[cotjockey]

I really, really, really, wish I could find another job. Unfortunately, we do not have a huge nursing shortage in this very rural area and the jobs are just not out there.

The LTC I work for somehow managed to contract for one more agency nurse than they really have a position for. Lucky for them, the night shift CNA quit without notice, so they have a CNA position open, which they are going to use me to fill. So...for they next five to 18 weeks, I am going to be utlilized as a CNA. I don't mind once in a while (it is a nice break now and then), but for five weeks? They want me to keep doing all of the "nurse" things like weekly skin assessments, monthly summaries, chart audits, and MAR reviews. I can guarantee you that the CNAs I work with don't have time for any of that...somehow they expect me to find the time though. When the agency nurse's contract is up in five weeks, they are going to re-eval and if they can get a CNA great, but if they can only get another LPN, I will remain on the floor.

If they are going to pull me off charge for 18 weeks, I think I want orientation when I come back.

[psalm]

Are you still gonna get paid as an LPN? All you can do is try it and give a detailed report what works and what doesn't, keeping copies of your findings for yourself...maybe someday you will be in management and then have something in black & white to back you up.

Let us know what you decide and what happens. I am an RN who has worked on my floor as a cna a couple of times, but got paid as an RN. It was a different change of pace...and difficult to not do the nurse's job.

[cotjockey]

I'll still be paid as an LPN, so that's not the part that I am really concerned about. We only have 1 CNA on the floor from 1200 - 0600. We have a lot of residents who are pretty heavy care and I just don't have the physical strength or stamina to do it by myself any more...and I know how busy the nurse is, so I know not to expect a lot of help from her. I guess if I do it for 18 weeks, that might come back. I think it will be confusing for the residents too...all of a sudden I'm not going to have keys to the cart, not going to be able to give them their PRNs, not going to be doing the treatments, etc. Anyone who knows how gossip spreads among the residents and their families knows that someone will get the idea that I lost my license or messed up and somehow had to be "demoted."

I was talking to my husband about it and his biggest concern is that when the next contract is up or when they finally hire someone, it will be as charge and they will continue to have me working the floor.

[mary23]

This is one of the most frustrating things..This used to happen to me all the time, last year 12 of the 13 shifts i worked i worked as a CNA i ended up finding anouther job; not becasue I have disrespect for a CNA but that i was charge and prn staff and agency was getting better treatment than there own full time staff, i thought that was wrong.

[marjoriemac]

In my place of work, nurses regularly work the floor as care assistants as we have too many nurses and not enough carers. We still get paid as nurses. We do not mind as it is a refreshing change and lets us see how the other half live so to speak. I do notice that some nurses in my work find ot below them to work as a carer.

[caliotter3]

I would have the same reservations as your husband. Things have a bad habit of turning around when it comes time to make the final decision.

I have worked as a CNA at the CNA rates of pay at a facility one time. Then, I changed to Charge Nurse. It did not turn out to be a good situation because the facility was a hellhole to begin with. They started bringing in agency nurses and could not keep them either. Because of the nature of the staffing and the policies of the owner/administrator, things would not have been better even with a change in mgmt (the DON was helping herself to the controlled substances and her behavior showed it).

I would not consider working at the CNA level again unless in an acute care situation, where I can better use my skills and might be less likely to encounter the kind of things that go on in LTC that lacks from decent mgmt.

In general, it may seem good to give them what they need in the present by working on the floor, but be wary down the road. When it is time to hire the new person, then act appropriately. Don't let them forget you. Good luck.

[cotjockey]

I don't think it is beneath me or that I am too good or anything like that, but...it is not what I was hired to do. Physically, it is very demanding and my out of shape, old, and weak body just can't do it as well as it used to. A few months ago, it wouldn't have been so bad...they staffed two CNAs, except from 2200-0600, there were only three or four residents who were total care (now there are 10), and we weren't responsible for all of the housekeeping duties as well as nursing. I don't know how the CNAs do it because it is so physically and emotionally demanding.

I don't mind working as a CNA once in a while, but I really don't want to do it all the time. I don't mind helping the CNA on the floor when I have time, but I'm not going to do it at the expense of being there an hour past my shift while the CNA leaves right on time or at the expense of residents getting their meds late or not getting their treatments.

Overall, this place has gone WAY downhill in the past three or four months. I actually like it there and would really like to see things change. I keep telling myself how much the residents need the staff that is there and how much I would like to be a part of the solution rather than leave and just make the staffing situation worse. I just don't know what to do right now.

[caliotter3]

You spoke about the physical demands and your concerns. You should either decline to continue in this situation or make certain that you have assistance for pt care. If you hurt your back in a bad way you will have more to deal with than just the issue of job duties or even being tired. Too many people have talked about how their lives have changed drastically after hurting their backs on the job. I have a relative who almost died on the operating table and is permanently disabled. Please pay attention to your own reservations. You can not help anybody at all, if you are laid up in the hospital.

[cotjockey]

I did mention my physical limitations and was told to use the lift to transfer everyone. That's all fine and good for transfers, but it doesn't help reposition in bed. One of the reasons I went to nursing school is because I knew I don't have the physical ability to work as a CNA for very long...especially when I am essentially doing it on my own. I've never liked the fact that so much is left to one CNA and I've mentioned it several times...I've even turned it in to the state and the corporation that manages the nursing home. Nothing has changed though...when state investigated, the administrator told them that the staffing situation was only temporary. Whatever.

More than anything, I don't want to lose my charge position. It's not a great job or anything, but I really do enjoy what I do. The residents are wonderful, my coworkers are great (but very few), the pay is decent...

Thanks for listening!

[JBudd]

Push for the agency nurse to be the CNA, while you the permanent staff person retains the responsibilities you were hired for. Who should they be most interested in keeping happy? The temp or the regular?

I agree with your husband, long term ramifications are worrisome.