How to properly manage nursing assistants

Stories - Carla ConfidentNursing assistants are some of the most important caregivers on the floor. Without these helpful, underappreciated professionals, we wouldn’t be able to provide even the most basic care for our patients.

As RNs and LPNs, it falls on us to properly use CNAs without misusing them. Sometimes it is too easy to delegate, and sometimes delegating isn’t done properly.

For this reason, it is important to understand exactly how to deploy CNAs for the good of the patients and to make your job easier. In some cases, it may be easy to overwhelm a CNA and cause them more stress than necessary.

Delegating is often walking a fine line, and it can be hard to determine how best to manage those below you. As nurses, though, we need to understand what the CNA is going through and help out when we can.

Scope of Practice

You need to first consider your nursing assistant’s scope of practice. Unfortunately, this varies from state to state and facility to facility.

For instance, in some facilities, CNAs are able to put in foleys and draw blood. Nurses need to know exactly what a CNA is allowed to do before giving them as task for completion.

Usually, assessment and reassessment are the purview of registered nurses. These are the only things that cannot usually be delegated to support staff.

Everything else is fair game, though, depending on state and facility regulations. In some places, CNAs are even allowed to pass meds, so be sure you know the scope of practice for both you and your CNA.


It can be remarkably easy to overload your CNA. Delegating may be hard at first, but once you get past that barrier it is often hard to stop.

CNAs work very hard, and it is your job to make sure that they aren’t doing more than they can without undue stress. While you are trying to focus on your own job, you may end up giving them so much work that they burn out.

The trick is to keep track of your CNAs, to check in with them from time to time. Communication is important on a nursing floor, and if your nursing assistant is overwhelmed, you should listen to them.

You can easily take a patient to the bathroom, make a bed, or answer some call lights. The point is that you have to know when you’ve delegated enough and start taking some of the duties on yourself when necessary.

Supervising and Responsibility

In the end, the acts of the CNA are your responsibility. If they cause patient harm from a skill that you delegated to them, you are ultimately responsible.

You need to develop a sense of trust with CNAs to ensure that they will do the best job possible. This means supervising and watching to make sure the patient is being cared for properly.

Some CNAs will take offense at too much supervision, but the responsibility lies with you. However, you don’t need to be abrasive about it either.

In fact, a heavy-handed approach to supervision isn’t recommended. Instead, communicate your concerns to your CNAs, deal with any problems that arise, and work together for the benefit of the patients.

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