What Can a Nurse Delegate to A CNA? The Complete Answer

Wondering what duties a nurse can delegate to a CNA? How can nurses effectively utilize the CNAs? How do you improve delegation skills? What determines the duties/responsibilities of a CNA? You’ll get all your answers in this article.

Working in a demanding & hectic environment can reduce productivity. However, the services of a helper can change that. At times in nursing, you’ll find yourself in a stressful situation that, without help, you can easily mess up. Luckily there are CNAs to help you. Certified nursing assistants are trained helpers that help nurses in performing duties. Nurses delegate CNA’s duties/tasks. However, CNAs cannot tackle a few medical responsibilities like nursing judgment or critical decision-making.

Nurses should know what duties they can delegate & when to delegate. The CNAs in your team are helping patients and nurses at the same time. Nurses should know how to utilize CNA’s skills and knowledge best. We’ll look into more details on this topic. Read more. 

What Is Delegation?

Delegation involves handing over the responsibilities of a task to a CNA or another person but maintaining the commitment to get the results of that task.

How Can Nurses Effectively Utilize the CNAs On Their Team?

CNAs are on your team to assist both you & the patients. In long-term care facilities, CNAs are the primary caregivers. While in hospitals, they’re seen more as the feet & hands of the nurse. Nurses should know the delegation rights and what determines the duties of CNAs to utilize them effectively.

Five Rights of Delegation

The national council of the state board of nursing & the USA nursing association has listed five delegation rights. These can help RN or LPN know how to delegate effectively and safely.

1.     Appropriate Task

As a registered nurse, you should ensure that the CNA can safely fulfill the activity you assign them to handle. The assignment should be within CNA’s experience field and hospital’s procedure.

2.     Credibility of Person

Every CNA has weaknesses and strengths. The nurse must ensure that the CNA has the skill and knowledge to perform this specific task.

3.     Appropriate Circumstances

Before delegating duties, nurses should assess the circumstances. The nurse should determine whether or not CNA has the necessary resources to perform the task. Also, evaluate if the situation and time are appropriate for delegation. Estimating the patient’s concerns and specific needs are also included in this.

4.     Appropriate Supervision

Delegating duties to a CNA doesn’t mean that CNA replaces you. Nurse practice act state that nurses must supervise the delegated tasks appropriately. After completing the assignment, the nurse should also evaluate the outcome.

It is best to give them feedback on their performance.

5.     Effective Communication & Direction

Effective communication is vital when delegating a task. The nurse must ensure that the CNA completely understands the job.

What Determines the Duties of a CNA?

There are 3 three areas determining the duties of a CNA.

Board Approval

1st factor is the state board of nursing that determines what CNAs are authorized to do. The board sets the rules & regulations that describe the dos and don’ts for CNAs. The board is the most significant determining factor under which other qualifications fall.

Job Description

The second factor is the health care facility (like a skilled nursing facility) where CNA works. They may have specific rules that apply to their CNAs. These limitations may prevent the CNA from passing medications (even if the state allows it). They put these limitations to protect both the patients and the CNA.

Competency

3rd factor is the nursing assistant’s competency level. Their command in each task will determine their capability. As a nurse, you’d know in which job the nursing assistant has already shown competency. In which task CNA still needs supervision and what task they can’t do or feels uncomfortable doing.

Evaluating these matters will determine the level of supervision you need to provide.

Read Also: What Not to Do as A CNA: A Comprehensive Guide

What Duties Can a Nurse Delegate to a CNA?

A licensed vocational nurse, licensed practical nurse, or Registered nurse can delegate all the tasks within the scope of the CNAs. The primary role of the CNA is to provide basic care to the patients & help them with regular activities such as bathing, feeding, turning patients, assisting patients in ambulating, non-sterile dressing change, bed making, blood glucose monitoring, administering medication, medical record collection, and gastronomy feeding (in some cases). The tasks delegated to CNAs vary from facility to facility & state to state.

The delegation from nurses to CNAs is summarized below:

• Nurses can’t delegate any activity or task involving nursing judgment, including critical decision-making.
• All the tasks delegated to CNAs are within the scope of the registered nurse’s practice.
• A registered or licensed nurse who delegates the tasks maintains overall patient accountability. However, RN or LPN is responsible for delegated skills, procedures, or activities.
• CNAs can perform specified nursing skills, procedure, or activity that falls outside the primary responsibilities & traditional roles of the CNA.
• Appropriate delegation permits tasks to transition in a safe, consistent manner. The RN or LPN transfers the performance of an activity procedure or skill to a CNA. But the practice of prevalent functions of nursing judgment, clinical reasoning, and critical decision can’t be delegated.

Delegatees obtained extra education, good competence & training to perform the delegated responsibilities and care.

Importance of Delegation

• It saves time for nurses by letting the nursing assistants handle other light duties.
• Enhances teamwork, allowing the nurse to lead the team of assistants.
• Enhances quality of care, as you can assign a CNA to a resident instead of yourself. Meanwhile, you can handle other patients.
• Promotes accountability by letting the CNAs know they are answerable when handling patients.
• Delegating the tasks helps the nurses to use their time to satisfy the patients & their family members.

How to Improve Delegation Skills?

Delegating has benefits, but it takes a lot of practice to utilize this skill effectively. By mastering delegation skills, you’ll deliver services effectively. You can do the following things to improve your skill:

• Learn to set goals & convey to the team the expectations.
• Learn coaching skills to utilize as a guide to the CNAs.
• Plainly describe the job description to the CNA.
• Take accountability for outcomes of CNA’s activity since they are under the RN.
• Comprehend the norms of knowing each team member’s strengths and weaknesses.

Tips for Effective Nursing Tasks/Duties Delegation

Here are some suggestions for effective nursing task delegation.

Leverage Your Team

You’d leverage the strength of team members to get the most out of the nursing delegation. You must know their weaknesses & strengths and actively guide them on how the nursing assistant carries out their duties.

Observe Qualifications & Job Description

When delegating, nurses should ensure that the tasks entrusted to a certified nursing assistant are those they are best qualified for. For instance, a CNA is suitable for helping in the operating room.

Obey Policies & Procedures

For delegating duties, follow the proper procedure and policies for patient safety. The CNA will perform fine since you would have given suitable responsibilities to the right assistant.

Esteem Your Team Members

You should appreciate the CNAs and promote integrity within the group for effective delegation. By accomplishing so, the team will perform in cohesion to gain the best results.

Consider Policies & Laws

When delegating, estimate the laws & policies of the jurisdiction. Different hospitals & States have various regulations. Before entrusting duties to a nursing assistant, you must apprehend these rules.

Can A Nurse Delegate A CNA Medication Administration?

Medication administration is an essential task for nurses as it has the most significant potential for detrimental error. As LPN, you need to look after this task personally whenever possible. However, if the CNA has obtained technical training in medication administration, more than 30 states authorize delegation. Sometimes, this could also have injections.

As the nurse, you’ll still be accountable for overseeing this task & evaluating your patient’s outcomes.

Can Nurses Delegate Other Nurses?

Nurses can charge nurses with higher scopes of practice & those with a lower range of training.

Nurses With the Heightened Scope of Training/Practice

Delegating nurses with a more heightened scope of training/practice could occur if the nurses require another set of eyes to assist with a patient assessment. It can also happen if the nurse requires to confer with a nurse practitioner when client treatment is needed.

For instance, you can contact your charge nurse or house supervisor nurse for assistance when you struggle with reading an EKG due to a lack of understanding.

Nurses With a Much Lower Scope of Practice

Delegating nurses with a much lower scope of practice occurs frequently & is what happens when you ask a nursing assistant to finish a specific task.

Final Thought

Delegation is a task that needs nurses to utilize their critical thinking skills to keep their patients safe all the time. It is a critical nursing competency. At times nurses have to handle a lot of residents, and the CNAs are assigned to help them manage some tasks.

If you’re a nurse functioning with CNAs, utilize this guide to assist you in allocating duties.