RN total patient care...

[julz68]

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.

[Tait, MSN, RN]

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.

[EmmaZ06]

How many patients do you have?

[julz68]

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.

[Do-over, ASN, RN]

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...

[JB2007, ASN, RN]

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.

[BrandonLPN, LPN]

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.

[brithoover]

Total care is the norm in Canada.

[VANurse2010]

I'm not paid enough to do total care on medical telemetry, nor do I have the back strength.

[applewhitern, BSN, RN]

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.

[applewhitern, BSN, RN]

You know what it is like when you go into a patient's room to do one thing, and end up taking them to potty, cleaning their bed, getting them some ice, etc.? Well, that is what primary nursing care is, or total patient care, whatever you want to call it. You can't just go in and get vitals, because they always want something and you can't leave. It is much, much better having someone to delegate to, and leave the RN free to do RN stuff, like answer calls from doctors, call doctors, respond to emergencies, etc. Rather difficult to do that when you have your patient half-way to the toilet, or have them naked, getting a bath.

[OCRN3]

We have something like that, but there are 2 CNAs on the floor for 30 patients. They take vitals a d do I & Os, occasionally change or bed or two. They Help as needed but have no direct responsibility for any of the patients. Most of the time they only do vitals. It is not a good system.

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