When to Call the Nurse: Situations CNAs Should Never Ignore

You’re halfway through a visit, helping with a shower or cleaning up the kitchen, and something feels off. It might be something the client says. It might be the way they look, move, or breathe. Maybe it’s a new bruise, a confused answer, or just a gut feeling that something isn’t right. This is the moment every CNA knows well: do I call the nurse?

In home care, CNAs are often the first to notice changes. You’re in the home more than anyone else. You see the patterns, the mood shifts, the subtle red flags. And while it’s not your job to diagnose or treat, knowing when to escalate can make the difference between safety and serious harm.

Obvious Changes That Must Be Reported

Some situations are clear-cut. A fall, new injury, bleeding, vomiting, sudden confusion, or chest pain... these all require a call right away. If the client tells you they feel strange or different, don’t brush it off. Even vague symptoms matter.

Trust what you see. If a client who normally walks easily is suddenly unsteady, or someone who eats heartily won’t touch their food, those are signals. Don’t wait to see if it passes. Call.

Good software for home care agency allows you to log these moments clearly, with time stamps, notes, and alerts that help the nurse respond fast. Documenting accurately protects the client—and you.

The Gray Areas: When Something Just Feels Off

Not everything is dramatic. Sometimes it’s just a sense that something’s shifted. The client is quieter. Their skin looks pale. They seem more tired than usual.

You don’t have to prove something is wrong before you reach out. Calling the nurse doesn’t mean you’re overreacting. It means you’re sharing what you observe so the care team can decide what happens next. Better to call early than to wish you had later.

Family Requests and Unusual Questions

If a family member asks about medication changes, equipment concerns, or requests you can’t fulfill—like adjusting care plans or skipping tasks—that’s a reason to involve the nurse.

You’re not there to negotiate care. You’re there to follow the plan. Redirect those questions to the nurse every time.

Some home health software includes secure messaging between care team members. That kind of feature can make relaying questions fast and simple.

When the Client Says “Don’t Tell”

Sometimes a client will say something concerning about pain, safety, or mental health and then ask you not to share it. This puts you in a hard spot.

But your responsibility is to the client’s well-being, not to secrecy. You can say gently, “I want to make sure you get the right support, so I need to pass that along to the nurse.”

After You Make the Call

Once you’ve alerted the nurse, document what you saw and what you did. Be specific. Include what time you called and any instructions you were given. Don’t try to manage more than your scope. Your job isn’t to fix the problem. Your job is to notice, report, and support. Trust your eyes. Trust your instincts. When you speak up, you make the entire care plan stronger.