Forcing nurses to work as aides - page 2

I have a question for you all. My employer (LTC facility) has hired and scheduled too many nurses on my shift. This means one person usually has to float, which is fine. Unfortunately they have... Read More

  1. by   mickeymouse1205
    HI.
    I think people are being a little judgemental here. I take it as more of a concern that she does not feel comfortable using the equipment, or transfering residents and one inservice is not going to change that. Did you feel comfortable starting an IV right out of school or heck calling a MD by yourself, No! But by repeating the tasks will make her more comfortable.I know in most practice acts No licensed person should be performing a job as another. In NV it states basically they don't care if you are an RN you are not to accept a job as a CNA without a certification for it. I understand shes not accepting a job as a CNA but she is acting as one for that day. To close to the same thing for me I would call the BON and clarify this within my state pronto. Let the director go work as an aid until its clarified, I believe it says RN after her name also.
    JMHO
    Cheryl
  2. by   mercyteapot
    Quote from mickeymouse1205
    HI.
    I think people are being a little judgemental here. I take it as more of a concern that she does not feel comfortable using the equipment, or transfering residents and one inservice is not going to change that. Did you feel comfortable starting an IV right out of school or heck calling a MD by yourself, No! But by repeating the tasks will make her more comfortable.I know in most practice acts No licensed person should be performing a job as another. In NV it states basically they don't care if you are an RN you are not to accept a job as a CNA without a certification for it. I understand shes not accepting a job as a CNA but she is acting as one for that day. To close to the same thing for me I would call the BON and clarify this within my state pronto. Let the director go work as an aid until its clarified, I believe it says RN after her name also.
    JMHO
    Cheryl
    I agree. Several posters have taken her to task for not "knowing the basics" when she clearly stated that she did. What always puzzles me when I read of these types of situations is how the facility can afford to pay a nurse to do an aide's work and how they justify the expense to the bean counters. I never worked LTC and its been a while since I worked in a hospital, but I never was asked to work as an aide (although, especially earlier in my career before the advent of HMOs and drastic budgets cuts, many times there was no aide at all). It doesn't seem like a good use of resources to me.
  3. by   webblarsk
    [font=Comic Sans MS]I say..............what a nice break to work as a aide and be paid Nursing wages. As far as not knowing how the equipment works I would be going along with the other aides and learning how to use the equipment regardless if I was having to be the aide or not. Sometimes its a nice break to be the aide and not have to worry about the nursing duties! I would just make sure that it was being rotated so that your not the only nurse being the aide!

    [font=Comic Sans MS]I am not trying to be mean or judgemental. I would just take every opportunity to learn the equipment. I don't feel like you are trying to get out of doing the work. But you are being a cautious and wonderful nurse!
    [font=Comic Sans MS]
    [font=Comic Sans MS]P.S. Most aides would be more than willing to show you how to use the equipment and some of the things that your not so sure about. Plus you will gain their respect! They will know your not one of the nurses that think they don't need to do "AIDE WORK"! Keep your chin up. It gets easier once you learn a routine!
    Last edit by webblarsk on Dec 22, '04
  4. by   acgemt
    I agree with webblarsk, I would be gracious to earn a nurses wage to do aide work. I find it unfortunate that the facility you are working in does not provide inservices on any of the equipment that aides use. What if, god forbid, a medical emergency happened in the process of using the equipment...higher trained personnel above an aide would be required to be there and treat the patient...what would happen if the higher trained members of the team couldn't operate the equipment to get the patient down on the ground or in bed to perform life saving procedures...sounds like the facility you are working in is not doing its part in properly training employees. I would take the time to learn from the aides how to use the equipment you specified...or make the facility do an inservice. Good luck to you
  5. by   nurse_wannabe
    Hi. I agree with the poster who recommended you approach your supervisor about your pregnancy. I am pregnant as well, and I would hesitate to lift anyone unless it was by machine, especially someone heavy. It might be perfectly fine, but I wouldn't risk it.

    I'm still a student, but as far as the machines go, they seem to be pretty easy to learn to operate. I had clinicals in one LTC that was a "no-lift" facility and had the opportunity to learn to use many different kinds of mechanical lifts. Just assist an Aid with it a couple of times and you've pretty much got it down pat.
    Good luck and congrats on your baby.
  6. by   RN4NICU
    Quote from webblarsk
    [font=Comic Sans MS]I say..............what a nice break to work as a aide and be paid Nursing wages. As far as not knowing how the equipment works I would be going along with the other aides and learning how to use the equipment regardless if I was having to be the aide or not. Sometimes its a nice break to be the aide and not have to worry about the nursing duties!
    You ARE kidding, right?

    The OP posted that she works in LTC - working as an aide in LTC is backbreaking physical labor. What a nice break indeed.

    They HAVE to pay her nursing wages, because she is still held to the level of accountability of an RN whether she is "working as an aide" or not.
  7. by   webblarsk
    Quote from RN4NICU
    You ARE kidding, right?

    The OP posted that she works in LTC - working as an aide in LTC is backbreaking physical labor. What a nice break indeed.

    They HAVE to pay her nursing wages, because she is still held to the level of accountability of an RN whether she is "working as an aide" or not.
    No I am really not kidding. I worked 5 years in LTC as aide and nurse. I loved being a aide and spending some quality time with my patients. And if they are paying me that much more money than the aides get I would do it with a smile on my face. And like I said earlier. Its a nice break!

    Besides the fact that in most LTC facilities I have seen the nurse is responsible for 30-40 patients where as the ratio for the aides is much less. So yes, what a nice break to be able to give some special time to the patients.
    Last edit by webblarsk on Dec 22, '04
  8. by   RN4NICU
    Quote from webblarsk
    No I am really not kidding. I worked 5 years in LTC as aide and nurse. I loved being a aide and spending some quality time with my patients. And if they are paying me that much more money than the aides get I would do it with a smile on my face. And like I said earlier. Its a nice break!

    Besides the fact that in most LTC facilities I have seen the nurse is responsible for 30-40 patients where as the ratio for the aides is much less. So yes, what a nice break to be able to give some special time to the patients.
    To each her own, I suppose. Would not be a break to me - more like a nightmare, but working with adults would be a nightmare in and of itself for me, so I guess its a matter of preference.
  9. by   Antikigirl
    For me...I have had to help out many times, and where I might be a little out of date on the equipment that seems to change all the time...I ask for help from my caregivers for a 'refresher' on that piece of equipment. They know that just because I am a nurse, that doesn't mean I am the all knowing goddess of all things CNA, LPN or RN! LOL! (oh and they razz me so hard too if I ask! LOL!). I have no probelm saying "well wow, ummmm I haven't done that in a few...can you help me?"...

    Transfers..heck I was never good at them, my upper body strength has never been good! I always ask for assistance for transfers..and my caregivers know that one and have no probelm helping me out..because I help them too!

    I guess the best thing to do is never stop asking questions or seeking help..I don't. And during times when a patient has new equipment, I ask to work with it so I can see how it works! We got a great new Vanderlift the other day, and the caregiver and I worked together to figure it out...not like it took a rocket scientist or anything..but once we got our patient in there we found areas that may be risky for skin tears or bruises if we weren't careful and marked them down so we could pad them or let other people know how it is for that particular client in it! I find taking that opportunity not only helps me learn it...but keep those skills fresh!

    Good luck to you, and definately...if you are pregnant you really should get a MD order for how much you are able to lift and submit that to your employer! No sense risking your baby for a transfer...none at all!!!!!! If I were pregnant..there is no way I would work as a nurse (but I am prone to miscarriages..so I am a tad overly cautious! My hubby knows it..if I get pregnant..I expect NOT to work!...go figure we aren't having any more kids! LOL!!!!!!).
  10. by   SKM-NURSIEPOOH
    this is only my opinion here.....but on the one hand....i understand findingmywayrn's concerns regarding not being oriented to 1) the equipment & 2) knowing how to execute certain said tasks in a timely & safe manner.

    :uhoh21: ohhhhhhhhhh....i remember my first time being scheduled as an aide in ltc....many (if not all) of the aides that day where ecstatic to see a new nsg being made to *do their work*! many sat back...placed bets...& *watched* the show so to speak...not offering any assistance when asked. their attitude was...'well you're a nsg...you *should* know how to do x, y, & z.' i was like...yeah...i *know* how the tasks are done...i just wasn't used to having a full a** assignment of 23 patients (half of which were total care) to get up, wash, feed, get dressed, & later do several rounds, take to & fro to places all within the required eight hours. i remember many laughing at me about 10:00 am & i only had something like three or four patients up & dressed...i literally didn't get done until close to shift end...& that was just washing & getting them all up....nevermind doing other changes! they'd completed all of *their* patients by 10:00 am & miraculously found *other* duties/tasks to perform (like putting clothes away...filling ice cups...which are 11-7 shift tasks mind you)...or they simply took their breaks rather than help a *new nsg* :angryfire .

    i learned quickly how it was they were completing all of their assignments faster than me. of course....many simply *hit* the vital areas to wash only...they didn't do *complete* bed baths. many just went into the rooms...wet one end of a towel with soap & water...then wipe off with the dry end!...skipping the rinsing. many also skipped on mouth care (if the residents had little or no teeth) nor did they perform necessary skin care via lotions or use proper soaps/shampoos. it was absolutely horrendous ! many were reported to administration...but nothing ever got done cuz 1) they needed bodies & 2) the facility was unionized.

    now...i'm not saying all aides did this...there were a few who took pride in their work & how their resident felt & looked...but there were many who didn't care. when i first started out there...i was hired part-time & never had a *home* or *permanent* unit. i was scheduled to work every weekend & every saturday (even saturday and sunday)...i'd be scheduled in an aide slot! this went on for some several weeks to months until i got tired of it & spoke-up to the shift supervisor & then to administration. i only got results once i threatened to involve the union on the matter. you see...the rule was that if you're assigned to an unit & you're pulled...you're 'spose to sign the pull book & not have to float again until everyone else was pulled first. by them not assigning me to an particular unit...this left the seasoned nsg staff (who were friends/buddy-buddy with that shift's supv) to get a break while breaking in the green nsg. it's wrong...but you'll often find this to be the case. people like to test new comers to see if they got what it takes...some will give the *crappiest* assissment to the new guy/gal just because the feel they have to earn their dues! it's not right...but that's how it is often times .

    now on the flip side...i've seen many aides work hard assignments (similar if not worse than the one i described above) while pregnant & they got no light duty previliges...but whenever it came to pregnant nsgs...then that was a different story & other nsgs & management bent over backward to keep them from doing anything remotely physical. i never understood why the pregnant nsgs got special treatment & the pregnant aides didn't...i'll never know! that definitely isn't fair...but i 'spose life just isn't fair .

    i guess my point, findingmywayrn, is that you'll have to re-learn basic body mechanics for pregnant/non-pregnant-healthcare workers...insist on learning what your facility's policies/proceedures are regarding lifts/equipment....& learn how to prioritize/organize (like maybe do the ambulatory/oriented residents first...then move onto the completes last). once you've got some sort of routine down...you'll be able to pick-up speed & even take breaks & leave on time ~ which is one good thing about doing patient care as a nsg. it used to bother me to hear the aides complain about how *us nsgs* don't have time to help them complete their tasks like feeding...yet...they all seem to be able to get breaks & leave on time...while the rest of us nsg are stuck there writing notes &/or trying to play catch-up if someone crashes sometime late in the shift! when will the aides be able to help us take-off orders, give meds, assess the ill, & perform countless of *mundane* duties like writing monthly summaries, performing skin assessments, etc so that we can get bathroom breaks, lunch breaks, & go home on time? that's a rhetorical question that need not be answered of course .

    findingmywayrn, if your employers continue to schedule nsgs in aide positions because of shortages & things don't improve for you any time soon & you depend on this job to pay your medical expenses on your up coming birth...i strongly advise to look elsewhere for employment before you're too far along in your pregnancy.

    good luck to ya & congrats on the little one .

    cheers,
    moe
    Last edit by SKM-NURSIEPOOH on Dec 23, '04 : Reason: What else....my terrible spelling...LOL!
  11. by   stbernardclub
    Findingmyway....I can see your concern about lifting a ltc resident that is over 200lbs since you are pregnant. If you need to, get a physicians script that states how much you could safely lift. Good Luck
    Quote from findingmywayRN
    I have a question for you all. My employer (LTC facility) has hired and scheduled too many nurses on my shift. This means one person usually has to float, which is fine. Unfortunately they have recently been getting nurses to work as aides when they are short. I am opposed to this because I have not been trained to work as an aide - they have a lot of training and knowledge about a wide variety of transfers, lifts and equiptment (such as shower and bathing chairs/lifts) that I have never seen in action, know nothing about operating and am scared to put a resident's safety in jeopardy because they are short on aides. All of our residents have physical limitations and some are completely unable to move on their own. Several people weigh over 200 lbs. I voiced my concerns to my boss and she said that "washing someone is common sense," and I can always ask an aide to show me how to use the equiptment. Am I crazy or is it highly unlikely that a CNA with a full patient load is also going to also be able to help me out with my transfers, lifts and general questions though out the shift?

    What is the liability for my employer if (god forbid) a resident should fall in my care - most likely taking me with them (I am physically limited/pregnant)? Isn't my licence in jeopardy? If I am given this assignment I'll have to refuse due to not being provided training for this position. From there it might even escalate into me being fired or having to quit. My boss said they have had to let people go who refuse to float. Has this happened to anyone else?

    Thanks for your replies.
  12. by   emeraldjay
    Quote from webblarsk
    No I am really not kidding. I worked 5 years in LTC as aide and nurse. I loved being a aide and spending some quality time with my patients. And if they are paying me that much more money than the aides get I would do it with a smile on my face. And like I said earlier. Its a nice break!

    Besides the fact that in most LTC facilities I have seen the nurse is responsible for 30-40 patients where as the ratio for the aides is much less. So yes, what a nice break to be able to give some special time to the patients.
    You got to spend quality time with your pts when you were an aide? Several thoughts are going through my mind; mainly where did you work as an aide and are they hiring. The facility where I work as a CNA believes that two aides can wash, dress, and transfer five to six residents each in addition to chasing bed alarms, call bells, and complete a full set of rounds for the other 28 pts all in two hours time, oh and I can't forget completeing the paperwork for I&O and repos.

    I've dealt with nurses that treat aides like they are less than dirt, our DON seems to be one of them. I've heard of a few nurses who consider aide work as beneath them. No nurse should act like this, ever, pt care is pt care, whether you're pushing pills or wiping hineys.

    In regards to the original poster, get yourself to your OB/GYN or your physician and get them to write a work limitation for you, if your facility balks at the idea, go to the labor board and file a complaint. Pregnancy plus aide work is a bad equation all around if you ask me. LTC pts can and _do_ get violent on occasion, some pts seem to think that you as the aide will do all the standing work for them and refuse to do anything that requires effort on their part.

    Every facility has some piece of equipment that is different from another. If yours has CNA training classes, see if you can go in with them on your day off to learn the equipment. My CNA class instructor made each of us use the hoyer lift and the stand-up lift as both the aide and the pt, to give us a real feel for the machines. There should be some videos instructing the use of the machines too, but don't count on it.
  13. by   findingmywayRN
    Thanks again for all the responses to this topic. I had no idea it would be such a "hot button."

    As far as posters who think I don't know basic nursing care, again, that is not the case. When I stated I was told by management that bathing someone is common sense it was said by management in response to my concerns as a way to give me the impression of how "easy" it would be to do an aide's job (no one can convince me that an aide's job is "easy").

    Unfortunately my facility has no formal training for nurses on how to use this equipment - their orientation consists of work policies and fire drills. It blows my mind that they don't consider nurses when they train them for their jobs, and I have always stated that the CNA orientation (where they learn how to use the equipment) should be a part of basic nursing orientation. It frustrates me that people think nurses just know everything the moment they walk in the door each day. I don't ever like feeling like there is something I should know, but don't. I am definiately going to learn how to use this equiptment and won't hesitate to ask anyone to show me.

    Again, thanks for your replies. I appreciate your insight.
    Last edit by findingmywayRN on Dec 23, '04

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