To make a complicated story simple. I do not believe a nurse's aide should be working over a RN in any capacity? Am I right or am I being over zealous about this.
I currently work at a large research university which has a very small research hospital on site.
I work with 2 cna's who both are excellent workers but have worked at the institution for a very, very long time and have seen plenty of nurses, nurse managers, and directors come and go.
I am new at this facility and coming from a traditional hospital where as a RN I am used to delegating, giving instruction to cnas and checking on the cnas work not the other way around.
I am concerned because I feel like at this facility the role (or should i say daily tasks) of the NA and RN are way too similiar and is too blurry. This issue has also been brought up by our new director at a meeting held only with the nurses, but nothing has really changed ( to be fair the director is also new)
Honestly there is very little that we do here. I was disappointed to find that my role as an RN was so limited (in comparison to a nurse in a traditonal hospital) especially coming from the ED where as a RN you do so much. All we do as RN's at this facility is take vitals, draw blood, process biopsies, and give photo-therapy treatments, we do not give any medications or do any assessments) the volume of patients just isn't there and you can go days without doing certain procedures. The role of the RN is drastically limited at this facility while the role of the cna is dramatically expanded here. Aides can draw blood as long as orders are signed by a MD, they can setup for and process biopsies, they even had access to the medication room and pulled anesthesia meds for the biopsies!!!???? until our new director restricted their access to the medication room (and one cna stated that she was offended that management did not tell her that they know longer had access to the med room...HA!) BUT they can & do still ask us for our card key to get what they need (which I already told my charge nurse wasnt a good idea and is not the way it should be done)
Because these cnas have worked there so long they know the investigators (scientists) and studies inside and out which gives them greater control of what goes on on the unit and at times leaves us nurses in the dark. One cna works closely with one of the investigators and so this investigator doesn't even prefer to work with anyone else on his study except this cna, so when we nurses need to know anything about that study we have to go this aide to find everything out. I also find that it is the aides giving me (and the other nurses) direction and instructions on what to do which I am definitely not comfortable with (not that I don't like being helped or feel like I am better than someone because of my title, but how can your subordinates listen to or respect you if they have so much leverage???)
Both cnas are nice and are not outwardly arrogant but do carry a chip on their shoulders. A times one of them can be very haughty and is obviously very proud of the fact that she has been and still can do most things the nurses can do on the job, and even mentions that she has been doing it for a long time. She often flaunts the fact that she was the one doing this task and that task and even said that certain things we as nurses do know she used to do many years ago (such as audit charts and fill out patient assessment sheets) This facility as you can see literaly had no nursing structure.
Like I stated before the role of the cnas here are way more expansive than the average cna working in a nursing home or hospitals. The aides here do no patient care. They order supplies, perform specialized sample processing, can deal with the MD's/PHd's on their own without any oversight.
Our new director of nursing recently offered the staff (both cnas & RN's) a ''safety survellaince'' role. She basically wants someone who can do mock JCAHO survey's and keep the units ready for a JCAHO visit . Normally at any other hospital someone would be hired to do this type of job, but in my opinion she is being cheap and just wants someone to do the dirty work for the risk management department.
So this particular cna who can be very overbearing and haughty about her work took the additional position (which btw she will not be getting a dime more on her salary for) and is now responsible for overseeing JCAHO related matters on our unit which means not only will she become even more haughty and somewhat arrogant but she will be responsible for making sure we do certain things that are in JCAHO regulation. Everyone both RN and cna are responsible for filling out a monthly building safety checklist (which I think RN's should NOT have to be doing in the first place) but I am uncomfortable with knowing that this cna or any cna will be looking over my work and I feel that it can potentially create an environment for insubordination.
What do you think? Am i being overly concerned about all of this?
Not "report to them" meaning, "give them report, tell them what's going on." The OP means, "report to them," as in, "they supervise me and direct my practice."
Oh, no. No matter how skilled a CNA is at some tasks like blood draws, a CNA does not have the experience, training, or licensure to supervise an RN.
Last edit by Joe V on Feb 28, '13
: Reason: removed bold formatting