Home Health Agency Says External Catheter Isn’t a Medical Device
Hey everyone! Sorry for the long post, but I don't know who to ask. I’m a Nurse Aide I in NC. I'm working for a home health agency, and I really need some advice from fellow CNAs to make sure I’m protecting my certification.
Here is what happened:
My current client’s care plan is only for basic personal care, and I was hired as a PCA, nothing more. When I got to the home, I saw he uses an external catheter system (a condom cath alternative). This device was not listed on his care plan, so I reported it to the office so it could be added. This was the beginning of a chain of contradictory phone calls.
First call: I was told an external catheter is a clinical medical device, so only a CNA could change or apply them, and he wasn’t a CNA client. I was told I shouldn't be doing it, and I won’t be paid the extra money for CNA work. This prompted me to look it up.
Second call: They backtracked and claimed his external catheter isn't a medical device. They said it’s just a personal care item, and the task is no different than normal toileting. They said that any PCA can do it. I brought up NCDHHS rules I’d found, showing that external catheters fall under Level III care, which requires a CNA registry listing and an RN delegation plan.
Today's call: A higher-up called me and said an RN can delegate to CNAs. I told him I understood, but this isn't a CNA client, and I'm not being paid CNA wages. He then said that even if I pretended I wasn't on the registry (I’m not pretending I’m not a CNA; it’s just not the role I have for this specific client). I told them if they were relying so much on me being on the registry to do CNA tasks then I wanted to be paid accordingly. He said no but that an RN can delegate higher level tasks to a basic PCA, even if it's out of my job description and not on the clients care plan. I was told they could send an RN out to train me to do it on this PCA shift. (I don’t work with a nurse, nor have I ever met her).
I am just worried about risking my Nurse Aide I registration by doing unassigned medical care on a shift that isn't classified or paid as a CNA. Am I wrong? What should I do?