diet
Exercise
Good posture and body
mechanics
• Eye examinations
• Dental care
• No use of drugs, alcohol or
cigarettes
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Professional Dress
• Uniform clean, pressed
• Shoes polished and
comfortable
• Shoe laces clean
• Stockings without
holes/runs
• Jewelry limited to watch
and wedding ring
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Nurse Aide
Work Assignment
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Nurse Aide Work Assignment
• Made by a licensed nurse
• Based on needs of residents
and availability of staff
• Allows staff to work as team
• Includes being cooperative
and helping others when
asked
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Nurse Aide Work Assignment
• Includes never
ignoring a resident
that needs help, is
uncomfortable or in
danger
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Nurse Aide Work Assignment
• Includes notifying the
supervisor of unfinished
assignments
• Includes answering call
signals even though not
assigned to the resident
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Nurse Aide Work Plan Considerations
• Workload
• Resident condition
• Time
• Support services assigned
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Establishing Priorities for Resident Care
• Activities of daily living
• Meeting hygiene needs
• Positioning and providing for
exercise
• Maintaining proper nutrition
• Providing for elimination of
wastes
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Establishing Priorities for Resident Care
Special procedures:
• Taking vital signs
• Measuring urine
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Establishing Priorities for Resident Care
• Support services
• Providing drinking water
• Delivering and picking up meal
trays
• Providing clean linen and
making beds
• Cleaning and caring for
equipment
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Establishing Priorities for Resident Care
• Documentation/
reporting
• Presenting oral
reports to supervisor
• Writing on record if
directed to do so
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Healthcare Team
Member Practices
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Identification of Team Members
Nurse Aide MUST wear
name tag or photo ID!
North Carolina G.S. 90-640 reads as written:
§ 90-640. Identification badges required.
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Working with Others - Guidelines
• Know the responsibilities, functions
and role expectations listed in job
description
• Display qualities and characteristics
befitting a nurse aide
• Be prompt in reporting to work
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Working with Others - Guidelines
• Notify facility of absence ASAP
• Display good health and hygiene
practices
• Follow facility dress code policy
• Practice ethical & legal actions
• Direct questions about things you don’t
understand to supervisor
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Working with Others - Guidelines
• Follow instructions and directions of
supervisor
• Display pride in appearance
• Promptly report unusual
observations to the supervisor
• Make supervisor aware of family and
resident complaints
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Working with Others - Guidelines
•
•
•
•
Perform duties in spirit of cooperation
Do not waste supplies and equipment
Follow facility rules and regulations
Be accurate in measuring, recording
and reporting
• Notify supervisor when leaving and
returning to unit
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Working with Others - Guidelines
• Assist other healthcare workers
willingly
• Never use supplies or
equipment belonging to the
facility or resident
• Never discuss personal
problems with the residents
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