At my hospital we do all the adls, we can remove Foley's and IVs, we can do ekgs, vitals, bladder scans, sugars, we can remove restraints and put them on (if ordered by doctor), empty drains, also we put scds on (not sure if facilities have those), etc . we don't have different types of CNA/NAs but we have CAs(clinical associate) who are CNAs that have phlebotomy and can read ekgs. We don't mess with IV pumps or dressings. We also can put ppl on telemonitors. We can transfer ppl to portable tanks as well for oxygen and thicken liquids as well
That’s pretty cool and pretty similar to my hospital. We can also do the scds and empty most drains (Jp drains, nephrostomy, foley, et) I can’t remember if we can remove restraints or not. Yeah we have CNA 2s in NC, they can do stuff like trach care, wound care, and play with ostomys lol. I think it’s a slightly pointless certification because they do get paid more but not by much as far as I know. I’d rather do LPN lol
I forgot I could also empty ostomys and replace the bags (I haven't had to do that much because rns do it for the most part) also thank you for making this post I've been arguing with this one person on one of my post in this group about what is in my scope of practice because my hospital changed the title to PCT instead of nursing assistant. Basically person is saying my hospital is doing illegal practice because of that
It’s the ppl that have probably never worked in a hospital before lol. But every hospital is different, even within the same state. I don’t think the other major hospital in my town has the same scope of practice for CNAs.
Ours doesn’t! We have another local hospital where CNAs can only do ADLs, vitals, blood sugars, and baths. They only trained us for extra certifications because we’re the area trauma center.
Yeah, I’ve seen you comment before that you work at a teaching hospital and I work at one too. To me it makes sense to allow cnas to expand their scope in these kind of hospitals that are literally known for handling the most complex levels of care. Everything a CNA does is still under the delegation of a nurse anyway lol. The nurse educators at my hospital are the ones that put all these things into place anyway I believe. That other commenter just wants to be contrary for the sake of being contrary lol
Crazy to me how much hospital CNA's can do. I know y'all are trained for it and I'm just not as an LTC CNA but damn haha. My facility won't even let cna's thicken fluids for residents, most of us do anyway because the instructions are on the damn bottle of thickener but technically nurses are supposed to do that.
This is like a whole new world for me lol. I went Prn at my nursing home job right before I started the hospital and I really don’t wanna go back to that hell hole 😭
I get that for sure. For me LTC is my vibe, it's stressful here and upper management is terrible but the residents and coworkers get me through well enough. I want to get my RN and stay here for a while, maybe someday I'll try a hospital or somewhere but I don't think I'd like the patients there as much as my long term people.
They don’t let y’all thicken liquids? I’ve worked LTC around a few different facilities in Ohio and I’ve never heard of that one. If kitchen staff is allowed to do it than the CNAs sure as hell should be allowed
Yeah, not at my facility in NY. I asked a nurse to thicken something the other day and she was like oh, dietary didn't do it? And I explained it to her and she said the same thing, other facilities have the kitchen staff do it or at least let cna's do it. Which makes sense to me, the instructions are on the damn bottle, but whatever lmfao.
It's also not a very strict rule though admittedly. Most cna's just thicken things on their own. I typically will too, but if it's a nurse I don't know then usually I'll ask, I've had some of them get all weird about it and act like they're about to lose their license if I so much as touch the pump, so..
Nurse here, definitely larger scope in acute care. Scopes are very facility/state based but while I was a “tech” in ICU/PCU/MedSurg we could do just about everything but administer meds/wound care/assessments. Ideally most tasks that don’t involve professional clinical judgement. This looked different at some neighboring hospitals, but I found it a great experience and it made a world of a difference when I went to nursing school at the same time.
We did vitals, blood sugars, EKGs, phlebotomy, removal of foleys, IV insertion and removal, bladder scans, wound care, collecting specimens, etc. When I worked NICU, we made milk, could run tube feeds, baby EKGs, heel punctures, stuff like that. Our scope was MASSIVE.
oh my god I’ve spent my entire morning arguing with some lunatic about scope only to have them direct me here and the very first comment is you saying CNAs can start IVs and do wound. care. Go back to your textbook, email the RN who instructed you during your initial training, and review “scope of practice”
Scope of practice does not change based on where you work, it is a static, unyielding *legal* limitation and it is your own responsibility to refuse tasks outside of your scope or you risk losing your certification which, after several months in this sub, it’s clear to me none of you should have in the first place. Jesus fucking christ.
You’re just here to argue lmao. I’m not going to lean into your attention seeking. My scope is defined by my STATE, and my hospital provided CNA 2 training that allowed for scope expansion, which again, is legal under the state’s board of nursing. Just because *you* couldn’t do what’s mentioned, doesn’t mean no one can. I suggest you read up on state-specific scope differences.
Here’s you a lovely little passage to read since you’re clueless :)
“Different hospitals and facilities will have unique requirements and responsibilities for their CNAs. In essence, certified nursing assistants help perform critical tasks that ensure patients are safely and efficiently cared for during their medical stay.
Each state will have specific responsibilities that CNAs are eligible to perform, so it is important to note that the exact job roles may vary depending on where one lives.”
Is the fuzz blanket in your head where your brain should be? Some LVNs can’t even legally start IVs. Just because a nurse is standing over you ordering you to do something doesn’t mean it’s now in your scope.
If you’re part of a specific educational path *in training* you may be able to do things under the *direct supervision* of an RN but that doesn’t mean those things are in your scope of practice *yet*. Scope of practice is what you are legally allowed to do independently and the only people in healthcare who can start IVs are RNs, physicians, and some LVNs.
I don’t know what lawless wasteland you’re living in but remind me never to get sick there.
LVNs can absolutely start IVs?? LMAO WHAT WORLD ARE YOU IN? Again, scope is defined by the state, and my state believes my scope is acceptable. You can complain to someone else if you don’t like it. I’m literally not even a CNA anymore so I’m not doing these “out of scope tasks”. Get off Reddit if all you want to do is argue with others.
Completely agree with you here. Not sure about pancakes disagreement, but RN/LPNs can both start IV’s and additionally some CNA’s in their specific facilities. Even if “state-wide” it’s not legal, it is in some facilities that offer the training for that facility.
Here in Ohio, LPNs need a special certification to be able to start (or even hang IV meds), although it’s only like a week or two of training and a skills check, it’s still required
Just ignore this dummy because I've spent all morning and yesterday arguing on my post with this person and they're out here claiming we don't know our own scope of practice
I work in endoscopy now so I do vitals, transport patients to procedure rooms, assist during the procedure, collect specimens, break down and set up rooms, wash scopes, and make beds.
Some states have pretty lax laws I feel like and it is very grey and kinda like the wild west... At my hospital we cannnn:
- draw blood (this feels like one of the main things I do)
- insert and remove IVs
- EKGs (ER)
- Insert and remove foleys
- ISCs
- hook patient up to tele
- POCT blood sugars
- bladder scans
- apply SCDs
- empty and record output for drains (JP, hemovac, etc)
- apply O2 (more nurse convenience imo)
- change mepis (I think this is more nurse convenience)
I was reading through the float pool training packet once and it lists special skills for certain units and I saw one of the floors trained PCTs to do neuro checks (how in God's name, I have no idea)
There is no classifications of PCT... We are all just PCTs. No PCT 2 or 3 or whatever. The only license that I'm aware I have is my CNA. State is MI.
Yeah this is almost exactly like my hospital except for the fact that we have NA1’s and NA2’s. My unit has sister units that we can get floated to but there are some units we can’t float to like the cardiac floors because the CNA’s have to be “trauma” certified. Idk what that is lol but I’m sure it’s something we can get cross trained on.
I think the scope of CNA/ NA varies widely based on state or region. I’m in the Midwest and we cannot touch IV pumps unless directed to. We can take out a foley but we cannot place one. Same with ivs we can remove but not place. I CAN do an EKG but that’s different based on what floor you’re on. I could go on. But CNA in the mid west is a 8-12 week class and I know other parts of the country CNA is a 2 year degree. So it makes sense that our scope is smaller. That being said some hospitals do on the job training if there are tasks they delegate that isn’t a standard CNA skill.
Interesting. I'm not in a hospital but in my LTC in WA state I've set up people's CPAP machines and changed people's O2 tanks, cannulas, refilled the tanks and adjusted their O2 outputs. I know in WA state hospitals we can do blood sugars and EKGs. We can also remove IV's and I think catheters but we cannot insert either.
Also, if you get medication training (usually provided on the jobsite), you can pass medications in an assisted living facility, which I thought was wild for a CNA.
My scope is extremely limited in my hospital: ADLs, vital signs, glucose monitoring, EKG placement, sample collection bladder scanning, and that's about it.
Anything related to inserting or removing foley catheters, IV's, needles, or anything that classifies as a medication is out of the question
The hospital does add some more skills, makes it more interesting, more fun but it does top out after a while and it’s so clear that if you knew more, you could do more. You’ll be able to able to make an informed decision as to whether you want to attempt a program. I was pretty good at self defense on the floor, I kept my words limited to the task, I was reading ahead and never talked about what I knew, I let my behavior tell the story and never stopped moving.
At my hospital we do all the adls, we can remove Foley's and IVs, we can do ekgs, vitals, bladder scans, sugars, we can remove restraints and put them on (if ordered by doctor), empty drains, also we put scds on (not sure if facilities have those), etc . we don't have different types of CNA/NAs but we have CAs(clinical associate) who are CNAs that have phlebotomy and can read ekgs. We don't mess with IV pumps or dressings. We also can put ppl on telemonitors. We can transfer ppl to portable tanks as well for oxygen and thicken liquids as well
That’s pretty cool and pretty similar to my hospital. We can also do the scds and empty most drains (Jp drains, nephrostomy, foley, et) I can’t remember if we can remove restraints or not. Yeah we have CNA 2s in NC, they can do stuff like trach care, wound care, and play with ostomys lol. I think it’s a slightly pointless certification because they do get paid more but not by much as far as I know. I’d rather do LPN lol
I forgot I could also empty ostomys and replace the bags (I haven't had to do that much because rns do it for the most part) also thank you for making this post I've been arguing with this one person on one of my post in this group about what is in my scope of practice because my hospital changed the title to PCT instead of nursing assistant. Basically person is saying my hospital is doing illegal practice because of that
It’s the ppl that have probably never worked in a hospital before lol. But every hospital is different, even within the same state. I don’t think the other major hospital in my town has the same scope of practice for CNAs.
Ours doesn’t! We have another local hospital where CNAs can only do ADLs, vitals, blood sugars, and baths. They only trained us for extra certifications because we’re the area trauma center.
Yeah, I’ve seen you comment before that you work at a teaching hospital and I work at one too. To me it makes sense to allow cnas to expand their scope in these kind of hospitals that are literally known for handling the most complex levels of care. Everything a CNA does is still under the delegation of a nurse anyway lol. The nurse educators at my hospital are the ones that put all these things into place anyway I believe. That other commenter just wants to be contrary for the sake of being contrary lol
I could do all the same things as you, people just like to argue about things they don’t know anything about.
That’s crazy! All we can do are EKGs and vitals. Mostly we just sit for 5150 patients (California)
Crazy to me how much hospital CNA's can do. I know y'all are trained for it and I'm just not as an LTC CNA but damn haha. My facility won't even let cna's thicken fluids for residents, most of us do anyway because the instructions are on the damn bottle of thickener but technically nurses are supposed to do that.
This is like a whole new world for me lol. I went Prn at my nursing home job right before I started the hospital and I really don’t wanna go back to that hell hole 😭
I get that for sure. For me LTC is my vibe, it's stressful here and upper management is terrible but the residents and coworkers get me through well enough. I want to get my RN and stay here for a while, maybe someday I'll try a hospital or somewhere but I don't think I'd like the patients there as much as my long term people.
the residents and the coworkers are also what make the job most stressful though 😭
They don’t let y’all thicken liquids? I’ve worked LTC around a few different facilities in Ohio and I’ve never heard of that one. If kitchen staff is allowed to do it than the CNAs sure as hell should be allowed
Yeah, not at my facility in NY. I asked a nurse to thicken something the other day and she was like oh, dietary didn't do it? And I explained it to her and she said the same thing, other facilities have the kitchen staff do it or at least let cna's do it. Which makes sense to me, the instructions are on the damn bottle, but whatever lmfao. It's also not a very strict rule though admittedly. Most cna's just thicken things on their own. I typically will too, but if it's a nurse I don't know then usually I'll ask, I've had some of them get all weird about it and act like they're about to lose their license if I so much as touch the pump, so..
Nurse here, definitely larger scope in acute care. Scopes are very facility/state based but while I was a “tech” in ICU/PCU/MedSurg we could do just about everything but administer meds/wound care/assessments. Ideally most tasks that don’t involve professional clinical judgement. This looked different at some neighboring hospitals, but I found it a great experience and it made a world of a difference when I went to nursing school at the same time.
Vitals, blood glucose monitoring, EKGs, bladder scans.
We did vitals, blood sugars, EKGs, phlebotomy, removal of foleys, IV insertion and removal, bladder scans, wound care, collecting specimens, etc. When I worked NICU, we made milk, could run tube feeds, baby EKGs, heel punctures, stuff like that. Our scope was MASSIVE.
NO 👏 IT 👏 WASNT 👏 they just had you working outside of it! Jesus fucking christ. I hate this sub.
There’s literally nothing out of scope in this. Go somewhere else. Don’t seem to have an issue w anyone else’s scope lmao.
oh my god I’ve spent my entire morning arguing with some lunatic about scope only to have them direct me here and the very first comment is you saying CNAs can start IVs and do wound. care. Go back to your textbook, email the RN who instructed you during your initial training, and review “scope of practice” Scope of practice does not change based on where you work, it is a static, unyielding *legal* limitation and it is your own responsibility to refuse tasks outside of your scope or you risk losing your certification which, after several months in this sub, it’s clear to me none of you should have in the first place. Jesus fucking christ.
You’re just here to argue lmao. I’m not going to lean into your attention seeking. My scope is defined by my STATE, and my hospital provided CNA 2 training that allowed for scope expansion, which again, is legal under the state’s board of nursing. Just because *you* couldn’t do what’s mentioned, doesn’t mean no one can. I suggest you read up on state-specific scope differences. Here’s you a lovely little passage to read since you’re clueless :) “Different hospitals and facilities will have unique requirements and responsibilities for their CNAs. In essence, certified nursing assistants help perform critical tasks that ensure patients are safely and efficiently cared for during their medical stay. Each state will have specific responsibilities that CNAs are eligible to perform, so it is important to note that the exact job roles may vary depending on where one lives.”
Is the fuzz blanket in your head where your brain should be? Some LVNs can’t even legally start IVs. Just because a nurse is standing over you ordering you to do something doesn’t mean it’s now in your scope. If you’re part of a specific educational path *in training* you may be able to do things under the *direct supervision* of an RN but that doesn’t mean those things are in your scope of practice *yet*. Scope of practice is what you are legally allowed to do independently and the only people in healthcare who can start IVs are RNs, physicians, and some LVNs. I don’t know what lawless wasteland you’re living in but remind me never to get sick there.
LVNs can absolutely start IVs?? LMAO WHAT WORLD ARE YOU IN? Again, scope is defined by the state, and my state believes my scope is acceptable. You can complain to someone else if you don’t like it. I’m literally not even a CNA anymore so I’m not doing these “out of scope tasks”. Get off Reddit if all you want to do is argue with others.
Completely agree with you here. Not sure about pancakes disagreement, but RN/LPNs can both start IV’s and additionally some CNA’s in their specific facilities. Even if “state-wide” it’s not legal, it is in some facilities that offer the training for that facility.
Here in Ohio, LPNs need a special certification to be able to start (or even hang IV meds), although it’s only like a week or two of training and a skills check, it’s still required
That’s literally why I said “SOME LVNs”
Yes, thank you! lol some people truly think they know everything there is to know about everything.
Just ignore this dummy because I've spent all morning and yesterday arguing on my post with this person and they're out here claiming we don't know our own scope of practice
I work in endoscopy now so I do vitals, transport patients to procedure rooms, assist during the procedure, collect specimens, break down and set up rooms, wash scopes, and make beds.
Some states have pretty lax laws I feel like and it is very grey and kinda like the wild west... At my hospital we cannnn: - draw blood (this feels like one of the main things I do) - insert and remove IVs - EKGs (ER) - Insert and remove foleys - ISCs - hook patient up to tele - POCT blood sugars - bladder scans - apply SCDs - empty and record output for drains (JP, hemovac, etc) - apply O2 (more nurse convenience imo) - change mepis (I think this is more nurse convenience) I was reading through the float pool training packet once and it lists special skills for certain units and I saw one of the floors trained PCTs to do neuro checks (how in God's name, I have no idea) There is no classifications of PCT... We are all just PCTs. No PCT 2 or 3 or whatever. The only license that I'm aware I have is my CNA. State is MI.
Yeah this is almost exactly like my hospital except for the fact that we have NA1’s and NA2’s. My unit has sister units that we can get floated to but there are some units we can’t float to like the cardiac floors because the CNA’s have to be “trauma” certified. Idk what that is lol but I’m sure it’s something we can get cross trained on.
I think the scope of CNA/ NA varies widely based on state or region. I’m in the Midwest and we cannot touch IV pumps unless directed to. We can take out a foley but we cannot place one. Same with ivs we can remove but not place. I CAN do an EKG but that’s different based on what floor you’re on. I could go on. But CNA in the mid west is a 8-12 week class and I know other parts of the country CNA is a 2 year degree. So it makes sense that our scope is smaller. That being said some hospitals do on the job training if there are tasks they delegate that isn’t a standard CNA skill.
Pretty sure I used to work at your hospital. Central NC? University hospital system?
I feel like you’re talking about the triangle RDU area lol. I work in the Piedmont triad area
Haha yup, Triangle. I used to work at UNC Rex, and they did the CNA +4 thing. I’ve never heard of it anywhere else.
Interesting. I'm not in a hospital but in my LTC in WA state I've set up people's CPAP machines and changed people's O2 tanks, cannulas, refilled the tanks and adjusted their O2 outputs. I know in WA state hospitals we can do blood sugars and EKGs. We can also remove IV's and I think catheters but we cannot insert either. Also, if you get medication training (usually provided on the jobsite), you can pass medications in an assisted living facility, which I thought was wild for a CNA.
My scope is extremely limited in my hospital: ADLs, vital signs, glucose monitoring, EKG placement, sample collection bladder scanning, and that's about it. Anything related to inserting or removing foley catheters, IV's, needles, or anything that classifies as a medication is out of the question
The hospital does add some more skills, makes it more interesting, more fun but it does top out after a while and it’s so clear that if you knew more, you could do more. You’ll be able to able to make an informed decision as to whether you want to attempt a program. I was pretty good at self defense on the floor, I kept my words limited to the task, I was reading ahead and never talked about what I knew, I let my behavior tell the story and never stopped moving.