Attention Nurses, Nursing Assistants, and other hospital assistive personnel!

Nursing Students CNA/MA

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assesment, and reasessment, IV push and so on so forth. Just like Physical Therapists Assistants are not Physical Therapists, Pharmacy Techs are Not Pharmicists, Deacons are not priests, Physician Assistants are not physicians, LPNs are not RNs, RNs are not Nurse Practicioners or Doctors,or nurse anesthitists, or midwives. Just like Personal Care, Home Care Assistants, and Direct support PCS workers are not CNAs, and know matter how many times they call themselves one, they do not assist nurses or perform tasks delegated by a Nurse Supervisor, and did not attend an OBRA NATCEP CNA training course and cannot work as a CNA until they go through the 3-5months of training, and get their certification and are listed on the registry.

I was always taught in my CNA class by an EXCELLENT Gerontology Certified RN instructor that you should never focus on what you are not, but what you are. We are Nursing Assistants. Vital tools to nursing. We are healthcare professionals assistants, certified by the state to do the basic nursing tasks on stable residents or patients. We are a part of Nursing, we do perform basic old school style nursing services under the supervision of a Registred Nurse. In long term care facilities we are held liable for our actions. If we carelessly drop a resident or forgert to lock the bedwheels, or carelessly feedthem til they choke, etc. we will be held responsible, and this negligent behavior will be placed by our name on the state CNA registry, and we will never find a job or be elidgble for CNA Certification again. We do have a Scope of practice established by the DHH and OBRA, in Long Term Care (all states) and Subacute Care (Some states).

And it is ILLEGAL to work as a Nursing Assistant in Sub Acute care in some states, and in a Sklilled Nursing Long Term Care Facility in all states as defined by OBRA 1987 and NATCEP. With all this being said we are NOT NURSES. At the end of the day nurses are Nurses and were Assistants. Nurses have much more comlex and advanced roles in patient care than we do. RNs have to maintaing a 3.5 GPA while in college to get accepted into nursing programs. They have to study their rears off to finish. They earn the title Registred Nurse. They dont want a Licensed Practical Nurse who went through 9-14 months of Vo Tech training assuming their responsiblities and acting like they know more than them. LPNs dont want CNAs who went through 3-5 months of training at a Votech, calling themselves Nurses and assuming their roles and responsiblities ILLEGALLY. LPNs go through 9-14 intense months of training to sit for there boards licensing test. Just like CNAs dont want uncertified personal care and support workers or other unlicnesed assistive personell not certified calling themslves a Certified Nursing Assistant.

CNAs go through 3-5 months of moderately challenging tarining. They learn signs and symptoms of many diseases, how to measure vital signs, the 5 step ADPIE nursing process, HIPPA practices, how to assist the Nurse with various procedure an much more stuff. WE ARE NOT NURSES. WE ARE NURSING ASSISTANTS. WE NEED TO BE PROUD OF WHO ARE, AND BE HAPPY TO HELP NURSES IN ANYWAY WE CAN. BUT THE KEY WORD IS HELP/ASSIST THE NURSE, NOT BE THE NURSE! Whether we are State Cerified Nursing Assistants or some type of other Unlicensed Uncertified Assistive personell such as medical assistants, Patient Care Technicians/Assistants and so on so forth. So lets make nurses stop ripping there hair out and professionally introduce ourselves as Nursing Assistants or or Assitive Personell (if uncertified) and respect each others levels of traininig and work together!

The top of the page was a comparison to how LPNs have a differnt scope than RNs and cannot pretend to be RNs are assume duties of an RN that are not within there legal scope. THIS POST IS TO EXPLAIN WHY Nursing Assistants are not nurses!! Some of the top got cut off some how. Btw I am a CNA state certified.

What an interesting post/rant.My experience with facility CNA's are they report changes in condition to nurses, not assess or treat them.Most of us are too busy to complete our daily tasks to pose as Nurses or M.D.'s. If we don't report, we aren't doing our jobs and most of us want to keep our jobs.Nobody benefits if a resident isn't treated by the appropriate professional.

I agree with you but I also think...scratch that know that some get just a little bit of a bigger ego because of the change of condition reports.

Not sure what the point of this thread was.

Some CNAs think they know more than RNs. Some RNs think they know more than Doctors, and some Doctors think they know it all. This is news how?

Specializes in Nursing Home.
The funny thing about (non certified) hospital NAs is that they have a much wider scope than the CNAs in LTC. I was a NA in the hospital (again, no certification of any kind, just on the job training) and I could do WAY more than the CNAs where I work now. I did fingersticks, EKGs, inserted Foleys, acted as secretary sometimes, placing orders in computers. Plus, I obviously did all the direct care stuff CNAs do. I was stunned when I started as a LPN in LTC to see the CNAs didn't do the fingersticks. I had never once seen a nurse get a blood sugar in the hospital!

Just they way it is, Hospital UAP is different than long term care. Hospital CNAs/PCTs/Nurse Techs whatever have no scope of practice defined, and can do whatever the RN feels appropriate, whereas in a Nursing Home a CNA can have no other title than CNA, has a strict defined scope of practice, than involves no sticking, enemas, etc. And in reply to an earlier comment REPORTING is an important part of being a CNA, we often save lives by noticing something the Med Nurse wont notice for another 3 days. You cant stereotype for one bad example. And if your the kind of Nurse who pretends your not interested when the Nurses Assistant tells you the Mr. So and Sos pulse in the 30s when its usually in the 80s and you blow them off and the next day Mr. So and So codes, you should be ASHAMED!! THIS IS FROM PERSONAL EXPERIENCE! There are alot of LPNs where i work who do not think CNA reports are anything to worry about! UNTIL THE MAN CODES AND DIES!!

Specializes in Nursing Home.
Dr. Frankenstein meet your monster.

If UAP/nursing support personnel are "mouthing off", going out of their assigned scope of practice, etc... on a regular basis you only have nursing service to blame, in particular administration.

A fish rots from the head down and as one who worked as a NA can tell you ran into many DON's, supervisors,head and even staff nurses that would slap (not literally) any nursing asssistant down on the spot if they got to big for their britches. Failing that one was sat down and given a verbal/written warning. Should the behaviour continue you were OWT, out. If a head/charge nurse couldn't get you fired they got you off their floor/unit. Let someone else put up with your nonsense. Sooner or later if you didn't mend your ways word got out and no unit/floor would have you, so there was the door, don't let hit you in the orifice on the way out.

Long story short the lady with the cap/RN after her name was boss, anyone who had a problem with that see above comment about that door.

If licensed professional nurses are being held captive by persons with a high school diploma and a certificate that is their affair. However leave us not make it out as the thing is normal.

I dont think LPNs are Nursing Support Personell they are Nurses

Some of the comments above (downsouth in particular) remind me of a story from a friend who was a paramedic. He quoted an EMT working in a hospital ER as saying she started 20 IVs a day, did all of the nurses' work for them while they sat around, etc.

If this story was true, one would think the EMT lost a lot of credibility from this.

Just they way it is, Hospital UAP is different than long term care. Hospital CNAs/PCTs/Nurse Techs whatever have no scope of practice defined, and can do whatever the RN feels appropriate, whereas in a Nursing Home a CNA can have no other title than CNA, has a strict defined scope of practice, than involves no sticking, enemas, etc. And in reply to an earlier comment REPORTING is an important part of being a CNA, we often save lives by noticing something the Med Nurse wont notice for another 3 days. You cant stereotype for one bad example. And if your the kind of Nurse who pretends your not interested when the Nurses Assistant tells you the Mr. So and Sos pulse in the 30s when its usually in the 80s and you blow them off and the next day Mr. So and So codes, you should be ASHAMED!! THIS IS FROM PERSONAL EXPERIENCE! There are alot of LPNs where i work who do not think CNA reports are anything to worry about! UNTIL THE MAN CODES AND DIES!!

It will of course vary by state but most BONs have laid down certain guidelines laying out what UAPs can and cannot do. It maybe general but usually in no way leaves it up to the RN "feels appropriate". If one understands your meaning if a RN felt a nursing assistant (certifed or not) was able to deliver NG tube feedings she could delegate that task. That isn't possible, well not in New York State anyway.

http://www.nysna.org/images/pdfs/practice/scope/rn_uap_guidelines04.pdf

While the title may differ by facility the roles of various UAPs does not in the eyes of most if not all state BONs.

Some of the comments above (downsouth in particular) remind me of a story from a friend who was a paramedic. He quoted an EMT working in a hospital ER as saying she started 20 IVs a day, did all of the nurses' work for them while they sat around, etc.

If this story was true, one would think the EMT lost a lot of credibility from this.

Have a family member who works as a UAP in a doctor's office who pretty much says the same thing. I do everything the nurses do already was her response when I suggested nursing school as career move (they're closing hospitals left and right here and she was laid off several times).

Specializes in Nursing Home.
It will of course vary by state but most BONs have laid down certain guidelines laying out what UAPs can and cannot do. It maybe general but usually in no way leaves it up to the RN "feels appropriate". If one understands your meaning if a RN felt a nursing assistant (certifed or not) was able to deliver NG tube feedings she could delegate that task. That isn't possible, well not in New York State anyway.

http://www.nysna.org/images/pdfs/practice/scope/rn_uap_guidelines04.pdf

While the title may differ by facility the roles of various UAPs does not in the eyes of most if not all state BONs.

It doesnt matter what an RN feels appropriate in a Nursing Home setting, they can not delegate any task to a CNA thats not defined in the CNAs scope of practice that is defined by OBRA, DHH, and the State board of Nursing Faclity Administrators and Nurse Aide Registry. In the hospital setting NCLEX defines Unlicnensed Assistive Personell's scope of practice and what the RN can and cant delegate, but the nursing homes a different ball game. If state surveyors catch a CNA getting a blood glucose reading in a nursing home, the facility will be fined greatly, the Charge Nurse will lose there license, the CNA will lose there certification permanently, to my understanding.

Specializes in Nursing Home.

I wanna say i have learned that in most states, if not all states, the BON does not, and cannot regulate nursing home CNAs!

I wanna say i have learned that in most states, if not all states, the BON does not, and cannot regulate nursing home CNAs!

In New York State RNs and LPNs are licensed professionals who fall under the DofE/Office of Professions thus can be held accountable via the state's practice acts and BON.

https://www.prometric.com/en-us/clients/Nurseaide/Documents/New%20York/NY%20NA%20Manual_20120703%20Web%20version.pdf

Certified Nursing Assistants do not hold a license professional or otherwise and thus do not fall under the control of the Office of the Professions as above. Rather the NYS Department of Health maintains as per federal law a registry of persons whom have met educational, training, background and other requirements to be listed as nursing assistants.

In theory what you say is true, yes the state's BON does not have direct control of nursing home or other UAPs, but it can do so via other methods.

UAPs work under the direct supervision of licensed professional nurses (RNs/LPNs), who are held accountable by law for patients in their charge. As employees of a facility nurses and UAPs are held accountable to whomever owns the place by state and federal laws and rules. Thus out of liability and several other areas a state's BON and or those licensed as professional nurses have more than a few arrows in their quiver to *regulate* CNAs in any setting.

As a nurse if you know the state BON takes a very hard line regarding complaints regarding UAPs (failing to properly supervise, improper delegation of tasks, failure to protect patients from unsafe assistive personnel, etc...) to the point of suspending and or yanking your license, you are going to do what it takes to protect the thing. If complaints to administration/management do not correct problems with CNAs/UAPs you can bet nurses who value their license will find someplace else to work, fast.

:yeah: Yes, if only more RNs, VNs, NAs, RAs, and Docs thought this way all of our lives would be so much easier. Be proud of what you do and be a TEAM! :yeah:
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