RN's forced to do CNA work - page 5

by rnckr 13,457 Views | 84 Comments

I am a new nurse and was wondering if this is a standard practice. When my floor needs to use a CNA to sit with a patient, they often have an RN take on the CNA's job for that shift. The RN no longer does any RN work for that... Read More


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    Again, some people are only reading a portion of what the OP is saying and taking it out of context.I completely get it. She has no problems wiping a butt or answering a call bell as an RN. But she would rather not have the duties of her professional title stripped of her. I personally wouldn't mind sitting a 1:1 and not have to worry about my RN duties for one night, but I get it. Plus, it is a horrible use of resources. But that isn't even the point. The Misreading of intent on this site has gotten awful.
    FecesOccurs and RNsRWe like this.
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    Quote from MomRN0913
    Again, some people are only reading a portion of what the OP is saying and taking it out of context.I completely get it. She has no problems wiping a butt or answering a call bell as an RN. But she would rather not have the duties of her professional title stripped of her. I personally wouldn't mind sitting a 1:1 and not have to worry about my RN duties for one night, but I get it. Plus, it is a horrible use of resources. But that isn't even the point. The Misreading of intent on this site has gotten awful.
    "They would do what a CNA would do" is a pretty broad statement. What does that mean? Answer call bells? Personal care? Getting someone up? Sounds to me like the RN just doesn't have an assignment. If a patient calls and says "I am in pain" an RN could assess, speak to the primary nurse, then medicate if indicated. If the RN truly is only doing "CNA duties" then it would entail saying, OK, let me get your nurse, finding said nurse and saying "room 334 is in pain" and letting the primary nurse take it from there--which is not the wisest choice, as regardless of assignment, an RN is held at a higher standard of care than a CNA, therefore, could be available to a number of patients, for a number of tasks. I get that it is hard work tending to the personal care needs of patients--it takes a special kind of person to be a CNA and to be a good CNA. But I was a bit taken aback by "I didn't go to school to do this" kind of statements. What will happen when this person works in a hospital that doesn't have CNA's? No one is stripping her of her professional title. But they are asking her to not take an assignment and float to help and be an extra set of hands. Because there's no CNA on the floor, that could entail some personal care and call bell answering.
    realmaninuniform likes this.
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    Quote from RNsRWe
    Seems like a foolish waste of resources.

    Frankly, if this is how they're going to divvy up staff, I'D offer to sit with the 1:1 patient and have the CNA do her job as normal. Seems you should get your preference, if you're not going to be functioning as an RN that shift, what YOU'D like to do: sit with patient or be floor CNA.

    There were times as a floor nurse I would've KILLED to sit with a 1:1 patient instead of running a full patient assignment!
    NO doubt!!
    nyemt2005 and RNsRWe like this.
  4. 0
    It's not as bad as taking an agency RN on the night shift making 60+ bucks an hour and having them sit on monitors for the shift. Now that is a waste of resources.
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    Quote from nyemt2005
    It's not as bad as taking an agency RN on the night shift making 60+ bucks an hour and having them sit on monitors for the shift. Now that is a waste of resources.
    If your facility has signed a no cancel contract with the agency they get paid whether or not they work.....might as well have them doing something.
  6. 0
    I agree with the nurses who say that this is ok to do, by having a nurse on the floor as a nursing assistant instead of nurse when there is needed staff and no NA or CNA whatever you want to call it. They are right, you have to start with the basics. In nursing school the first thing we learned was basics that a nursing assistant would do such as vitals, bathing, feeding, dressing, hygiene etc. This is just as big a part of care as all the big stuff that only nurses get to do.
    I was what was called a nurse technician and worked in trauma SICU. I learned the basics of being both a nurse tech(nursing assistant) and what it takes to be a good nurse, know why? Because in trauma we all worked together. Nurses would help us and we would help them. Changing a patient who had voided or had a bm could be a 3 or 4 person job because of the condition of the patient. Bathing was also done with both nurses and nurse techs. Point being? We all worked together. When I was sent to MICU they were excited to have a tech because they never had one, I actually felt the floor was a little boring to be at because every time I asked a nurse if they needed help they would say they didn't because they were used to working without a tech. They were even better at team work then the floor I was on.
    Furthermore here in my state LPN's are desperate in seeking jobs. No one will hire without experience. So I did the only thing I could. I worked in a Acute Rehab hospital where I worked with LPN's who were there before they stopped hiring them and I worked with nurses who were new graduates that had less experience then me. I had to work as a nursing assistant for 9 months. I was kept from performing any nursing duties, though some nurses would let me do what I was licensed to do, but that was once in a blue moon. The work was fine, there were still things I learned that I did not know. I was able to work with kids which is my passion. I just hated not being able use my skills, though that didn't keep me from not using my knowledge, nor my compassion for working with people. My patient's loved me, and you can bet they knew I was a licensed nurse even if I couldn't be their nurse. I did bathing, feeding, and all that good stuff you are complaining about and I did it well without complaining even if I was a trained nurse I never looked down upon my fellow CNA's, nor did I ever think I was too good. I needed to work and I needed to work in the field I loved and at the time this was my only option with the economy and the way no one is hiring LPN's.
    Now I am a 1:1 nurse with the school system. I take care of children with special needs and do diabetic monitoring. Guess what I am responsible for? Everything. I help the student with feeding, oral care, hygiene, changing the child who is incontinent. All this plus what you call actual nursing care.
    Nursing is tough and I admit it is not fair when there isn't enough staff and nurses are taken off the floor to things that are what they call below them, but get over it, roll with the punches, or find another career because I was taught right from my school. I was taught that you are never too good to change a patient, help feed a patient, give a patient a bath or any other ADL's you might be responsible for.
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    I only asked people if what I was seeing was normal. All the negative and hateful remarks surprised me. I know I am trained to do the "CNA work". Yes, I called it "CNA work". I took a job on a unit that has CNA's. I was never told I would need to do "CNA work" for an entire shift several times a month. I don't mind doing everything they do during the course of my day doing "RN work". I understand that's part of the RN's job. I don't want to do "CNA work" all day long. I don't consider myself better than the CNA. CNA's have a very hard job and are not paid enough to do it. I have a great deal of respect for them, but I don't want to do their job. I am also qualified to sweep the floor and do maintenance work. I don't want that job either. As a second career nurse, I am qualified to do a great many things. I chose to be an RN. I want to do what RN's do on a daily basis. That's what I went to school to learn. If I wanted to do the CNA's job, I would have saved a lot of money and time and gotten a CNA job instead of going to college.

    For those of you who answered my inquiry without harsh remarks, thank you. Your input is appreciated.
    FecesOccurs, Dazglue, MomRN0913, and 2 others like this.
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    Quote from loriangel14
    Even though we have aids,our charge nurse will still answer bells, toilet and shower patients and clean up code browns.
    All of the above, plus put the rubbish out and clean the floor (itu sister)

    Sent from my iPad using allnurses.com
    loriangel14 likes this.
  9. 0
    Quote from rnckr
    I only asked people if what I was seeing was normal. All the negative and hateful remarks surprised me. I know I am trained to do the "CNA work". Yes, I called it "CNA work". I took a job on a unit that has CNA's. I was never told I would need to do "CNA work" for an entire shift several times a month. I don't mind doing everything they do during the course of my day doing "RN work". I understand that's part of the RN's job. I don't want to do "CNA work" all day long. I don't consider myself better than the CNA. CNA's have a very hard job and are not paid enough to do it. I have a great deal of respect for them, but I don't want to do their job. I am also qualified to sweep the floor and do maintenance work. I don't want that job either. As a second career nurse, I am qualified to do a great many things. I chose to be an RN. I want to do what RN's do on a daily basis. That's what I went to school to learn. If I wanted to do the CNA's job, I would have saved a lot of money and time and gotten a CNA job instead of going to college.

    For those of you who answered my inquiry without harsh remarks, thank you. Your input is appreciated.
    I am curious.......When did you graduate and pass boards? How "new" of a nurse are you?

    Just remember that when you are in the position of being a CNA, while not what you wanted, remember that while you can perform in the position of the CNA the CNA cannot be placed in the position of being a nurse.

    I know I have canceled CNA's when I supervised a small facility and utilize the nurse as a sitter for it gave me more flexibility at 3 am if the feces hit the fan.

    I will also admit that there are times the "seasoned" staff tend to utilized the newer nurses as the sitters as they may need the strength on the floor.

    I don't know the circumstance of your situation but if you seem to be getting this assignment more that the others then talk with your boss. But it does happen, it is not always the most efficient use of resources but sometimes it's the only option available. With fluctuating census and staffing needs and 1:1's being a huge expense but absolutely necessary......the most flexible way to keep a license in the house is to choose the RN to do the watch or the CNA's position for that shift.

    Then there are the times I really need a CNA and can't find one but I have a surplus of nurses....I will use a nurse for that void. You are just helping out a fellow nurse. It has been done this way since I graduated license wise is the one I choose to leave in the house. When I would be pulled for CNA duties that day I remind myself that I am lucky I am working.

    I wish you the best.
    Last edit by Esme12 on Oct 1, '12
  10. 0
    I have been in nursing since 1986. I have switched specialties many times. One thing I have learned is that in nursing there is no typical day. (Due to staffing issues, census issues, acuity issues, legal issues, and financial issues etc)
    A facility tries to staff based on the above issues and most will prioritize these by going down a line. Legal first, financial second, and then the care based issues. With that said, they try to get the most bang for their buck. What this amounts to, is the nursing staff is in a constant flux trying to deliver the care. You can see this on individual units, where they are constantly changing the type of nursing (ie primary, team, etc) the shifts (ie 12, 8, split, rotation, etc.) Once you have been in nursing long enough you will realize that these are part of the challenges that we must face. As far as scopes of practice go, many RN's actually do get set into a position not having to take care of the patients' bedside needs and then find themselves lacking in this area when the need arises. I was a DON in LTAC in the early 90's at a progressive facility that allowed me to rotate all nursing staff through one shift a month as a care provider below their normally scheduled position. I also rotated through the positions. It will stay with me forever, it kept everyone apprised of their coworkers challenges and kept everyone working more as a team. I understand the frustration of going into to work assuming you are going to be doing ... fill in the blank, however once I learned that there was no typical day and went into work knowing that I was there for X hours to provide care to my patients the best way that the facility saw to have me do it; I was able to maintain a greater sense of accomplishment in myself as a nurse.


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