All RNs All the Time: Wave of the Future?

  1. 0 Not sure if this counts as "news" or an "article" so mods please feel free to move as deemed necessary.

    Article from RNCentral.com speaks about a movement to eliminate nursing assistants and have all RNs doing patient care.

    http://www.rncentral.com/blog/2012/a...of-the-future/
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  3. Visit  DoGoodThenGo profile page

    About DoGoodThenGo

    From 'La Pomme Grand - NY'; Joined Jul '09; Posts: 3,865; Likes: 4,754.

    18 Comments so far...

  4. Visit  elkpark profile page
    2
    This is not really "new" -- different models of nursing staffing move in and out of style as the years go by. Plenty of us practicing now have worked in the past in settings where the staffing was all RNs and no aides. It was just becoming popular (referred to as "primary nursing" at the time) when I graduated nursing school in the early '80s.
    Altra and roser13 like this.
  5. Visit  classicdame profile page
    3
    Another option would be to train the aides to do more tasks and pay them better to keep the good ones.
    beeker, Fiona59, and sonja77 like this.
  6. Visit  Jennerizer profile page
    0
    My unit has been doing primary care for over the last 2 years. I wish we had techs to lend a helping hand as most of the patient assignments can be overwhelming. A lot of the hospitals in the area have also gone to primary nursing due to HCAPHS.
  7. Visit  Lovely_RN profile page
    1
    Sounds like a nightmare. I can take care of 4 pts tops with no aid and all 4 can't be total cares. I sincerely doubt the hospital is going to give me a ratio like that on tele or med/surg.
    anotherone likes this.
  8. Visit  PennyWise profile page
    2
    I wish my unit would go with primary care. The aids there are simply awful, and I don't say that about people unless they really deserve it. We do the majority of the vitals, end up getting the blood glucose checks (if we want them done anywhere near the right time) and they don't answer call lights.

    Sooo........since we are already doing primary care as it is.........may as well have one less patient to do it with.

    We all float down here.
    Not_A_Hat_Person and anotherone like this.
  9. Visit  ckh23 profile page
    2
    They are doing it at my facility. They cite the increase in patient satisfaction and increased patient safety, but I think it comes down to money. At our facility the aids are unionized and are making a nice paycheck and I think this is a way for my facility to phase them out.
    Lovely_RN and anotherone like this.
  10. Visit  DoGoodThenGo profile page
    0
    Quote from elkpark
    This is not really "new" -- different models of nursing staffing move in and out of style as the years go by. Plenty of us practicing now have worked in the past in settings where the staffing was all RNs and no aides. It was just becoming popular (referred to as "primary nursing" at the time) when I graduated nursing school in the early '80s.
    Primary care? You mean that is all this was about? Could have saved myself the bother posting. *LOL*

    As always Elkpark you hit the nail right on the head. Everything old in nursing service is new again.
  11. Visit  DoGoodThenGo profile page
    0
    Ok, this what one does not understand.

    First *they* phased out LPNs, now these facilities are getting shot of aides, however there is only a finite number of patients a RN can provide total care to before things get really scary.

    IMHO it isn't that aides are the problem per se, just that in many places from what one hears the lunatics have taken over the asylum.

    Will agree with the other poster that in some cases wages and such need to be improved to attract and keep a better quality of nursing assistant. Spoke with a CNA at the nursing home near my NYC home and was told they only make about $7/hour. Well that is the same average MacDonald's workers make in this area.
  12. Visit  wooh profile page
    0
    Quote from PennyWise
    Sooo........since we are already doing primary care as it is.........may as well have one less patient to do it with.
    You really think when this is done that they give the nurse better ratios?

    Quote from DoGoodThenGo
    there is only a finite number of patients a RN can provide total care to before things get really scary.
    Doesn't stop the powers that be from trying it though.

    Just remember, all we need to do is improve our time management skills and we can take care of infinite patients without help!
  13. Visit  elkpark profile page
    1
    Quote from wooh
    You really think when this is done that they give the nurse better ratios?



    Doesn't stop the powers that be from trying it though.

    Just remember, all we need to do is improve our time management skills and we can take care of infinite patients without help!
    As usual, it depends upon the individual facility. Hospitals that care about the quality of care they provide and their staff will use better (lighter) staffing ratios -- those that don't, won't. At least, that's how it worked the last time around ...

    DGTG -- that (all-RN staffing) was the original meaning and use of the term "primary nursing" (not to be confused with "primary care," which is something entirely different); however, over the years, many different facilities have used the term to mean different things. I've learned to never assume that I understand what any facility means by any staffing or scheduling term until I've heard from the facility how they define the term. "Primary nursing," "Baylor position," "prn position," lots of other terms -- they all mean (somewhat) different things at different facilities.
    Altra likes this.
  14. Visit  GrnTea profile page
    0
    montfiore in nyc and beth israel in boston used to have all-rn staffing, and they were the best places to work in those cities. they had to beat applicants off with sticks-- everyone wanted to work there.

    long gone, though.
  15. Visit  PennyWise profile page
    0
    Quote from wooh

    You really think when this is done that they give the nurse better ratios?

    Doesn't stop the powers that be from trying it though.

    Just remember, all we need to do is improve our time management skills and we can take care of infinite patients without help!
    Quote from elkpark

    As usual, it depends upon the individual facility. Hospitals that care about the quality of care they provide and their staff will use better (lighter) staffing ratios -- those that don't, won't. At least, that's how it worked the last time around ...

    DGTG -- that (all-RN staffing) was the original meaning and use of the term "primary nursing" (not to be confused with "primary care," which is something entirely different); however, over the years, many different facilities have used the term to mean different things. I've learned to never assume that I understand what any facility means by any staffing or scheduling term until I've heard from the facility how they define the term. "Primary nursing," "Baylor position," "prn position," lots of other terms -- they all mean (somewhat) different things at different facilities.
    Elkpark said it right. I do think my facility would give one less patient. Mind you, it should be two less if we are doing true primary care, but when there is no aid on the unit that is what they do.........give one less.

    On the other hand, yes, many facilities will just go with the same ratios they have. When their staff burns out and quits and the PG scores reflect the poor care being given, they'll lose out. Of course they will try to place the blame on the nurses but..........the general public has kinda stopped falling for that. At least in my area.

    We all float down here.


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