CNA Legal & Ethical Behaviours 1

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You observe your co-worker verbally abusing a resident. What should you do?

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Verbal abuse (also called bullying) is a form of emotional abuse that can be as harmful as physical abuse. It includes yelling, criticism, blaming, insulting, belittling, or threatening. Clients are emotionally vulnerable, and verbal abuse leads to stress and low self-esteem. It must be reported the same as physical abuse.

You observe your charge nurse holding a resident’s nose to get him to take his medications. You should

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All abuse or suspected abuse must be reported. Every health care facility has a procedure for handling concerns about client care. If the issue cannot be resolved, it moves to the next level of authority. If an incident involves a supervisor, proceed to the next level. In this case, if a nurse aide observes the charge nurse in situation that could be dangerous or neglectful for the client, the nurse aide can go directly to the Nursing or Administrative Supervisor.

You don't answer a call light because the patient is always hitting it accidentally. No responding is considered to be

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Abuse and neglect occur when a client does not receive necessary physical or mental care. This includes failure to respond to a call light. Do not assume the client does not need assistance. If a client is accidentally hitting the call light, it is the staff's responsibility to fix the situation.

After the end of the shift, some nurse aides go to a restaurant. Acceptable topics of conversation would include

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The HIPAA Privacy Act regarding protecting a client's confidential information is clear: Absolutely no information can be shared outside those who need it in order to care for the client. Even a discussion in a hallway or the cafeteria, where others can overhear, is a violation. Discussing other workplace issues in a public place is rude and inappropriate; these can be disturbing or misunderstood by other restaurant patrons.

The nurse aide reports directly to the

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Every staff member has a role in providing excellent client care. Each person can work within their scope of practice and allow others with different authority to handle appropriate tasks. The nurse aide reports to the RN or LVN, who reports to the Director of Nursing. The facility's Administrator and Medical Director may be the people with the most responsibility. A staff development nurse oversees training and education.

What is the main purpose of continuing education for the nurse aide?

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Learning does not end with certification. New methods and advancements are constantly being discovered. Staying current makes sure that clients are getting the safest care and best treatment. Also, hospitals and facilities must show training records to maintian accreditation, so continuing education must be current.

Once a nurse aide’s name is placed on the abuse registry for neglect they may

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Each state licensing board has regulations regarding reinstatement after claims of abuse or neglect. If the state allows reinstatement, they will provide information about the process. An attorney may be useful in reviewing the case and helping dispute or reinstate the license.

A resident's call light

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All clients have a right to have access to their care givers. For clients who are confined to bed or have limited mobility, their safety could be at stake. A client who needs something might be in distress, or try to get out of bed alone. When they use their call light, a quick response is a clinical standard.

The client offers a nurse aide a twenty dollar bill as a thank you for all that the nurse aide has done. The nurse aide SHOULD

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When a client is grateful for the care they have received, they may wish to acknowledge the nurse aide with a money. The nurse aide's response can be, "I'm sorry, but I can't accept." Gifts or money compromise the client-nurse boundary. It can also destroy the trust that clients have in nurses. In some facilities, it can result in disciplinary action.

Forgetting to raise the side rails as ordered causes a resident to fall and be injured. This could be called

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Neglect is considered mistreatment that results from lack of attention or carelessness. Neglect can be physical, emotional, or financial. Failing to put up a client's side rails is physical neglect, because basic safety was disregarded.

After your elderly neighbor falls, he is admitted to your unit. Another neighbor asks you how he's doing. Your best response is

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It can be tempting to share medical information with others who know the patient. But even general information or conversations about behavior are violations of the HIPAA Privacy Rule. Be honest and firm about your responsibility as a health care professional.

If the nurse aide is concerned about client care, who should the nurse aide speak to FIRST?

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Every health care facility has a procedure for handling concerns about client care. If the issue cannot be resolved, it moves to the next level of authority. For example, a if a nurse aide observes a situation that could be dangerous or neglectful, the nurse aide should notify the charge nurse. The charge nurse will attempt to resolve the issue before calling the Nursing or Administrative Supervisor. At the top of the chain are the Chief Medical Officer and the Hospital Administrator. Each level has increasing authority and responsibility to address the situation.

While at work, you receive a call from someone who says he is a client's nephew. He asks about his uncle's condition. However, he is not on the client's list of approved people who can have access to his condition. What should you say?

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HIPAA gives patients the right to restrict who can have access to their health information. When someone requests information, only those listed are able to receive information. A hospital or health facility can confirm that the patient is there, but no medical information can be provided.

The nurse aide should refuse to perform a task if the

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You must be trained before doing a nursing task. It should also be included in your job description, so that you are working within the scope of practice for a CNA. If asked to do something that you haven't been taught, let the nurse or supervisor know. Once you have been trained, follow all procedures carefully and only as you were instructed.

When starting a job, when is HIPAA training mandatory?

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All health care professionals must be trained in HIPAA regualtions before beginning client care. Facilities are responsible for protecting client privacy at every level. Every facility must have proof of HIPAA training records in place for each employee.

Proper use of a waist restraint requires that the nurse aide

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Physical restraints are devices or equipment that prevent normal movement. Examples are waist,arm, or leg restraints, hand mitts, or vests. It is against the law to use restraints unless necessary to treat a client's medical symptoms, or if there is a risk of harming self or others. Restraints are not used for punishment, convenience, or a method of control. Either a physician's order or the client's consent is required before a restraint can be applied. If a restraint is in place, monitor closely for, and report, signs of injury.

A client with metastatic cancer has an Do-Not-Resuscitate (DNR) advance directive. If the client's heart rate begins to slow, what should you do?

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When a client has a DNR in place, it is legal and final. Do not try to change or interfere with the outcome. Notify the nurse, in case other measures, such as morphine, are in place. Support and care for a dying client.

Keeping information confidential about a client is

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HIPAA (Health Insurance Portability and Privacy Act) is the Federal law that protects a client's privacy about their medical nformation. This includes documentation, records, and communications. There are severe penalties for sharing information, even if it is unintentional.

You hear another nurse aide tell a confused resident, “If you don’t eat, I’ll lock you in your room.” You should

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Whether or not a resident seems confused, verbal abuse is inappropriate and must be reported. It is a form of emotional abuse that can be as harmful as physical abuse. It includes yelling, criticism, blaming, insulting, belittling, or threatening. Confused clients can perceive emotional abuse, even if they are unable to respond. All abuse must be immediately reported.

Mr. Joseph overhears the nurse aide speaking to the nurse about his roommate's diagnosis and demands to know more about the roommate’s condition. The nurse aide should

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Absolutely no medical information can be shared with others without the client's consent. This can even include the client's family, if the client wishes. Remember that client information can only be shared with health care workers. Be aware that If information is overheard by anyone other than the health care workers involved in the client's direct care, a breach of privacy has occurred.

The nurse aide reported bruises on Mr. Jenkins’ arm last week. Today, during A.M. care, there were more bruises. The nurse aide should

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Reporting suspected abuse is the mandated responsibility of every health care professional. If it continues after reporting, or no investigation has taken place, another report must be filed. Every state has a hot-line to report suspected or known abuse.

The nurse aide gave a client the wrong diet. What will the nurse aide do after realizing this error?

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The very first thing to do after making a mistake is to admit that it happened. All health care professionals make mistakes. Common errors happen when the patient's ID is not checked before giving a meal tray, giving care, or passing medications. Never disregard a mistake. Immediately tell a nurse. If asked to complete an Incident Report, provide all details.

You observed a coworker being physically abusive to a resident. You did not report the incident to the Nurse Supervisor. You can be charged with

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Aiding and abetting is a legal term that means you have knowledge of a crime, even if you weren't present. If you do not report it, you are considered to be an accomplice, or that you assisted. Always immediately report any type of abuse, neglect, or malpractice to your supervisor.

Incident reports are written in order to

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An incident report is completed to give all the details of an unusual event, such as a patient fall or a staff injury. The investigation following an incident report is not meant to blame anyone, but to find if there is anything that should be changed to prevent future episodes. Incident reports are also studied to detect patterns that are unsafe.

Misuse of a resident’s money or property by family, friends, or staff, is known as

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Abuse can take several forms, including financial. Elderly and ill people are vulnerable to being exploited by those they rely on. As with other forms of abuse, family members and others who care for the resident are most often responsible. Financial abuse includes taking property or money, forging a signature, changing a will or a deed, and falsely promising care in exchange for property or money. All forms of abuse are illegal and should be reported.

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