What should the NA do when providing care? Essential Duties and Best Practices

According to the U.S. Bureau of Labor Statistics, employment for nursing assistants is projected to grow, highlighting their critical role in patient care. So, what should the NA do when providing care? Their responsibilities are comprehensive, requiring compassion, technical skill, and a vigilant eye for a patient's well-being.

Quick Summary

A nursing assistant provides direct patient care by assisting with daily living activities, monitoring vital signs, and ensuring a safe, hygienic environment. NAs must communicate effectively with patients and the healthcare team, report significant changes in a patient's condition, and prioritize dignity and independence while adhering to care plans.

Key Points

• Core Duties: NAs assist patients with daily living activities (ADLs) such as bathing, dressing, and eating, ensuring their basic needs are met.

• Observation and Reporting: A key responsibility is to observe and accurately report any changes in a patient's physical condition, mental state, or behavior to the supervising nurse.

• Dignity and Independence: NAs must always prioritize and promote a patient's dignity and independence by offering choices, respecting privacy, and encouraging self-care where possible.

• Safety and Hygiene: Maintaining a safe and clean environment through proper hygiene, infection control practices, and safe patient handling is a fundamental NA duty.

• Effective Communication: Compassionate and clear communication with patients, families, and the rest of the healthcare team is essential for quality care and positive patient outcomes.

• Adherence to Care Plans: NAs implement the specific care plan interventions designed by the nurse to meet each patient's unique needs.

The Foundational Role of the Nursing Assistant

Nursing assistants (NAs), also known as certified nursing assistants (CNAs), are the backbone of direct patient care in various healthcare settings. Their role is hands-on and requires a unique blend of physical stamina, technical knowledge, and compassionate communication. Under the supervision of licensed nurses, NAs perform a wide range of duties that are essential for the comfort, health, and safety of patients and residents.

At its core, the NA's job is to assist patients with activities of daily living (ADLs), ensuring their basic needs are met with dignity and respect. This includes helping with bathing, dressing, grooming, and feeding. While these tasks may seem routine, the NA's approach can make a profound difference in a patient's quality of life. Empathy and respect for a patient's privacy and preferences are paramount.

Providing Personal Care and Promoting Hygiene

One of the most frequent duties of an NA is assisting with personal care. This involves bathing patients, helping with oral hygiene, and assisting with grooming tasks like combing hair. It is crucial to perform these duties while protecting the patient's privacy and dignity. For instance, explaining each step of a procedure beforehand and keeping the patient's body covered whenever possible is a standard best practice.

Hygiene and cleanliness also extend to the patient's environment. Making beds, ensuring rooms are tidy, and cleaning bedpans are all part of maintaining a healthy and sanitary space. These actions help prevent the spread of infection, a primary concern in any healthcare facility.

Observation and Accurate Reporting

NAs spend the most one-on-one time with patients, making them the first line of defense in identifying changes in a patient's condition. Vigilant observation and accurate reporting are among the most critical skills an NA must possess. An NA must be trained to notice and document subtle changes, which could signal a serious health issue. This includes changes in vital signs, behavior, and physical appearance.

To ensure all significant information is relayed accurately and promptly to the nursing staff, many facilities use structured reporting methods like the SBAR technique (Situation, Background, Assessment, Recommendation). The NA's assessment is key to providing a complete picture of the patient's status. The following are examples of changes that must be reported immediately:

• Sudden change in mental status, such as increased confusion or agitation.
• Significant change in vital signs (e.g., fever, sudden drop in blood pressure).
• Signs of bleeding, new bruises, or unexplained wounds.
• Difficulty breathing or chest pain.
• Changes in appetite or fluid intake.

Promoting Patient Independence and Dignity

In senior and long-term care, fostering a patient's independence is vital for their mental and emotional well-being. NAs play a key role in this by encouraging patients to do as much for themselves as they can. This may involve:

• Offering choices, such as which outfit to wear or what to eat for lunch.
• Providing verbal encouragement during tasks like brushing teeth or transferring from a bed to a chair.
• Allowing the patient to set the pace for their care, respecting their right to make decisions about their own daily activities.

Respecting boundaries and cultural preferences also falls under promoting dignity. This includes addressing the patient by their preferred name, knocking before entering their room, and being mindful of body language during interactions. As the National Institutes of Health emphasizes, treating individuals with respect, autonomy, and compassion is fundamental to high-quality care.

Specialized Considerations for Different Patient Needs

Caregiving is not a one-size-fits-all practice. NAs must adapt their techniques for patients with different health conditions and needs. For instance, providing care for someone with dementia requires extra patience and a calm, structured approach. This may involve maintaining a consistent daily routine, speaking clearly in short sentences, and minimizing environmental stressors that can cause agitation.

For patients with limited mobility, NAs must be skilled in proper body mechanics for turning, repositioning, and transferring to prevent skin breakdown and injury to both the patient and themselves. Regular monitoring of skin integrity is a critical task.

The Importance of Communication and Teamwork

NAs are part of a larger healthcare team, and effective communication with nurses, doctors, and other specialists is vital for coordinating care. Clear, concise, and respectful communication ensures that all team members are on the same page regarding the patient's needs and goals. NAs also serve as a crucial bridge of communication between the patient and their family, providing updates and reporting concerns as appropriate.

Aspect	NA Responsibilities	RN Responsibilities
Care Planning	Implements the plan of care as directed by the RN; provides input based on observations.	Creates, updates, and oversees the entire nursing care plan; sets patient-specific goals.
Assessment	Collects objective data, such as vital signs and intake/output; observes and reports subjective changes.	Performs initial comprehensive assessment; analyzes NA observations; makes clinical judgments.
Medication	Reminds patients to take medication; may administer in some states with specific training (rare).	Administers medications as prescribed by a physician; educates patients on their purpose and side effects.
Direct Care	Provides hands-on assistance with activities of daily living (ADLs).	Oversees all patient care; may assist with ADLs but focuses on clinical tasks and procedures.

Conclusion

In summary, the role of a nursing assistant is multifaceted, combining essential daily care tasks with keen observation and effective communication. By focusing on fundamental duties like assisting with ADLs, promoting hygiene, and adhering to strict infection control measures, NAs ensure patient safety and comfort. Crucially, their commitment to promoting independence, respecting dignity, and accurately reporting changes in a patient's condition elevates their contribution from a task-oriented role to an integral part of the patient's journey toward wellness and healthy aging. The compassionate care provided by NAs is a cornerstone of a high-quality healthcare experience.

For further guidance on the principles of patient dignity in care, the resource alwaysbestcare.com offers valuable insights and examples.

Frequently Asked Questions

What is the most important thing an NA should do when providing care?

The most important thing an NA should do is prioritize patient safety and dignity. This means following the care plan, practicing strict infection control, respecting the patient's privacy, and actively observing and reporting any changes in their condition.

How should an NA report a change in a patient's condition?

An NA should report a change in a patient's condition promptly and accurately to the supervising nurse. Using a structured communication method, such as SBAR (Situation, Background, Assessment, Recommendation), ensures all relevant details are conveyed clearly and concisely.

How can an NA promote a patient's independence?

NAs can promote independence by encouraging patients to participate in their own care as much as possible, offering choices regarding daily routines, and providing only the necessary assistance. This helps patients maintain a sense of control and self-worth.

What are some key infection control practices for an NA?

Key infection control practices include performing proper hand hygiene (washing hands before and after patient contact), using appropriate personal protective equipment (PPE), and ensuring the patient's environment and equipment are kept clean and sanitary.

How should an NA handle a patient with dementia?

When caring for a patient with dementia, an NA should maintain a predictable routine, use simple language, be patient and gentle, and create a calm environment. Offering choices and redirection can help minimize agitation and confusion.

What should an NA do if a patient refuses care?

If a patient refuses care, an NA should first try to understand the reason, use respectful communication, and offer alternative options if possible. The refusal should be documented and reported to the supervising nurse to ensure the patient's safety and wishes are respected.

How can NAs ensure good communication with the healthcare team?

NAs can ensure good communication by being clear and concise when reporting observations, participating actively in team meetings, and maintaining a respectful and professional demeanor with all colleagues.