Staffing: Just Licensed Personell or Including Unlicensed Assistive Personell

  1. HI,
    I am Angelica and currently attend an ADN program of which I will be graduating in May 2004. Do you think that it is more time efficient and safe practice to staff a 39 bed medical floor with RN's, LPN's and CNA's, or would it be better to staff just RN's on a floor. This of course brings up other issues, such as total patient care. I have completed clinical hours in a hospital that doesn't generally staff CNA's but does have LPN's so that the nurses are performing unskilled labor with all of their patient's, as well as skilled labor. I was curious to hear about anyone who has worked in situations where there is just RN's, or RN's and CNA's with no LPNs. Is there a feeling of security and safety of patients or is it more efficient to staff in a style where there is RN's, LPN's and unlicensed assistive personnel?:angel2:
    Last edit by angelicaparki on Apr 13, '04
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  2. 9 Comments

  3. by   suzanne4
    First, there is a big difference in what you call skilled vs. unskilled labor. No CNA or certified nursing assistant is unskilled. They just have different responsibilites from nurses. It isn't a matter of choice usually, it depends on what your hospital will support you with. I have worked units in the past with CNA's, who I definitely preferred working with over some other RNs. It all depends on the actual people who will be working, not just the title. I usually work OR when I am stateside now, but when I do help out on a telemetry unit, I have no problem getting my own baths done while doing my assesments and letting the CNAs help patients whne they need it. It is not "this is my job, and that is yours", sure with meds and IVs it is, but there are many other things that they can do, but I am able to do the same things, too. I definitely am not one to sit on a phone while someone else is running around................

    Hope that this helps...........................
  4. by   nurse_robin
    I've worked both team and primary over my 20 years as a nurse. I prefer primary as long as I don't have more than 4 and don't have to cover anyone. I like providing total care for my patients. Maybe it's a control thing, but since I am the one ultimately responsible for my patients, I know exactly what kind of care they get and everything that's going on with them.
  5. by   zacarias
    The large teaching hospital I work at only employs RN nurses in all units. We hospital assistants though that do help a lot. I think team nursing (with LPNs) would be more time efficient but it would mean the RN would be responsible for more patients which is a safety concern.
  6. by   tmiller027
    A friend of mine at our LTC facility is an LPN. SHe used to work at a local hospital, but she quit because she said they only use LPNs there as CNAs pretty much. Not sure why they do that, unless its so they can say that they only use nurses.
  7. by   NursesRmofun
    Quote from angelicaparki
    HI,
    I am Angelica and currently attend an ADN program of which I will be graduating in May 2004. Do you think that it is more time efficient and safe practice to staff a 39 bed medical floor with RN's, LPN's and CNA's, or would it be better to staff just RN's on a floor. This of course brings up other issues, such as total patient care. I have completed clinical hours in a hospital that doesn't generally staff CNA's but does have LPN's so that the nurses are performing unskilled labor with all of their patient's, as well as skilled labor. I was curious to hear about anyone who has worked in situations where there is just RN's, or RN's and CNA's with no LPNs. Is there a feeling of security and safety of patients or is it more efficient to staff in a style where there is RN's, LPN's and unlicensed assistive personnel?:angel2:
    Your questions aren't really totally clear to me, but I think I get the gist of it. My opinion is that it is nice to have RNs, LPNS, and CNAs or Techs working together. However, I also think RNs and LPNs -OR- RNs and CNAs/Techs would work too.
  8. by   Ortho_RN
    Well I like having the RN, LPN, and PCAs.... But as someone said, the RNs tend to have more patients this way.. Even if our LPNs take patients, then we still must assess them and chart behind them (stupid)... But if it was just RNs then I think that would be good if they cut down the number of pts per nurse... No way I could do total care on 13pts....
  9. by   Sekar
    Eveyone in the healthcare arena has someone supervising them. RNs may be required to supervise LPNs and make sure that they are doing their duties in an appropriate manner but that same RN has someone who is required to supervise them and make sure that they are doing their duties in an appropriate manner. Strange that I don't hear anyone bemoaning that burden on the system and it's increased patient safety risk. RNs and LPNs can both be either competent or incompetent. There is a Charge Nurse somewhere in every facility that is resposible for making sure that ALL nurses perform their duties properly. Frequently these Charge Nurses have a patient load they must carry in addition to their supervisory duties. This tired rhetoric of LPNs being a burden should be dropped. LPNs are Licensed Nurses and when utilized properly can be a great asset to any organization. The same goes for CNA's, who have their own skills and abilities to contribute any organization. I, for one, would hate to work in any organization that didn't use LPNs or CNAs.
    On the issue of skills and abilities, as Nurses we should be willing and able to perform any duty of any person assigned to unit. No task should be "beneath" us to peform for our patients. It doesn't matter if the task is "skilled" or "un-skilled" if you are available to perform and it falls within your abilities to do so, then you should perform the task. If any Nurse is unwilling to perform a necessary task because it is "beneath" them, they should move onto another career field because they no business in the nursing profession. Nothing irritates me more than the healthcare "professional" who is too good to empty a bed pan or wipe a patient's butt. I'm not saying anyone here said that, it's just a pet peeve of mine.
  10. by   inna
    I would prefer to have an all RN staff and just keep the ratio1:4 or 1:5, I could give more care, assess my pts. better, keep track of their I&O's V/S, etc..etc.. rather than have auxilliary help and take care of 10-12 pts. Anyway with a heavier load I still end up most of the time doing almost what the CNA's supposed to do as it's impossible for them to help all the nurses.
  11. by   Tweety
    I think a mix would be o.k. as long as the ratios would be safe. Would be nice to have that 4:1 or 5:1 ratio with some good CNA help. But the reality is the hospital is willing to hire that many nurses, even if they were out there.

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