[Music] delegation what our nursing assistants allowed to do a presentation brought to you by for your CNA comm hi in this lesson we will discuss delegation every state has written rules on what nurses and CNAs can and cannot do these rules are usually found in your state statutes every state has a nurse Practice Act that defines the nursing profession in that state you can locate your state's nurse Practice Act here if your state defines specific tasks that CNAs are allowed to perform it will be found in your state's nurse Practice Act this lesson will cover the nurse Practice Act for Florida but other states are similar refer to your state statutes for specific information according to Florida Statute four six 4.20 one subsection five the practice of a certified nursing assistant means providing care and assisting persons with tasks related to the activities of daily living most of the tasks that CNAs are trained to do involve normal daily activities that you do for yourself everyday things like bathing dressing grooming shaving hair care oral hygiene skincare perineal care bed making and maintaining a clean environment CNAs also help patients with mobility tasks including ambulating or walking transferring transporting positioning turning lifting range of motion exercises and maintaining proper body alignment assisting patients with nutrition and hydration are also very important tasks for CNAs and this would include feeding or assisting patients with eating meals setup encouraging fluids assisting with fluids and thickening fluids and we can't forget about elimination what goes in must come out so we will assist patients with toileting assisting with bedpans and urinals providing catheter care collecting specimens emptying ostomy bags and bowel and bladder retraining maintaining a clean environment is important to the safety and well-being of the patient and will include maintaining a clean environment ensuring resident safety infection control techniques and safe handling of blood and body fluids assistive devices are commonly used by residents and we must be prepared to help patients with them so as a cna you will be trained to care for dentures eye glasses hearing aids and contact lenses you will learn to apply prosthetic and orthotic devices braces anti embolus stockings and assist patients with wheelchairs walkers and crutches you will learn how to use comfort devices such as pillows cradles and foot boards assist with self-help devices and using restraints properly you will also perform basic nursing skills - like taking vada signs height and weight oral intake measuring urinary output measuring emesis and liquid stool and reporting abnormal findings signs and symptoms CNAs assist patients in both life and death providing CPR when appropriate assisting with first aid and emergency care assisting with end-of-life care maintaining comfort measures and providing post-mortem care and finally remember that there is more to the patient than medical needs so CNAs promote resident socialization we facilitate participation and leisure activities we perform reality orientation direction provide validation and promote resident and patient rights so you can see that CNAs perform a lot of tasks you will learn to do most of these tasks in your training program but once you are in your work setting the patients who are caring for may need additional skills performed and that's where delegation comes in delegation is a term that allows nurses to assign additional tasks to unlicensed personnel the state statute specifically allows for the delegation of nursing tasks to other personnel Florida statute for six for further declares and any other tasks that a certified nurse assistant may perform after training beyond that required for initial certification and upon validation of competence in that skill by a registered nurse this subsection does not restrict the ability of any person who is otherwise trained and educated from performing such tasks this means that legally you can be trained to perform any other tasks that the RN deems appropriate as authorized by the facility there are certain rules that must be followed by the nurse prior to delegating tasks including making sure that the CNA is trained to perform that new task as a CNA should never perform a task you have not been trained to perform that could put both you and the patient in jeopardy but you can be trained to perform any nursing task by any RN in your work environment but the RN is responsible for making sure that the patient is stable the task must be routine and not require any judgment on your part the RN must also know the capabilities of the staff that they are working with delegation is an extremely complex process requiring the RN to comply with very strict rules first the RN has to assess the patient to identify the patient's specific needs second the RN must establish a goal and ensure that the goal can be met by another person third the RN must assess the skill level of the person they are delegating the task to and ensure that they have the proper training skills and knowledge fourth the RN must communicate what is to be done how it is to be accomplished when it should be performed and what needs to be reported and fifth the RN must monitor and evaluate the performance of the delegated task and will maintain liability for the outcome so there are five specific steps to delegation but from the CNAs point of view there are a few things you need to know about delegation the RN will ultimately decide what tasks can be delegated safely CNAs never perform a task on a patient unless they have received clear instructions from the RN including what how and when CAS must know exactly what is to be done and have the proper supplies to perform the task CAS must have received training on how to perform the task and how to contact the RN and CAS must know when the task is to be performed and most importantly CAS must be aware of what needs to be reported to the RN when performing the task there are very few limits on the type of tasks a CNA can be trained to perform if your state has limitations they would be outlined in the nurse Practice Act or in your state administrative rules the liability for the task always remains with the RN even if the CNA is actually performing the task so it is in the RNs best interest to ensure that all delegation rules are met because ultimately they are still responsible for everything you do if an RN assigns a task to you and you know how to do that task and all the rules are met you can do the task so don't be afraid of learning new skills they will make you a more valuable member of the healthcare team as long as you have been trained on the task and you know what how and when you can safely perform any delegated task you should now understand how tasks are delegated and your responsibilities regarding delegation always work within these rules and you will continue providing safe competent care to your patients while increasing your skills [Music]