RN total patient care...

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  1. 1
    Apr 26, '13 by
    I'm just curious how many of you work in hospitals that has gotten rid of all LPNs and CNAs. My hospital is moving in this direction and a few floors have went to RN total patient care. I don't mind doing everything myself, but I hate the fact that when I'm busy in a patient's room and I have other call lights going off, there is no one to answer them. The unit clerk will sometimes answer lights but they can't do patient care and usually page me to tell me someone needs to go to the bathroom. It's just very frustrating.
    Joe V likes this.

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  4. 47 Comments so far...

  5. 8
    Apr 26, '13 by
    While I am supportive of total care, facilities also need to understand this doesn't mean you can still carry a 5-7 patient load of total cares. If they want to drop the LPN/CNA then they need to add an RN. I fear this is something that is not happening.
    Not_A_Hat_Person, not.done.yet, mds1, and 5 others like this.
  6. 0
    Apr 26, '13 by
    How many patients do you have?
  7. 0
    Apr 26, '13 by
    Quote from EmmaZ06
    How many patients do you have?
    We usually have 4-5 patients, which is doable, but during busy times like assessments, med pass or if a new admit comes, I worry about my other patients.
  8. 5
    Apr 26, '13 by
    My boss asked me once what I thought of 3:1 ratio with no CNA's. I thought it would be great, although we have several excellent aides, there are many days when I am doing all care for 4 or 5 anyway...
    not.done.yet, jtmarcy12, bebbercorn, and 2 others like this.
  9. 10
    Apr 26, '13 by
    I work in the ICU so I only have 2 patients. We do total care on our unit and I love it. I usually plan the baths around the assessment times and I can get a good look at the skin. Do my wound care at that time as well. One of the many reasons I wanted to work in the ICU. I was tired of depending on someone else to do care that I would be held accountable for. Now I know my patients are being bathed and turned like they are suppose to be.
    Not_A_Hat_Person, jedromey, jtmarcy12, and 7 others like this.
  10. 7
    Apr 26, '13 by
    Well, of course RN total care would be the bee's knees if each RN on a med/surg floor had 2-3 patients. But unless said RNs are willing to work for $14 an hour, how is this economically feasible? How could a RN possibly care for 5 patients or more?? Someone has to take the total care patients. Or is this hospital only going to admit "walkie talkies"?

    In the ICU, yeah sure, the ratio is already 1:1 or maybe 1:2. But med/surg? If someone could explain to me how this would work with a 1:5 or 1:6 ratio, I'm all ears.
    Aradien, jtmarcy12, JustMe54, and 4 others like this.
  11. 5
    Apr 26, '13 by
    Total care is the norm in Canada.
    GrnTea, SummitRN, Pepper The Cat, and 2 others like this.
  12. 6
    Apr 26, '13 by
    I'm not paid enough to do total care on medical telemetry, nor do I have the back strength.
    jtmarcy12, BrendaH84, cole804, and 3 others like this.
  13. 0
    Apr 26, '13 by
    I have been an RN for 24 years now, and I have only worked at one hospital that even hired LPNs. The one I am at now does. In every ICU I worked at, we did total patient care, with no aides whatsoever, and it was very manageable, unless a doctor suddenly wanted to place a swan or something sterile, then it was a pain. I have worked in ICU where we only took 2 patients, and some that we had to take 4 patients without even as much as a secretary. It really does just depend on where you work, what type of unit you work on, etc. Right now I am working at my first med-surg job, and we take up to 8 patients each, but we have nursing assistants that do all vitals and hygiene. Basically all I do for my patients is assessments and meds. If I have my choice, I prefer having nursing assistants. I do not like having the LPNs because I end up doing all of their initial assessments, care plans, IV pushes, etc., myself. The jobs I had that were all RN, primary care nursing, were a little more stressful because it is difficult to answer call bells, bathroom duty, etc., when you are already in another room with a patient or doing a procedure with a doctor.
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