Question

A client has just died from terminal pancreatic cancer. Which task is best delegated to the nurse's assistant? A. Talking with the family about aftercare B. Assisting with postmortem care C. Assessing the chart for funeral arrangements D. Calling the doctor about the patient's death

Short answer

Answer: B. Assisting with postmortem care.

Step-by-step solution

Review the role and responsibilities of a nurse's assistant

It is essential to understand the nurse's assistant's scope of practice. They mainly perform activities like basic patient care (bathing, dressing, feeding, and taking vital signs), document patient information, and assist licensed nursing personnel in providing care. Since the client has just died, we need to determine which of the tasks A, B, C, and D would fit within the nurse's assistant role.

Evaluate Task A

Task A involves talking with the family about aftercare. This type of communication requires empathetic and sensitive communication skills, as the family members would be under emotional stress. Such a task usually falls under the responsibilities of a registered nurse, a social worker, or a case manager, not a nurse's assistant.

Evaluate Task B

Task B is assisting with postmortem care. Postmortem care is part of the basic care for a deceased patient and includes cleaning and positioning the body, as well as providing privacy and dignity. Since nurse's assistants are trained in providing basic patient care, this task is within their scope of practice.

Evaluate Task C

Task C requires assessing the chart for funeral arrangements. This task typically falls under the domain of registered nurses or other healthcare professionals with more authority and responsibility than nurse's assistants. This task is not within the scope of practice for a nurse's assistant.

Evaluate Task D

Task D involves calling the doctor about the patient's death. Communication with healthcare providers about critical events, such as a patient's death, is the responsibility of registered nurses or other higher-level healthcare professionals. This task is not within the scope of practice of a nurse's assistant.

Choose the best task for the nurse's assistant

Based on Steps 2-5, Task B (Assisting with postmortem care) is the most appropriate task for the nurse's assistant, as it falls within their scope of practice which includes providing basic patient care. Consequently, the answer is B. Assisting with postmortem care.

Key concepts

Nurses' Assistant Responsibilities

When considering the role of nurses' assistants, it's important to recognize the fundamental support they provide in healthcare settings. These professionals are vital to the daily operations within medical facilities, performing crucial tasks that ensure patient comfort and well-being. Their duties often include bathing and dressing patients, helping with feeding, taking and recording vital signs like temperature and blood pressure, and assisting patients with mobility.

They also play a significant role in documentation, updating patient charts with information such as intake and output or changes in behavior. When it comes to the end-of-life care, assisting with postmortem care falls within the remit of a nurse's assistant, which can include tasks such as cleaning and preparing the body for the family or funeral home. However, communicating complex information to the patient's family or making clinical decisions is beyond their scope of practice.

Postmortem Care

Postmortem care is an essential aspect of nursing that ensures the respectful handling of a patient after death. It involves various tasks, such as cleaning the body, positioning it to prevent disfiguration, closing the eyes, and sometimes involve placing dentures. This care provides dignity for the deceased and comfort for family members viewing the body.

Nurses' assistants, who are trained in basic patient care, are often responsible for assisting with these tasks. It is important to note that postmortem care also includes respecting cultural and religious practices of the deceased and their family. In fulfilling these duties, the nurse's assistant must wear appropriate personal protective equipment (PPE) to prevent the transmission of infection.

Scope of Practice in Nursing

The scope of practice in nursing defines the procedures, actions, and processes that a nurse is legally permitted to undertake in keeping with the terms of their professional license. The scope of practice is determined by each state's Nurse Practice Act and varies across different levels of nursing, like Registered Nurses (RN), Licensed Practical Nurses (LPN), and Certified Nursing Assistants (CNA).

It is crucial for all nursing professionals, including assistants, to understand their scope of practice to provide safe and effective care. For example, while nurse's assistants can perform basic care and assist with postmortem care, they would not be responsible for tasks that require clinical judgment such as communicating with doctors about patient deaths or assessing charts for funeral arrangements.

Patient Aftercare Communication

Patient aftercare communication is a sensitive and critical component of healthcare that involves discussing the patient's care plan after discharge or, in the case of a deceased patient, providing the family with information and resources for aftercare. This requires strong interpersonal and professional communication skills, as these conversations can involve emotional support, addressing questions about the patient's illness, and planning for the next steps.

Typically, this level of communication is handled by RNs or social workers who have the necessary training and authorization within their scope of practice. Nurses' assistants, while they might be present during these discussions or may provide relevant information to the nursing staff, do not lead these conversations due to the complexities involved, such as legal implications and the need for clinical knowledge.