I am a little put off by the comments that the nurses in this scenarios delegated tasks then went to do non-nursing tasks. In my hospital that would last about one time and then the nurse would be in the nurse manager's office with the HR rep and being told when to expect their final check. Just not going to happen!
On the other hand, I see red when a PCT/MA/NA says "shouldn't we all be a team player?" That seems to work really well when the NA wants your help but does nothing to help the RN meet all the obligations thrown at them.
Let me be real clear. I don't think PCT/MA/NA understand how they got to where they are today. We went from a Team nursing care delivery system to a Primary Care nursing delivery system to a Task nursing delivery system. Nursing has been reduced from a Profession to a Trade. This situation was created by for profit companies injecting the profit motive into health care instead of the care motive.
In the days of the Team model (70s) there were only NAs (nursing assistants). Their role was to provide the basic necessities of care including filling ice pitchers, serving trays, feeding, emptying urinals, bedpans and BSCs, bathing and changing beds. Then overnight Primary care into play and all the NAs were gone! The ratio of RN to patient was never to be more than 1 to 5 and the nurse would do everything. Nurses left the profession and we had a major nursing shortage (80s). Then hospitals decided to make more money and figured out they needed "nurse extenders" also known now as Patient Care Technicians. The nurse practice act was violated and all of a sudden these super NAs were trained to put in foleys, do Accucks, start IVs in some facilities and other skilled tasks. Now nurses are thinking less critically with a higher nurse to patient ratio and much, much sicker patients. Forget holistic practice. Now it is a matter of how many tasks can you perform in one 12 hour shift and can you chart it at leas 3 different ways. The ANA is expecting a loss of 25% of the current nursing workforce at the bedside when the economy turns around.
So let me clarify PCT expectations: take the vital signs on rounds. While you are in the room empty the urinal or the BSC, offer the patient the bedpan if necessary and take them off. Fill up the ice pitcher. Get them something to drink from the diet kitchen if they want it. Empty the foley and record it on the I&O sheet. Give the bath if needed. Do the Accuck. Call me the out of range results on any test or vital sign. If you need help to clean up a patient or turn the patient then let me know. And while you are doing these things I will be taking off orders, giving meds every hour, calling the doctor, assessing the patient for changes, filling out Influenza and Pneumonia screens, doing core measures sheets, learning how to use the new RX for DVT Prevention, attending the training on the new pump, attending the meeting on the upcoming JACHO review, learning how to use the new defibrillator, trending outcomes, reviewing patient satisfaction scores and learning how to use the new computer system update.
Yes, I am your team member. We are here to help each other help the patient. But always remember, you are an extension of me, you are doing the things I would do myself if some hospital CFO would let me. But they want me to take my 3rd admission of the day before I can discharge my other patients. I have walked in your shoes, you can't walk in mine.