Nursing Assistant Registry
• Official record or listing of persons who have successfully completed
that state’s approved NATCEP
• The registry has information about each nursing assistant.
• All information stays in the registry for at least 5 years.
• Any agency can access registry information.
• You receive a copy of your registry information.
• You can correct wrong information.
• Registry information includes:
• Full name, including maiden name and any married names
• Last known home address
• Registry number and date of expiration
• Date of birth
• Last known employer, date hired, and date employment ended
• Date the competency evaluation was passed
• Information about findings of abuse, neglect, or dishonest use of property
Other OBRA requirements
• Retraining and a new competency evaluation program are required
for nursing assistants who have not worked for 24 months.
• Agencies covered under OBRA must provide 12 hours of
educational programs to nursing assistants every year.
• Performance reviews also are required.
• Each State’s NATCEP must meet OBRA requirements
• If you want to work in another state, contact the state agency
responsible for NATCEPs and the nursing assistant registry.
• Each state has its own competency evaluation review
• After successfully completing your state’s NATCEP, you
have the title used in your state (CNA, LNA, RNA).
• To work in another state you must meet that state’s
• Apply to the state agency responsible for NATCEPs and the
nursing assistant registry.
• Your application is reviewed.
• Certification (a license, registration) is granted if requirements
Roles and Responsibilities
A nursing task is the nursing care or nursing function, procedure, activity, or
work that can be delegated to nursing assistants when the professional
knowledge or judgment of an RN is not required.
•Scope of practice/Range of functions
• Legal limits of your role
• Varies among states and agencies
• An agency can further limit what you can do, so can a nurse based
on the person’s needs.
• No agency or nurse can expand your range of functions beyond
what your state’s laws and rules allow.
• Protects persons from harm
•Licensed nurses supervise your work.
• You assist them in giving care.
• You perform nursing tasks.
• Before performing a task, make sure it is allowed by your state, it is
in your job description, you have the necessary education and
training, and a nurse is available to supervise and answer questions.
Roles and Responsibilities
• Do not take a job that requires you to:
• Act beyond the legal limits of your role
• Function beyond your training limits
• No one can force you to do something beyond the legal limits of
your role, or threaten your job if you refuse.
• Perform acts that are against your morals or religion
• You need to know:
• What you can safely do
• The things you should never do
• Your job description
• The ethical and legal aspects of your role
• Delegate means to authorize another person to perform a
nursing task in a certain situation.
• Nurse practice acts give nurses:
• Certain responsibilities
• Legal authority to perform nursing actions
• A responsibility is the duty or obligation to perform some act
• RNs are responsible for supervising LPNs/LVNs and nursing assistants
—only RNs can carry out this responsibility.
• Delegation is one responsibility of the RN
• The person must be competent to perform a task in a given situation.
Steps of Delegation
• The National Council of State Boards of Nursing
(NCSBN) describes four steps in the delegation
• Step 1—Assess and plan is done by the nurse.
• Step 2—Communication involves the nurse and you.
• Step 3—Surveillance and supervision; the nurse observes
the care you give.
• Step 4—Evaluation and feedback is done by the nurse.
• The person’s needs, the nursing task, and the staff member doing the
task must fit.
• Delegation decisions must result in the best care for the person. The
nurse may face serious legal problems for a bad decision.
• If you perform a task that places the person at risk, you also can face
serious legal problems.
Delegation – The NA’s right to say No
• Sometimes refusing to follow the nurse’s directions is your right and duty
• Refusing a task
• The task is beyond the legal limits of your role.
• The task is not in your job description.
• You were not prepared to perform the task.
• The task could harm the person.
• The person’s condition has changed.
• You do not know how to use the supplies or equipment.
• Directions are not ethical or legal.
• Directions are against agency policies.
• Directions are unclear or incomplete.
• A nurse is not available for supervision.
• Never ignore an order or a request to do something.
• Share your concerns about a delegated task with the nurse.
• You must have sound reasons for refusing a task.
• The nurse can:
• Answer your questions
• Demonstrate the task
• Show you how to use supplies and equipment
• Help you as needed
• Observe you while you perform the task
• Check on you often
• Arrange for needed training