Role of the Nursing
Interdisciplinary Team
• A group of professionals from
different health care disciplines
who each contribute their
expertise to the care of a
single patient
Interdisciplinary Team
• Members
– Physicians make a diagnosis and prescribe
– 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
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
The Nursing Team
– Licensed-passed state board exam
– Works under the supervision of a RN, MD or
– Provides most of the care when patient’s
nursing needs are not complex
– Assists the RN in more complicated situations
The Nursing Team
– 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
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
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
Attend care plan conferences and give your
Attend in-service training sessions
Become cross-trained
Cooperate with other team members to provide
patient focused care
Regulation of Nursing Assistant
• 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
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
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
Line of Authority
• Health care facilities all have different lines of
authority or chain of command
– CNA, LPN, RN Charge Nurse, Director of Nursing,
• 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
Line of Authority
• Know your facility’s organizational
Charge Nurse
Team Leader
The Patient
Guidelines to Follow
• Work with your line of authority when solving
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.
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
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
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
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
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)
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
Personal Adjustments
• Develop good relationships with your
• Show empathy for the patient by being
eager to serve and by using a gentle
• You may have patients with different
problems or concerns, but to a patient,
his/her own problems are the most
Personal Adjustments
• Not all patient responses are about YOU or your job
• Patients may become irritable, complaining or
uncooperative because of
Fear about their diagnosis, disability or death
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
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
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
– Offer to help others and accept help when you
need it
– Have a positive attitude
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
– Treat all with respect
– Practice good hygiene, nutrition and stress
Personal Hygiene
• Bathe daily
• Use deodorant
• Good oral hygiene
• Clean hair, pulled
• Only stud earrings,
Short, clean natural
nails-clear polish
wedding band and
watch are allowed
Clean socks or
Well fitting shoes
• 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
Stress, Stress, Stress
• Avoid burnout by
reducing stress
Sufficient rest
Good nutrition
Leisure activities
Stress reduction
Group discussion
Stress management
Exercise programs
• Personal Stress
– Go for a walk
– Devote time to
– 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

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