182. Study Notes: The CCA Role, Scope of Practice, and Health Care Team

The Big Picture

Health care takes teamwork. Different workers bring different skills and knowledge together to meet each client’s needs and provide quality care.

A CCA forms part of this team. The other team members involved depend on what the client needs.

You also need to know the limits of your own role. Safe care starts with knowing which tasks belong inside your role, which tasks do not, and where to ask for direction.

Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.

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Course Notes: Key Ideas You Need to Know

What Is a Health Care Team?

A team is a group of people who work together toward a shared goal.

A health care team includes workers with different skills and areas of knowledge. They work together to meet the client’s needs and provide quality care.

One client might receive care from several health care professionals, including support workers. The client’s needs determine which professionals join the team.

Regulated and Unregulated Health Care Workers

Health care professions fall into two broad groups:

• regulated professions
• unregulated care providers

These groups differ in how their roles and professional conduct receive oversight.

Regulated Health Care Professions

A regulated profession governs itself through a professional organization called a college.

The college:

• sets education requirements
• sets licence requirements ⓘ
• establishes the profession’s scope of practice
• establishes a code of ethics ⓘ
• sets standards of conduct
• investigates complaints about members
• disciplines members found guilty of misconduct ⓘ

Legislation ⓘ describes the roles and responsibilities of members within each regulated health care profession.

Nursing is one example of a regulated health care profession.

Unregulated Care Providers

Unregulated care providers (UCPs) perform clearly identified services under direction and supervision.

That direction and supervision might come from:

• a client
• a family member
• a regulated health care provider
• an employer

UCPs do not belong to a professional college that governs their role. Legislation does not regulate them as a profession.

UCPs do not currently follow an official code of ethics. They must follow the behaviour standards set by their employers.

Support workers in most provinces and territories are currently considered UCPs.

What Is a Support Worker?

A support worker provides services to people who need help with daily activities.

Support workers work in facilities and community settings. They work as part of the health care team while following the limits of their role.

What Scope of Practice Means

Scope of practice means the limits and extent of a health care worker’s role.

For a support worker, it identifies what the worker is allowed and not allowed to do in client care. The term applies to both regulated and unregulated health care workers.

A support worker’s scope can differ by province, territory, city, municipality, and employer.

Why Scope of Practice Matters

Support workers must understand:

• what they are expected to do
• what they are not allowed to do
• how far their role extends
• where their role ends

Role limit: Never act beyond the legal limits of your role.

Avoid: Never perform a task that you have not received training to perform.

Working outside these limits risks harming the client. It also creates serious legal problems for the support worker and employer.

The Three Sources That Shape Scope of Practice

Three main sources determine a support worker’s scope of practice.

1. Provincial or Territorial Educational Standards

Educational standards set out what support workers need to learn during their training.

The educational program teaches students about:

• the scope of support work in that province or territory
• laws connected to the support worker role
• professional responsibilities in that part of the country

Students should ask their instructors for clarification when they do not understand a role requirement.

2. Employer Policies

Every employer has written policies that explain which tasks support workers are allowed and not allowed to perform.

Support workers should read these policies carefully before starting work.

Educational standards and employer policies both help set the limits of the support worker role. Support workers must follow the written policies that apply in their workplace.

3. Your Supervisor

At work, your supervisor gives direction about employer policies and procedures.

On the job, the supervisor is the best source of clarification about the employer’s policies.

Safety: Ask for direction before performing a procedure when you feel unsure. Asking protects the client from harm.

Professional Development and Lifelong Learning

Health care keeps changing. Support workers need to keep their knowledge and clinical skills up to date.

Current knowledge and skills affect the health and safety of:

• clients
• support workers
• co-workers

Depending on the region, support workers might take postgraduate certificate courses or workshops. Examples include advanced palliative care, conflict management, and medication management.

Ongoing learning does not change your scope by itself. Support workers still need to know the limits that apply in their province, territory, and workplace.

Critical Thinking

Critical thinking means thinking clearly and logically.

It draws on:

• experience
• observation
• education
• reflection
• reason

Critical thinking helps a support worker think carefully about care instead of acting without thought.

Reflective Practice Review

A reflective practice review is a self-evaluation of care already provided.

The worker looks back at the care and identifies ways to improve future caregiving and clinical performance.

This review supports professional growth. It helps the worker learn from experience and strengthen future practice.

Supervision of Support Workers

Support workers might work:

• in facilities
• in community settings
• in private homes

A nurse or another health care provider might supervise their work.

The supervisor depends on the care setting, department, employer, and client situation.

Registered Nurse

A registered nurse (RN) holds a licence and receives regulation from the province or territory.

The RN maintains overall responsibility for planning and providing client care.

RN responsibilities include:

• assessing clients
• making nursing diagnoses
• developing care plans
• implementing nursing care
• evaluating nursing care
• carrying out physicians’ orders

An RN is usually the team leader of a health care team that includes LPNs or RPNs, support workers, and other allied health care providers.

RNs have different educational backgrounds. Some hold community college diplomas, while others hold university degrees or postgraduate education.

Licensed Practical Nurse

A licensed practical nurse (LPN) holds a licence and receives regulation from the province or territory.

The LPN performs basic nursing procedures and provides client care.

Ontario uses the title registered practical nurse (RPN) for this role.

LPNs and RPNs must hold current nursing registration in the province where they practise.

When caring for stable clients with uncomplicated health issues, an LPN or RPN works in a decision-making position.

When clients have serious and unstable health issues, the LPN or RPN assists the RN and helps with complex procedures.

LPNs and RPNs often supervise support workers.

Primary Care Nurse

Some clients, especially in a live-in setting, may be assigned to a primary care nurse.

A primary care nurse manages a client’s health on an ongoing basis.

This nurse communicates and coordinates with:

• other health care team members
• the client
• the client’s family

In an acute-care setting, the primary care nurse may or may not provide the client’s daily care directly. The nurse still oversees the work of those who provide that care, including the support worker.

Other People Who Might Supervise a Support Worker

A support worker does not always report to an RN, LPN, or RPN.

The supervisor might include:

• a recreational therapist in a long-term care recreation department
• a social worker in the community
• a physiotherapist
• another health care provider
• the client who directly hired the support worker

Support workers hired and supervised by clients need to stay aware of the provincial or territorial legislation that limits the tasks and procedures they perform.

Common Mix-Ups

Wrong Idea	Better Idea
Scope of practice applies only to regulated professionals.	Scope of practice also identifies what a support worker is allowed and not allowed to do.
UCPs belong to a professional college.	UCPs do not belong to a college that governs their role.
One source determines every support worker’s scope.	Education standards, employer policies, and supervisor direction all shape the role.
Training gives permission to perform a task everywhere.	The task must also fall within legal limits and employer policies.
An RN and an LPN or RPN hold the same care responsibilities.	The RN holds overall responsibility for planning and providing client care.
A nurse always supervises every support worker.	Another health care provider or the client might provide supervision.