Key Takeaways
- CNAs work as part of an interprofessional healthcare team
- The chain of command goes from CNA to nurse to charge nurse to DON
- CNAs are the "eyes and ears" of the team due to direct patient contact
- Effective reporting includes patient name, observations, timing, and changes
- Professional boundaries must be maintained with all patients and families
The Healthcare Team
CNAs work as part of an interprofessional healthcare team to provide comprehensive patient care. Understanding each team member's role helps you communicate effectively and provide better care.
The Interdisciplinary Team
Healthcare facilities use a team approach because no single professional can meet all patient needs:
| Team Member | Role | CNA Interaction |
|---|---|---|
| Registered Nurse (RN) | Assessment, care planning, medications, supervision | Direct supervisor, takes CNA reports |
| Licensed Practical Nurse (LPN/LVN) | Medications, treatments, wound care | Supervises CNAs in some settings |
| Physician (MD/DO) | Diagnosis, treatment orders, prescriptions | CNA reports observations through nurse |
| Nurse Practitioner (NP) | Advanced assessment, prescriptions | Similar to physician interaction |
| Physical Therapist (PT) | Mobility, strength, rehabilitation | CNA reinforces exercises |
| Occupational Therapist (OT) | Daily living skills, fine motor | CNA practices techniques with patients |
| Speech Therapist (ST) | Swallowing, communication | CNA follows feeding precautions |
| Social Worker | Discharge planning, counseling, resources | CNA reports patient concerns |
| Dietitian | Nutrition assessment, diet planning | CNA reports food intake |
| Activities Director | Recreation, socialization | CNA transports patients to activities |
Chain of Command
The chain of command establishes clear lines of communication and authority:
- CNA → Reports to and takes direction from
- LPN/LVN or RN → Reports to
- Charge Nurse → Reports to
- Director of Nursing (DON) → Reports to
- Administrator → Reports to
- Governing Board
CNA Role on the Team
As a CNA, you are the "eyes and ears" of the healthcare team because you:
- Spend the most direct time with patients
- Observe changes in condition first
- Know patients' normal behaviors and habits
- Can report subtle changes others might miss
Effective Team Communication
When reporting to the nurse, include:
- Patient name and room number
- What you observed (specific and objective)
- When it happened (time, during what activity)
- Any changes from normal (compare to baseline)
- Vital signs (if relevant)
Example of good reporting:
"Mrs. Smith in room 203 has had a change. During morning care at 8 AM, I noticed her left leg is swollen and she says it hurts. Her vital signs are normal but she's more confused than usual."
Professional Boundaries
Maintain appropriate professional boundaries with:
| Do | Don't |
|---|---|
| Be friendly and caring | Become personally involved |
| Use appropriate touch | Touch inappropriately |
| Share about your work role | Share personal problems |
| Maintain confidentiality | Discuss patients outside work |
| Accept small tokens of appreciation | Accept cash or expensive gifts |
| Treat all patients equally | Play favorites |
Teamwork Principles
Effective healthcare teams practice:
- Respect - Value each team member's contribution
- Communication - Share information openly
- Collaboration - Work together toward patient goals
- Flexibility - Adapt to changing needs
- Accountability - Take responsibility for your actions
- Support - Help team members when needed
Who is typically the CNA's direct supervisor?
Why is the CNA called the "eyes and ears" of the healthcare team?