Is This Accurate Information? Inaccurate?

[Multicollinearity, BSN, RN]

I am taking an NCLEX review course right now, and the instructor has said these three things that I'm thinking are inaccurate. What do you all think?

1. A CNA can do a clean dressing change. (Maybe in NCLEX-land? I've never seen this in real life.)
   
2. When a hospital goes on divert and does not take new admits, this is called "safe harbor." (I thought safe harbor was available only in some states and has to do with a nurse protecting her license and having to take too many patients, not a hospital going on divert.)
   
3. It is illegal for a nurse to refuse to float to another unit. The concern was the nurse states she is not qualified to work on that unit. (I clarified if it's "illegal" on NCLEX, or in real-life, and the instructor stated a nurse cannot refuse to float to another unit because this violates nurse practice acts in most states.
   

[morte, LPN, LVN]

your instructor needs a new job

[pennyaline]

These are NCLEX questions?

[caliotter3]

None of this sounds right to me.

[Multicollinearity, BSN, RN]

These are NCLEX questions?

These topics came up while going through sample questions and ruling out incorrect answers. Yesterday's topic in review class was management of care. When the instructor said these three things, there was a flurry of questions from the students.

At first, I thought the instructor was going through the questions too quickly, and not making herself clear regarding NCLEX v. real-world. Then I thought maybe she knew the NCLEX-slant on these topics, and was more focused on trying to imprint this in our brains instead of giving correct legal information.

We questioned her on these things, and she was adamant about the above 3 items. I feel like my brain is being contaminated with inaccuracies while I'm trying to review for NCLEX.

Besides these three items, the class has been very helpful, though.

[April, RN, BSN, RN]

I don't have any information on whether it's right or not, but I have seen units where the PCAs do basic dressing changes, like a DSD on a surgical incision during a bath.

[Virgo_RN, BSN, RN]

1. Yes, CNAs can do clean dressing changes.

2. EMTALA requires emergency departments to provide a medical screening exam for anyone who presents. "Safe harbor" would refer to the emergency department being protected from charges of EMTALA violation when going on divert when the emergency department has reached maximum capacity, or at least, this is my guess. I might be wrong.

3. I don't know about this. I do know that at my facility, we cannot refuse to be floated, but we can refuse to take a patient assignment. For example, a med/surg nurse is floated to an ICU. The nurse must float, but can refuse to take the assignment because he or she does not have the education and experience to care for patients of that acuity level. However, the nurse could function as a resource/float and assist with IV starts, boosting, turning, other things that the nurse *is* qualified to do.

[netglow, ASN, RN]

CNA's and LVN/LPNs cannot do assessment, planning, decisionmaking, teaching, evaluating. All my Nclex study resources reserve dressing change to the LVN/LPN. And only simple dressing changes, nothing that even possibly would require an eval by an RN. Nclex CNA's are pretty much lumped in with UAP and given only the most basic duties!!!!!

[racefan88]

I'm not sure what state your in, but in NC, CNA's can do clean dressing changes. Usually they're so busy with their work that a LPN does the job and in some LTC's they only permit LPN's to do them. But it's part of the CNA's training here in NC.

[DogWmn]

cna's and lvn/lpns cannot do assessment, planning, decisionmaking, teaching, evaluating. all my nclex study resources reserve dressing change to the lvn/lpn. and only simple dressing changes, nothing that even possibly would require an eval by an rn. nclex cna's are pretty much lumped in with uap and given only the most basic duties!!!!!

thanks for the laugh, i don't know what state you live in but ummm lvn/lpn's do all of the above every day, visit a ltc and you'll see us doing it all or many of the other places we work -clinics, schools, ect. i think you'd be surprised.

what i find sad from this statement is what are they teaching rn's in school about us, and because we are for the most part no longer in hospital settings there are generations of rn's who've never work with lpn's when we are allowed to practice the full scope of practice.

btw, good luck with your nclex.

[cookienay]

I don't know where she gets this "illegal" business of floating to other units. The states do not legislate hospital staffing policies. there is a standard of practice under each licensure. P&Ps and competencies for each unit is determined by the facility. I mean, really do you think the BON is going to come down and haul everybody in because they floated outside their regular unit??

VirgoRN's post was very relevant in regard to this matter. Though my facility does not mandate nurses to float, many do in the manner described by Virgo.

[Multicollinearity, BSN, RN]

Had another class this evening. The instructor is a smart woman. I just think the format (live, online video) is not the best for in-depth questions. She's rushing to get through all the questions each night.