The Certified Nursing Assistant (Aide) provides personal care and services to the terminally ill to augment that care given by family members in a patient’s residence or patient care facility. Aide functions under the direction, instruction and supervision of the Registered Nurse and/or Clinical Supervisor.
Performs only those personal care activities contained in a written Certified Nursing Assistant assignment which may include:
• This is a safety-sensitive position
• Helps the patient to maintain good personal hygiene
• Assists in maintaining a safe and healthy environment.
• Prepares and serves meals.
• Assists in feeding patient when needed.
• Assists the patient in ambulation
• Assists with the safe use of a walker or wheelchair as taught and supervised by the nurse or physical therapist for a specific patient.
• Assists with certain treatments as ordered by the physician and taught and supervised by the Registered Nurse for a specific patient including assisting with the change of the colostomy bag, reinforcement of a dressing, assisting with prescribed ice cap or collar, measuring intake and output, and may remind patients to take medications that are ordinarily self-administered
• Assists with prescribed range of motion exercises which the Registered Nurse or the Physical Therapist has taught to the Aide and patient.
• Attempts to promote patient’s mental alertness through involvement in activities of interest.
• Gives basic emotional and psychological support to the patient and other members of the household
• Reports any change in the patient’s mental or physical condition or home situation to the Registered Nurse and members of the interdisciplinary team.
• Demonstrates basic care to the primary caregiver.
• Practices infection control measures and standard precautions.
• Provides accurate documentation with visit itineraries
• Completes a minimum of 12 hours of in-services per year
• Attends staff meetings.
• Participates in at least one Quality Improvement activity yearly, as assigned by supervisor.
• Hands in paperwork and finishes system documentation in a timely manner as outlined in orientation.
• Performs other duties as assigned
• Consistently promotes company values
• Completes required Curo annual training
The Certified Nursing Assistant May Not
• Change sterile dressings.
• Irrigate a colostomy or wound
• Perform a gastric lavage or gavage
• Catheterize a patient.
• Administer medications or apply medicated ointments.
• Apply heat by any method.
• Care for a tracheotomy tube.
• Suction a patient.
• Transport a patient or family member in any personal vehicle or company car.
• Provide personal health service which has not been included in the patient care plan by the Nurse.
Note: See additional State Specific Requirements for Illinois, Nebraska, and Minnesota beyond what is listed below for each state respectively.
STATE-SPECIFIC REQUIREMENTS FOR:
Revision Date 3/1/2017 (Covers Nebraska, Minnesota, and Illinois)
ILLINOIS: requires nursing services be provided under the supervision of a registered nurse. If the clinical supervisor, therefore, is not a registered nurse, the Aide may not function under his/her direction, instruction and/or supervision.
MINNESOTA: requires hospice to ensure the Aide successfully completes 75 hours of training and a competency evaluation, described below. The hospice may offer the training program itself, or ensure the training meets the requisite requirements as set forth below.
TRAINING AND COMPETENCY EVALUATION
• Home health aide training:
o Combine classroom and supervised practical training totaling at least 75 hours, with at least 16 hours devoted to supervised practical training. The individual being trained must complete at least 16 hours of classroom training provided by a registered nurse before beginning the supervised practical training. "Supervised practical training" means training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual.
o Be performed by or under the general supervision of a registered nurse who possess a minimum of two years of nursing experience, at least one year of which must be in the provision of home health care. Other individuals may provide instruction under the supervision of the qualified registered nurse. A mannequin may be used for training.
o Be based on an instruction plan that includes learning objectives, clinical content, and minimum acceptable performance standards.
o Be documented and retained in personnel records.
• Home health aide competency evaluations will:
o Be performed by a registered nurse;
o Address each of the following subject areas: communication skills; observation, reporting, and documentation of patient status and the care or service furnished; basic infection control procedures; basic elements of body functioning and changes in body function that must be reported to an aide's supervisor; maintenance of a clean, safe, and healthy environment; recognizing emergencies and knowledge of emergency procedures; physical, emotional, and developmental needs of and ways to work with the populations served by the hospice provider, including the need for respect for the patient, the patient's privacy, and the patient's property; adequate nutrition and fluid intake; reading and recording temperature, pulse, and respiration; appropriate and safe techniques in personal hygiene and grooming, including bed bath; sponge, tub, or shower bath; shampoo in sink, tub, or bed; nail and skin care; oral hygiene; toileting; and elimination; safe transfer techniques and ambulation; normal range of motion and positioning; and any other task that the registered nurse may choose to have the home health aide perform, including medication reminders, assistance with self-administration of medications, and administration of medications;
o Use evaluation after observation of the tasks identified above, subitems (9) to (12). Subject areas identified above as subitems (1) to (8) and (13), must be evaluated through written examination, oral examination, or after observation of the home health aide with a hospice patient.
o Determine that a home health aide who is evaluated as satisfactory in all subject areas except one is considered competent. The aide is not allowed to perform the task in which the aide is evaluated as unsatisfactory, except under direct supervision of a registered nurse.
NEBRASKA: The home health aide may not perform acts which require the exercise of nursing or medical judgment. Home health aide services must be provided by a person who is:
• At least 18 years of age;
• Is of good moral character;
• Has not been convicted of a crime under the laws of Nebraska or another jurisdiction, the penalty for which is imprisonment for a period of more than one year and which is rationally related to the person’s fitness or capacity to act as a home health aide;
• Is able to speak and understand English or the language of the hospice patient and the hospice staff member who acts as the home health aide’s supervisor;
• Meets one of the following qualifications and provides proof of meeting the qualification to the hospice:
o Is a graduate of a practical or professional school of nursing, or
o Successfully completed a 75-hour home health aide training course which meets the standards described in Neb. Rev. Stat. § 71-6608.01, or
o Has been employed by a licensed hospice or a home health agency as a home health aide II prior to September 6, 1991, or
o Has successfully completed a course in a practical or professional school of nursing which included practical clinical experience in fundamental nursing skills and has completed a competency evaluation as described in Neb. Rev. Stat. § 71-6608.02, or
o Has successfully completed a 75-hour basic course of training approved by the Nebraska Department of Health and Human Services for nursing assistants as required by Nev. Rev. Stat. § 71-6039 and has completed a competency evaluation described in Neb. Rev. Stat. § 71-6608.02, or
o Has been employed by a licensed home health agency as a home health aide I prior to September 6, 1991 and has completed a competency evaluation as described in Neb. Rev. Stat. § 71-6608.02, or
o Has met one of the qualifications listed above in another state or territory of the United States.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
• Education: High School graduate or equivalent preferred.
• Experience: Six months direct patient care experience in an institutional setting, prefer one year.
• Licenses, Certifications and/or Registration:
o Proof of state certification, listed as Certified Nursing Assistant I or II in accordance with state law of the state the hospice is located.
o Must maintain good standing with the State specific Certified Nursing Assistant Board
o CPR Certification
o Current automobile insurance and valid driver’s license
• Equipment/Tools/Work-Aids: Ability to operate computer, facsimile equipment, copier and cellphone/beeper. Must have and maintain transportation to be used for work.
• Specialized Knowledge and Skills: Ability to apply knowledge of the special needs of hospice patients and families; knowledge of community resources.
• Personal Traits, Qualities and Aptitudes: Must demonstrate skills and written/oral competency prior to working independently with a patient: Sensitivity to feelings of the terminally ill and their families before and after patient’s death. Must be able to demonstrate flexibility by performing a variety of tasks, often changing from one to another of a different nature without loss of efficiency or composure. Good oral and written communication skills. Communicate effectively with people of all socioeconomic backgrounds. Display evidence of patient advocacy.
• Working Conditions: Patient’s homes and/or institutional setting and automobile travel. Potential exposure to infections, communicable diseases, odors, blood, excreta and hazardous materials.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be requested by individuals with disabilities to allow them to perform the essential functions.
• The ability to work in a constant state of alertness and safe manner
• Express or exchange ideas by means of the spoken word
• Must be able to read, write, and comprehend English
• Perceive the nature of sounds by the ear
• Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus.
• Endure long periods of driving
• Stand, walk and/or sit for extended periods of time.
• Recurring movement to fingers, hands, wrists, legs and feet.
• Moderate bending, kneeling, crouching, reaching, pushing, pulling
• Demonstrate manual dexterity
• Ambulate on rough surfaces and climb stairs
• Lift or move up to 25 lbs when transporting supplies and lift and turn patients in excess of 50 lbs
• Maintains high standards of integrity and business ethics.
• Abides by company rules, policies and procedures, and applicable laws and regulations.
• Conducts self in an honest, ethical manner.
• Reports promptly any suspected violation of compliance standards via the open door policy.
• Reports to the Director of Operations.
• Receives clinical direction from the patient’s primary nurse.