Is it legal to teach CNA?

I had a patient who has been trached/pegged at home for 2 years. His 2 CNA's (awesome smart ladies) were taking care of him, doing all suctioning, trach care, tube feeds. I assume theyve been doing a good job because there have been no reported problems, such as infections, aspiration...

When I discharged him, I gave the CNAs written instructions on trach care and tube feeds. I also demonstrated again, had them verbalize and demonstrate safe technique, including emergency interventions.

Now my question is, isnt trach care and PEG care supposed to be done by a RN? Am I allowed to chart that I taught the CNA how to do it. (A home health RN visits the pt. every morning and is available on call)
It seems like what I did was wrong, but then again, I have taught family members trach care before as well!
It probably depends on your state's scope of practice for CNAs. Check with your BON.

I did it as an LPN.

Here in FL, I do trach/PEG/vent/suctioning care everyday I work ^^. I'm an LPN ;DMaybe you can find the answer in the Nurse Practice Act? I don't know :3!

The factor to consider: are the CNA's private or from an agency. The agency should have parameters on what the CNA's are and not allowed to do. If they are private, they can do whatever.

I agree that you should check with your state CNA laws. Keep in mind though, family members can be taught these same cares so it shouldn't be a problem. Especially with good documentation and ongoing education for the CNAs.

Who employs the CNAs? If the agency employs them, they are working outside of their scope of practice. If the family employs them, you can teach whoever the family has working for the patient.

Home care RN's teach family members all the time trach and PEG tube care and tube feedings, so teaching patient caregivers i.e. CNA's is not necessarily illegal.HOWEVER, Certified Nursing Assistants employed by a homecare agency have to follow 2 things:a. Scope of practice within their state.b. Home Health Agencies regulations regarding tasks they are permitted to perform. Both require:a. Education and trainingb. Skills check off satisfactory performance observed.In PA, most certified agencies do not allow CNA's to perform invasive procedures: suctioning, trach care, administering tube feedings as CNA state education does not include those skills, not considered part of routine tasks our aides permitted to do and legal liability ensues when exceeding scope of practice.Other states have aides administering insulin injections to patients---prohibited in my area.. Need to know what standards are in your state. However, I'm taught tons of aides privately hired by family members to perform these skills as considered private companions, unregulated in my state.Please review with your nursing supervisor to keep yourself and agency out of legal troubles. Sometimes just documenting "taught caregivers (list names),privately hired by family with return demonstration using correct clean technique" is enough to relieve your agency of liability as documenting not agency CNA employee's. I've been in the middle of sticky situation like this when family thought CNA could perform these tasks, CNA were willing to learn and assume care ---call to their employer given OK to teach them....other times agency said " NO WAY ---not on skills list to perform ---need to stop immediately", family worked FT and no one to give care that afternonn---so I got caught in middle between private duty agency and family fuming at me for reporting situation..... one of those grey land mines that can appear in practice.

I have a friend who expected the home health aides hired by an agency to administer meds to her grandmother. The aides did not seem comfortable with this and she got very annoyed because she was an HHA herself and her particular agency stated that if the family pours the medications and labeled them, and if the patient was able to put them in their own mouths, that this was okay. I explained to her that this particular agency apparently did not allow this, nor should she want them to because if a mistake is made, then, WHO is really held liable? No HHA I know is formally trained in medication administration. But, it was a similar situation...she is a full time worker and the only caretaker, how can she assure that her grandmother would actually receive her meds on a timely basis?I think that it is best that the OP check with her own employer for the next time, because we don't want surprizes later.

I'm sorry I don't know the answer to your question...I do, however, know that each state has their own scope of practice laws. Case in point: In Oregon a CNA can get certified in giving meds of all kinds. This has been a thorn in the side of LPN's because LPN's aren't utilized much since employers get to pay less for almost the same work. Here's something else (unrelated) that sucks as a LPN--in my state (Washington) and in Oregon (I think) a LPN cannot be hired as a CNA. The job market here is sucking hardcore and it does chap my hide that I can't even take a job as a CNA until I can find a LPN job. Unless of course I want to spend approximately 600 bucks about a month to obtain a CNA certification. Likewise, a RN cannot be hired as a LPN. I guess I sort of understand it, but in this economy when jobs are so hard to come by (my area unemployment rate is 12%) it's very frustrating.

Quote from DaFreak71I'm sorry I don't know the answer to your question...I do, however, know that each state has their own scope of practice laws. Case in point: In Oregon a CNA can get certified in giving meds of all kinds. This has been a thorn in the side of LPN's because LPN's aren't utilized much since employers get to pay less for almost the same work. Here's something else (unrelated) that sucks as a LPN--in my state (Washington) and in Oregon (I think) a LPN cannot be hired as a CNA. The job market here is sucking hardcore and it does chap my hide that I can't even take a job as a CNA until I can find a LPN job. Unless of course I want to spend approximately 600 bucks about a month to obtain a CNA certification. Likewise, a RN cannot be hired as a LPN. I guess I sort of understand it, but in this economy when jobs are so hard to come by (my area unemployment rate is 12%) it's very frustrating.

Thanks for all your replies. Im assuming that the aids are all privately hired since an agency was never mentioned. The aids were at the bedside 24 hrs even though the patient was on our intermediate care unit.Our social worker separately set up a home care agency RN to visit the patient every morning. In my charting I documented "Pt's private CNA at bedside "Renee" verbalizes understanding and demonstrates correct clean technique"..... Hope it's ok. Im a little nervous!

Instead of using the term "private CNA", I would use the term "private caregiver". That gets around the issue, which isn't an issue, now that we know they are private caregivers.