LPNs called to come in and work as Aides? Is this common?

Specialties Geriatric

Published

Hello Everyone,

I am a brand new LPN grad, a brand new LPN in LTC, and brand new to allnurses. I love this site! It has been so comforting to me as a student and now as a new nurse. I have a few questions and would really appreciate any feedback.

Does your LTC facililty expect you to work as an aide to cover a shift when an aide calls out? I am brand new on my job (3 weeks) but I hear the aides on the phone when an aide has called out for a shift trying to get someone to cover. They first call all the aides, who usually say they can not come in to cover. And then the aide starts calling the nurses to see if they can come in to cover the aide's shift. They do pay the nurses their LPN salary to work the shift as an aide. This is on an Assisted Living floor and the aides are not certified. I was really surprised when I heard the aide, not my administrator, calling nurses to come in to cover. I think the aides burn out because they don't have enough help and they rely on the nurses to help them, rather than the nurses being able to delegate some responsibilities to the aides. P.S.- the nurses' are overwhelmed and overworked as well, but try to take on as much as they can because there just don't seem to be enough aides for all the resident's many needs.

Also, when I work my shift on the work on the Dementia floor, I am expected to give my early morning meds, shower and dress 3 people and get them to breakfast. In the afternoon, I am to "toilet" 3 or 4 residents and either help with making beds and replacing towels in the rooms, or help clean the tables off after lunch. My first day was rough. I did my meds, and got my first resident showered and dressed and I heard a resident screaming, he had fallen. Of course, I immediately went to him. In between helping the aides, I had meds, assessments, calls to the MD, dressing changes, speaking with families, incident report, 24-hr report, my shift report and nursing notes. I have to say they have 2 aides on for 15 dementia residents. These aides must shower, serve food, clean up, do activities, toilet...all of it. So, I dont' believe the aides are lazy, just overwhelmed and need and expect help from the nurse on duty.

Being completely new to this field, I am asking...is this a normal practice?? Thanks so much in advance for any feedback!!!!

DeeLee99,

I couldn't agree with you more...it truly is about the resident. Ironically, I was supposed to be the charge nurse on the dementia unit yesterday and one of the two aides called out. So, I was told by my Administrator that I would work as the aide for the shift and she would have the Assisted Living nurse do my meds. Well, I worked right along side the aide and did all the bathing, feeding, toileting...heck we even painted nails and baked a cake. And I managed to get the meds done as well and didn't have to take the Assisted Living nurse away from her hectic word load. I will say this...we DO need more help to provide quality and safe care for the dementia residents. And I talked to my Adminstrator about that yesterday.

And you are right, I was able to assess things I would not have otherwise seen if I hadn't toileted and bathed the residents. I, in no way, think I am above it. As a new nurse, I have to learn to do both. And I am sincerely working on it. It will take time.

Thanks for you advice!! Hope you have a great day. And in my opinion, I can tell your residents and staff are lucky to have you.

I've worked as an aide since becoming a LPN, and I did get paid the same LPN wages when I did it. However, I was never expected to be an aide, and perform nursing (LPN) duties at the same time. I ran around the whole shift when I did my CNA duties, so there wouldn't have been any time to do a med pass. I figure that if a facility wants a nurse to be an aide for a shift, then the nurse should only perform CNA duties during that time.

Specializes in Gerontology, Med surg, Home Health.

We've had LPNs and RNs be aides if we were short. We had a few days where there were too many licensed people and not enough CNAs so I asked who wants to be an aide today?? The RN jumped at the chance to do something other than the med pass. Whoever said it's about the residents was right.

There is not a snowballs chance in Yuma, Az that myself or any nurses I know would come in and pull a shift as a CNA. My SNF wouldn't dare ask that. CNAa looking for work are a dime a dozen(like nurses) and there is no time they can't get someone. We always have CNAs wanting to pull a double. There are times while working that we do wind up toileting a resident or other CNA stuff just because we all have to work together to get it done.

Legally an employer and your licensing board can expect you to do anything that you have been licensed/trained to do.

Since nursing is such a diverse field and nurses have such an array of capabilities it is up to a nurse to make sure that their duties are described to them in detail before agreeing to accept a position. For example some nurses can only handle private duty patients that are bed ridden and others can take on the responsibliites of running an 800 bed acute care facility.

From what you are saying this doesnt sound like it is for you. It wouldnt be for me either. Most LTC facilities utilize licensed nurses to admin. Medications, treatments, charting, etc. things that unlicensed nurses cant do. If asking a licensed nurse to perform unlicensed duties interferes with their ability to perform licensed nurse functions then it is a problem.

You can do a time study and document how you spend your time and how much of it when you come to work everyday. If you can prove that providing personal care to the residents interferes with your med pass, charting, etc. then maybe the employer would understand that it is an unreasonable request. If others are able to do it and have no complaints then the employer might think you are not organized or working efficiently.

We've had LPNs and RNs be aides if we were short. We had a few days where there were too many licensed people and not enough CNAs so I asked who wants to be an aide today?? The RN jumped at the chance to do something other than the med pass. Whoever said it's about the residents was right.

As an RN and normally the one with the most senority, I would be able to bump the other nurse and have her work and an aid....not a chance! I wouln't say it is "fun", but I enjoy mixing it up and seeing things differently.

Thank you ALL so very, very much for your insight and wisdom. It means more to this new nurse than you could possibly know. I can honestly say that while on the Dementia Care floor, the aides are so over-burdened, that functioning as one of them, while also performing all of my nursing duties, IS interfering with my nursing abilities. And the other nurses who work on this unit, who have much more experience then me, have the exact same complaints and worries. It is not a matter of "helping out" with the residents. That is absolutely no problem. But my Administrator has made this "her baby", as she quoted to me the other day, and is bound and determined to make this work. The nurse on the Dementia Unit of 17 residents has 2 aides and 1 LPN who must be LPN and aide on the 7-3 shift. I have found one nurse is out on permanent disability and like I said the others have fled. I feel this is unsafe for the residents. I will inevitably miss something important by being so caught up in making beds and serving lunch, while giving out morning and afternoon meds. I plan on looking for other employment. I don't feel this is safe and I am not comfortable with it. I've got to go with my gut.

Thank you ALL so very, very much for your insight and wisdom. It means more to this new nurse than you could possibly know. I can honestly say that while on the Dementia Care floor, the aides are so over-burdened, that functioning as one of them, while also performing all of my nursing duties, IS interfering with my nursing abilities. And the other nurses who work on this unit, who have much more experience then me, have the exact same complaints and worries. It is not a matter of "helping out" with the residents. That is absolutely no problem. But my Administrator has made this "her baby", as she quoted to me the other day, and is bound and determined to make this work. The nurse on the Dementia Unit of 17 residents has 2 aides and 1 LPN who must be LPN and aide on the 7-3 shift. I have found one nurse is out on permanent disability and like I said the others have fled. I feel this is unsafe for the residents. I will inevitably miss something important by being so caught up in making beds and serving lunch, while giving out morning and afternoon meds. I plan on looking for other employment. I don't feel this is safe and I am not comfortable with it. I've got to go with my gut.

I think you said the ratio is an RN and an LPN plus two aids for 17 patients? I wonder if I am missing somthing because if that is the ratio it doesn't get any better than that. Most facilities have up to 35 patients, one nurse, and three aids per floor. I am in a SNF and consider myself very lucky to have 22 patients and two good aids on my floor.

I work as a nurse on the "memory care" unit. On the am shift there is 1 TMA, 1 nurse, and 4 aides. On the pm, 1 nurse, 1TMA, 3aides. Noc, 1nurse, 2 aides. There are 36 residents. The nurses are LPNs or RNs. I help the aides as much as I can, I feed residents at dinner (have to be in the dining room for safety reasons anyway). Seriously, I couldn't do the aide's job. It is hard physically, and the residents are hard to deal with. It takes a very special person to redirect over and over, sometimes agressive and combative people. It can be exhausting to care for these people and keep them safe. Still, we maintain a sense of humor and love on my unit. I love my job and consistent staffing is key to trust and routine on a dementia unit. Its not for everyone.

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