UAP/CNA — What Can & Cannot Be Delegated

A CNA reports a client's blood pressure is 82/50. If you delegated that task correctly, the system works. If you delegated the wrong task, the error started with you — not the CNA.

Unlicensed assistive personnel (UAPs), including CNAs and patient care techs, can perform tasks that are routine, predictable, and do not require clinical judgment. The defining rule: if the task requires assessment, interpretation, evaluation, or teaching, it cannot be delegated to a UAP. A UAP can measure and record vital signs but cannot interpret whether those vitals are abnormal or decide what to do next — that judgment stays with the RN. UAPs can perform standard ADLs (bathing, feeding, ambulation, toileting), obtain height and weight, perform simple fingerstick glucose readings, collect specimens, and provide postmortem care. They cannot perform sterile procedures, administer medications (with limited state-specific exceptions for medication aides in long-term care), receive telephone orders, perform initial or focused assessments, or provide discharge teaching. The client's condition must be stable and the expected outcome predictable. A newly postoperative client with labile vitals is not an appropriate assignment for a UAP to independently manage, even for tasks otherwise within scope.

Key Distinctions

Don't confuse data collection with assessment — a UAP collects data (records a BP of 82/50), but the RN assesses (determines the reading is clinically significant and acts). Students frequently select 'UAP cannot take vital signs' on exams, but UAPs can measure vitals; they cannot evaluate them. A UAP can reinforce what the RN has already taught, but cannot initiate new patient education.

Clinical Pearl

If it needs a brain, keep it with the nurse. UAPs use their hands; RNs use their judgment. Stable, predictable, no interpretation — that's the UAP lane.