Our clinic recently eliminated two RN positions and replaced them with a CNA and MA. Our state nursing practice act says UAPs are not allowed to do anything that requires RN training and education.
A discussion with our boss about our legal concerns ended with our boss ranting, raving and accusing us of sabotaging his plans. He is not a nurse. Where can we find out more about the do’s and don’ts of tasks that can be delegated to a UAP?
Dear Nancy replies:
You were correct in trying to determine if your state nurse practice act gave you any guidance on the issue of what UAPs can do in your state. You also should check the rules accompanying the act. Many times, the rules or regulations contain more specific information about a particular section in a nurse practice act can guide you.
Another resource for you is to determine what agency or what institution trains UAPs. Reviewing its curriculum might provide you with some answers. If your UAPs are certified nurses aides, identifying the agency that certifies them and disciplines them for violations of their regulatory obligations and contacting the agency for an opinion would be best. In some states, the agency is the state public health department. In others, it may be the board of nursing.
Your concerns are well founded, regardless of your boss’ accusations. Because you are a nurse licensee, you are responsible and accountable for your own behavior. If you delegate a patient care responsibility to a UAP, or knowingly allow a UAP to do something only an RN, APN, or LPN can do in your state, you can face disciplinary action by the state board of nursing. So, getting specific direction on this issue is important and urgent.