Can a CNA Assist with Mobility? Understanding the Scope of Practice

Certified Nursing Assistants (CNAs) are the backbone of direct patient care, with assisting with mobility being one of their core responsibilities. Their training includes crucial skills to help individuals move safely, which is vital for maintaining independence and preventing injuries. The specific mobility tasks a CNA can perform are defined by their scope of practice, which varies by state.

Quick Summary

Certified Nursing Assistants are extensively trained to provide mobility assistance, including helping patients transfer from beds to chairs, ambulating with a gait belt, and repositioning to prevent bedsores. Their role involves supporting and encouraging patient movement under the supervision of licensed nurses, with a strong focus on ensuring safety and preventing falls.

Key Points

• Core Responsibility: Assisting with patient mobility is a fundamental duty for a Certified Nursing Assistant (CNA), trained to help with transfers, ambulation, and repositioning.

• Ensuring Safety: CNAs are extensively trained in fall prevention strategies, including using assistive devices like gait belts and maintaining a hazard-free environment.

• Proper Technique: They learn correct body mechanics and techniques for lifting and moving patients to prevent injury to both themselves and the patient.

• Clear Limitations: CNAs operate within a defined scope of practice, which means they do not perform specialized therapeutic interventions or make clinical assessments.

• Supervision is Key: All CNA mobility assistance is conducted under the supervision of a licensed nurse (LPN or RN), and any changes in a patient's condition must be reported immediately.

• Know When to Ask for Help: CNAs are trained to recognize when a patient's needs exceed a single person's capacity and know to seek a two-person assist to ensure safety.

The CNA's Role in Patient Mobility

Certified Nursing Assistants (CNAs) are on the front lines of patient care, making them an indispensable part of the mobility support team. Their training equips them with the necessary skills to help patients and residents with a wide array of movement-related tasks. This assistance is essential for daily activities and overall well-being, especially for older adults or those recovering from illness or injury. CNAs often spend more one-on-one time with patients than many other healthcare professionals, allowing them to closely monitor mobility and identify potential issues early on.

Assisting with Transfers and Ambulation

One of the most frequent mobility tasks for a CNA is assisting with transfers and ambulation. A transfer involves moving a patient from one location to another, such as from a bed to a wheelchair or a chair to a toilet. Ambulation, which is the medical term for walking, is also a key area of support. For many patients, the simple act of standing and walking requires professional help to ensure safety and prevent injury. CNAs use specific techniques and safety devices to perform these tasks correctly.

Key aspects of transfers and ambulation assistance include:

• Using a transfer belt: A gait or transfer belt is a critical tool for safely assisting a patient to stand and walk. The belt is secured around the patient's waist, and the CNA holds onto it to provide stability and support, guiding the patient's movements.
• Repositioning: For bedridden or mobility-impaired patients, CNAs regularly help reposition them in bed. This is done to prevent pressure ulcers (bedsores) and improve comfort by shifting weight and relieving pressure points.
• Supporting walking: CNAs may walk alongside patients, offering physical support and encouragement. They are trained to walk slightly behind and to the side of the patient, maintaining a firm grip on the transfer belt in case of a stumble.
• Assisting with assistive devices: For patients who use devices like canes, walkers, or wheelchairs, CNAs help them use the equipment correctly and safely.

The Critical Role of Fall Prevention

Falls are a significant concern in senior care, and CNAs play a vital role in prevention. By being attentive and proactive, they minimize fall risks for their patients. Their strategies include:

• Risk assessment: CNAs can assist licensed nurses in conducting fall risk assessments. By identifying factors like mobility issues, unsteady gait, or medication side effects, they help create a personalized care plan to address specific needs.
• Creating a safe environment: A CNA ensures the patient's immediate surroundings are free of hazards. This includes keeping floors dry and clear of clutter, ensuring proper lighting, and placing frequently used items within easy reach.
• Frequent monitoring: Patients at high risk for falls require constant vigilance. CNAs perform routine rounds, answer call lights promptly, and never leave a patient unattended during transfers.
• Promoting safe footwear: CNAs encourage patients to wear appropriate, non-slip footwear to reduce the risk of slipping.
• Education: By building trust and rapport, CNAs can effectively educate patients on safety protocols, encouraging them to ask for help rather than attempting risky movements on their own.

What CNAs Cannot Do Regarding Mobility

While highly trained in assistance, a CNA's scope of practice has clear limitations. They are not authorized to perform certain actions that fall under the purview of a licensed nurse or a specialized therapist. These restrictions are in place to ensure patient safety and proper care.

• Administering specialized therapy: CNAs can support mobility exercises prescribed by a physical therapist, but they cannot design or administer the specialized therapy themselves.
• Making clinical decisions: They cannot independently assess a patient's condition or determine the appropriate course of mobility treatment. Any change in a patient's mobility or health must be reported to a supervising licensed nurse.
• Complex equipment management: While CNAs can assist with basic equipment like gait belts and walkers, they cannot operate or troubleshoot advanced medical equipment such as ventilators or dialysis machines.

When and How a CNA Should Seek Assistance

Safety is the top priority for both the patient and the CNA. CNAs are trained to recognize situations that exceed their capabilities and require additional support. If a patient is too heavy for a safe transfer or if the CNA feels a risk of injury, they must not attempt to lift the patient alone. This is when they should summon a coworker or supervising nurse for a two-person assist. In the event of a patient fall, a CNA's training dictates that they do not try to stop the fall, but instead, safely lower the patient to the floor while protecting their head. Following this, they must notify a supervising nurse immediately for a full assessment.

The Difference: CNA vs. LPN Mobility Roles

Aspect	Certified Nursing Assistant (CNA)	Licensed Practical Nurse (LPN)
Primary Role	Provides fundamental, hands-on assistance with Activities of Daily Living (ADLs), including basic mobility.	Has a broader scope of practice, which includes basic nursing care and some medical tasks, in addition to overseeing CNAs.
Mobility Tasks	Focuses on safe patient transfers, ambulation support, and repositioning. Reports any observed changes in mobility to an LPN or RN.	Monitors patient condition, reports observations to an RN, and helps develop care plans that CNAs then assist in carrying out. Can assist with mobility but is not the sole focus.
Supervision	Works under the direct supervision of an LPN or Registered Nurse (RN).	Works under the supervision of an RN or physician.
Specialization	General assistance role; no specialized medical or therapeutic skills.	Broader responsibilities including medication administration and wound care.

Conclusion

In short, can a CNA assist with mobility? Absolutely. Providing mobility assistance is a fundamental and critical component of the certified nursing assistant's role. Their work directly contributes to the patient's independence, dignity, and safety. By expertly using tools like gait belts, employing proper techniques for transfers, and remaining vigilant about fall prevention, CNAs ensure that patients receive compassionate and effective mobility support every day. For a detailed guide on CNA training and skills, you can consult resources from authoritative organizations like Nurse.com: What is a CNA? Education, Skills, & Work Settings.

Frequently Asked Questions

What is the difference between a CNA and a physical therapist regarding mobility?

A CNA is trained to provide hands-on assistance with day-to-day mobility tasks like transfers and walking. A physical therapist, on the other hand, is a licensed professional who designs and directs a therapeutic plan to improve a patient's overall mobility and function. The CNA then helps carry out the therapist's plan.

Can a CNA help a patient with a walker or cane?

Yes, assisting patients with walkers, canes, and other assistive devices is a standard part of a CNA's training. They ensure the patient uses the device correctly and provide additional support during ambulation.

What should a CNA do if a patient starts to fall?

If a patient begins to fall, a CNA is trained not to try and catch them, as this can cause injury to both parties. Instead, the CNA should lower the patient safely to the floor, protecting their head. Once the patient is on the floor, the CNA must notify a supervising nurse immediately.

How do CNAs assist with bed transfers?

CNAs use safe transfer techniques, often with a transfer belt, to help patients move from a bed to a chair or wheelchair. This process involves proper body mechanics, clear communication with the patient, and ensuring the bed and wheelchair brakes are locked.

Is it safe for a CNA to lift a patient alone?

CNAs are trained in proper lifting techniques and know to perform a two-person assist or use a mechanical lift when a patient's weight or condition makes a transfer unsafe for one person. Safety for both the patient and the caregiver is the top priority.

Do CNAs help with mobility in all care settings?

Yes, CNAs provide mobility assistance across various settings, including nursing homes, assisted living facilities, hospitals, and in-home care. Their specific tasks and level of independence may vary based on the care setting and state regulations.

How does a CNA's work help prevent bedsores?

By regularly repositioning patients who are bedridden or have limited mobility, CNAs help prevent the development of pressure ulcers (bedsores). This is a standard and crucial part of their daily care routine.