The scope of practice for nursing assistants in France is based on a series of texts that have overlapped since 2021. Between the revised framework from that year, the decree of February 26, 2025, and discussions about a potential supplementary decree in 2026, professionals struggle to precisely identify which acts they are authorized to perform, under what conditions, and with what training obligations. This article compares the current regulatory frameworks with those announced, to measure what is actually changing in daily practice.
Regulatory Framework 2021-2025 Compared to Expected Developments in 2026
| Criterion | Framework 2021 and Decree of February 26, 2025 | Discussed Developments for 2026 |
|---|---|---|
| Reference Text | Decree of June 10, 2021, supplemented by the decree of February 26, 2025 | Draft supplementary decree, not yet published in the Official Journal |
| Common daily care | Authorized without the presence of a nurse if the health condition is stabilized or if there is a stabilized chronic pathology | Proposed extension of the scope under medical protocol |
| Technical acts | Delegated by the nurse based on the assessment of the situation and the qualifications of the nursing assistant | Formalization of written protocols for certain procedures (suction, capillary blood glucose) |
| Update training | Mandatory for graduates before 2021 (decree of February 26, 2025) | Likely integration of additional modules related to new acts under protocol |
| Responsibility | The nurse remains responsible for the acts they delegate | No transfer of responsibility announced |
This table highlights a point often misunderstood: the texts of 2025 reinforce an existing framework without creating a break. The discussions around 2026 focus on a more detailed formalization of protocols, not on a disruption of the division of responsibility between nurse and nursing assistant.
To understand in detail the technical care acts under protocol as defined in the current texts, the new nursing assistant decree 2026 is the subject of an in-depth analysis that complements this reading.
Common Care Without Nurse Presence: Real Conditions and Limits
The regulatory framework of 2021 introduced the notion of common daily care. These care acts concern actions that an autonomous person could perform themselves or that a caregiver could take on. The nurse can delegate them to the nursing assistant, even in their absence.
The central condition remains the stabilization of the health condition. A patient whose chronic pathology is stabilized falls within this framework. A patient in an acute phase or whose treatment has just been modified does not.
What These Care Acts Actually Cover
- Assistance with taking medications prepared by the nurse, when the method of administration does not present particular difficulties and the dosage is predefined
- Monitoring of common parameters (temperature, weight, observation of skin condition) without diagnostic interpretation
- Hygiene and comfort care adapted to a stabilized chronic pathology, including changes, mobilization, and prevention of pressure sores
The gap between theory and practice lies in the assessment of stabilization. It is the nurse who decides, on a case-by-case basis, whether the situation allows for the act to be delegated. No text establishes a closed list of eligible pathologies, leaving significant room for clinical judgment.
Technical Acts Under Protocol: What 2026 Could Formalize
The distinction between common care and technical acts constitutes the core of the reform. Technical acts (endotracheal suction on a tracheostomized patient, capillary blood glucose measurement) currently fall under the nurse’s own role. Their delegation to the nursing assistant requires an individual assessment and verifiable training.
The decree of February 26, 2025 does not create a general right to perform these acts. It structures the conditions under which the nurse can delegate them: qualification of the nursing assistant, written protocol, traceability. The discussions for 2026 aim to standardize these protocols at the national level, where each establishment currently defines its own procedures.
Written Protocol and Traceability
A written protocol specifies the authorized act, the conditions for execution, the monitoring criteria, and the actions to take in case of anomalies. Traceability requires that each delegated act be documented in the care record, including the identity of the professional who performed it.
The issue of a potential reform in 2026 concerns the harmonization of these protocols. A nursing assistant trained in one establishment currently applies procedures that may differ significantly from those of another establishment, even for the same act. National standardization of protocols would reduce this disparity.
Mandatory Update Training for Nursing Assistants Graduated Before 2021
The decree of February 26, 2025 targets professionals whose diploma was issued before the 2021 reengineering. These nursing assistants were trained under a framework organized differently, with less detailed competency blocks than the eleven competencies of the current framework.
The update training aims to achieve several educational objectives:
- Analyze clinical information to identify the general state of the person and adapt activities accordingly
- Integrate multidisciplinary teamwork and structured communication into daily practice
- Master traceability and evaluation tools related to acts delegated under protocol
- Update knowledge in prevention, particularly regarding risks associated with stabilized chronic pathologies
Approved training organizations offer these modules, the duration and content of which are regulated by the decree. Funding goes through the usual continuous training mechanisms (OPCO, employer’s skills development plan).
Graduates After 2021: No Additional Obligation at This Stage
Nursing assistants trained according to the 2021 framework already incorporate these competencies into their initial curriculum. If a supplementary decree appears in 2026, it could introduce specific modules for newly formalized technical acts, which would then concern all professionals in practice.
The current framework does not change legal responsibility: the nurse remains responsible for the acts they delegate to the nursing assistant. The update training does not transfer this responsibility; it ensures that the professional has the competencies to perform the act under the conditions set by the protocol. Any regulatory evolution in 2026 will need to clarify this point, which remains the most frequent concern in practice.
