Delegating to UAP. How do you feel about it?

Nurses General Nursing

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I am now learning about this. It scares the s*** out of me. :angryfire Why should I as an RN tell a UAP to do something that falls under my license?

How do you deal with it. ISTM that we are putting our license on the line and take away time needed for the patients.

Thanks!!

______________________________________

In His Grace,

Karen

Failure is NOT an option!!

Specializes in Geriatrics, Pediatrics, Home Health.
Yeah, just what ARE the MDs doing?

Believe it or not, MD's are joining unions to stop this crap.

Read this:

http://www.academy.umd.edu/AboutUs/news/articles/9-30-00.htm

and this:

http://www.progressive.org/mpflor699.htm

I find it interesting that doctors are joining unions for the same reasons nurses are: To protect the patient!!

Let me know what you think of these sites!!

__________________________________________

In His Grace,

Karen

Failure is NOT an option!!

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I worked hospitals in Texas where I was the only RN, supervising a staff of LVN's on a ICU stepdown unit. I much prefer this to supervising a staff topheavy with PCT's, which is what these same hospitals may be going to now that LVN's are not going to be allowed, by BNE statute, to practice critical care.

Why I wonder is the BNE not making helpful law on PCT/UAP other than to place entire responsibility solely on the RN's head? How is this helping anyone??? It just piles more responsibility/liability on the overworked RN's head, IMHO.

Personally when I'm supervising PCT's, I maintain control and I delegate what I wish. I prefer they assist with physical care and answer call lights...vs doing fingersticks. Do baths and toiletings vs simple dressing changes or trach care. This pizzes most of them off...they want to task vs do personal care. I remind them I am in charge and I will decide. If we let them take control, they will.

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Believe it or not, MD's are joining unions to stop this crap.

Read this:

http://www.academy.umd.edu/AboutUs/news/articles/9-30-00.htm

and this:

http://www.progressive.org/mpflor699.htm

I find it interesting that doctors are joining unions for the same reasons nurses are: To protect the patient!!

Let me know what you think of these sites!!

__________________________________________

In His Grace,

Karen

Failure is NOT an option!!

Very interesting articles.

All I can say is I think it's just a sign of the times that we are living in.

The rich get richer and the poor get poorer.

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Specializes in Geriatrics, Pediatrics, Home Health.
The rich get richer and the poor get poorer.

And nurses lose their profession!! The bottom line is WE can change what is happening in healthcare. We need to open our mouths and tell the community what is going on in the hospitals we work in. If your [3rd person] hosptial is doing a good job, GREAT!! Help support nurses that don't work in a good hospital. Support the ANA and the UAN!!

Help all nurses change the tide to better nursing for the patients!!

_______________________________

In His Grace,

Karen

Failure is NOT an option!!

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Wow!! Good question!

I used to be a CNA in a long term Care facility and I was required to pass medications after recieving a 4 hr medication class which pretty much told me how to pop them from the med packs, sign them off correctly and adminster them.

I looked up so many medications it was scary because I wanted to know what I was giving. I became very proficent at doing this accurately and quickly and on several occasions had to adminster to three floors since staffing was so bad!

Did I have the knowledge base to give these meds? No way!! This is just one of the reasons I gave up being a CNA. Since I was experienced and profecient giving meds..i had no knowledge base and I was doing an LPN job and not getting paid for it!

It was frustrating both ways..for the LPN who positions were filled by CNA and for CNA expected to work out of thier scope.

This way made possible because of a loophole..a loophole in the state law allowing me to do this UNDER the nurses lisence..that means if I made a big mistake..the nurse would suffer the consequences!

Yeah that is scary..since these facilities do not like it when a nurse says no..not under my lisence.

I'll pass my own meds thank you!!

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
after recieving a 4 hr medication class which pretty much told me how to pop them from the med packs, sign them off correctly and adminster them.

(Screaming) That should be illegal.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I think I know what you're saying, but relax rare for licensed personnel get into trouble for the things UAPs do. In fact in my working years, I've never heard of it happening. Of course the potential is there, so the trick is "is it a task they have been trained to do and are competent in?". So, if you delegate within their scope of practice and what they are competent in you'll be fine.

I'd much rather have 3 or 4 patients and do the work myself, but the reality is that's not happening. Here, they do vital signs, accuchecks, I&O's, baths, EKG's and insert and d/c foley's. I have no problem delegating these tasks to them. As a profressional RN, delegation is part of what I do, and I'm quite good at it, because I can't do it all. :)

We don't have medication aides, but I don't think I'd be comfortable with that.

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I think I know what you're saying, but relax rare for licensed personnel get into trouble for the things UAPs do. In fact in my working years, I've never heard of it happening. Of course the potential is there, so the trick is "is it a task they have been trained to do and are competent in?". So, if you delegate within their scope of practice and what they are competent in you'll be fine.

I'd much rather have 3 or 4 patients and do the work myself, but the reality is that's not happening. Here, they do vital signs, accuchecks, I&O's, baths, EKG's and insert and d/c foley's. I have no problem delegating these tasks to them. As a profressional RN, delegation is part of what I do, and I'm quite good at it, because I can't do it all. :)

We don't have medication aides, but I don't think I'd be comfortable with that.

I was wondering if you've ever had any patients refuse to have certain procedures performed by UAPs and how would you handle it if a patient did refuse and requested that a licensed nurse perform those tasks?

I'm thinking that the majority of the public does not know what is being handed to them on this plate.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
I was wondering if you've ever had any patients refuse to have certain procedures performed by UAPs and how would you handle it if a patient did refuse and requested that a licensed nurse perform those tasks?

I'm thinking that the majority of the public does not know what is being handed to them on this plate.

No, thankfully I haven't had to deal with that sort of situation. But I also agree the majority of the public has no idea what is truly going on.

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Maybe this sounds strange, but I'm a CNA that actually DOESN'T want to do any of these things, such as passing medications, doing phlebotomy, wound dressings, or anything involving foley catheters other than simply emptying them. I know my scope of practice, and it makes me cringe knowing that what I do wrong falls onto the RN. As CNAs, we aren't professionals, but we do work under our own certification, so why shouldn't we be responsible for our own actions?

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Specializes in Emergency & Trauma/Adult ICU.

Note that the OP is almost 7 years old ... ;)

I think that this concept gets twisted sometimes. You are most certainly responsible for your own actions. This is why all health care facilities validate the skills of all their employees -- to demonstrate competency. If it is the policy and procedure at your facility that x "nursing" task is delegated to CNAs ... and that task is not something that explicitly requires a nursing license to perform ... then the CNA is responsible for that task. It is the LPN/RN's responsibility to ensure that it was done for the patient. But that is not the same as, "the LPN/RN is responsible if I do this task incorrectly."

There is considerable variation from facility to facility regarding job responsibilities of unlicensed staff. This is good to keep in mind when interviewing.

I hope this helps.

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Refer to your job description.. then see Their job description... RN's are legally responsible for the "UAP's" performance.

Most nursing assistants are unaware of that .. it is up to YOU to make them aware that it is YOUR license on the line.

Good luck with that...

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