Compromised Patient Care? Need LNA's?

[RN2begin]

I work at a state psychiatric hospital. A few years ago they did away with "LNA's". The people who remained, and who were LNA's were no longer ackowledged as such. In addition, they no longer hire them, they instead hire people to be Mental Health Workers. While they do go through an orientation process, they are not mandated to have any medical knowledge, nor are they provided with any while on the unit, unless of course they are able to obtain some from a unit nurse. I work on what is quickly becoming a medical unit, as most in our hospital are. MHW's are performing duties of LNA's re: vitals, O2 set up, patient cares...but are not licensed to do so...or educated about MRSA, VRE, C. diff...etc. We had a patient, MRSA + who had to have his O2 sat taken every hour, as well as a patient with an NG feeding tube on a level I (one staff person within arms reach of pt at all times). The MHW's were taking the pulse ox without gloves, because nobody bothered to explain contact precautions to them...and then sitting with our patient with an NGT and fiddling with it at times, because it would pull partially out at times...

How can this go on? Am I overreacting or is this a huge patient care issue??

[TheCommuter, BSN, RN]

MHW's are performing duties of LNA's re: vitals, O2 set up, patient cares...but are not licensed to do so...

You are obviously in one of the very few states that has LNAs (licensed nursing assistants). Let me guess, New Hampshire?

The vast majority of the states have CNAs or STNAs, which are essentially unlicensed nurse aides. They are not licensed to do anything, as they do not have any licensure in the first place. They are, however, certified to perform basic patient care. Psych hospitals prefer to hire unlicensed mental health workers because their scope of practice is not restricted by a certification, and these people are working under the nurses' licensure.