Aides being "nurses"

[raebabelvn]

Ok... so poor grammy is in the hospital on the tele floor. Thought it was gonna be the icu, thank you Jesus! Anyway, the aides on the floor are doing things that I as an LVN can't do. Pushing buttons on the IV pump mainly. I watched the aide come in and adjust the pump yesterday afternoon. I was shocked! They also call themselves nurses, and speak directly to the doctors about patients. That last one just seems odd to me. I just think its outrageous that they're stepping way outside their scope of practice and are getting away with it!

Also... what is an "ACA"? I know CNA, and PCA but I've never heard of an ACA...

[nohika]

A CNA performing tasks outside their scope of practice is NOT called teamwork.

The big thing here is what IS the scope. In a state close to mine, there is a second certification called CNA2 where they can do things such as place foleys, bloodwork, can touch some feeding tubes, can remove casts, suction, and some other things.

So while I agree messing with the IV pump was WAY out of line, there are some states where they are ACA (Acute care aids) and have a "higher" scope of practice than "regular" CNAs.

[Poi Dog]

I am a CNA and I would never pretend to be something I am not or practice out of my realm of whatever.

Those aides should be written up/fired if they are not performing delegated tasks.

[classicdame, MSN, EdD]

You are either a nurse or you are not. It might be mandatory in your NPA to report such behavior as the BON is responsible for protecting patients. If what you think is actually true, it may be construed as fraud.

[NiquiCNA]

The only thing that really bothers me about that is CNAs saying they are nurses.. I would never say that, though I when someone is hollering nurse, nurse, nurse.. yeah, I will answer and see what they want. Nothing wrong with CNAS talking to doctors... though I can honestly say I try to avoid our doctors because most have attitude problems.. Since you don't know what she did to the IV.. not sure how you are judging that what she did was wrong...

[systoly]

Ask them what exactly? Why they're doing things they shouldn't be? The role of an aide is not to maintain the IV pump and flow. That is a job for the RN. Like I said before, I'm an LVN and I'm not even allowed to do this. I know what the roles of an RN and Aide in my state are.

Just ask them what all nurses get asked, "Are you an RN or LPN?" Am I the only one who gets asked this question?

[klone, MSN, RN]

Just ask them what all nurses get asked, "Are you an RN or LPN?" Am I the only one who gets asked this question?

No, but I've been asked if I was the OB!

[JDZ344]

I am surprised the CNA is allowed to replace tele or was she assigned a task outside her scope? But if she can place a foley then surely she can put tele electrodes/snaps on!

Why would starting/replacing tele be outside the scope of an aide? It's non-invasive and easy enough to do. Our hospital policy, BTW, is that UAP can turn off the pump/hit silence if the infusion has finished and the bag is empty. That's all. We don;t touch pumps other than that.

[NotFlo]

Ask them what exactly? Why they're doing things they shouldn't be? The role of an aide is not to maintain the IV pump and flow. That is a job for the RN. Like I said before, I'm an LVN and I'm not even allowed to do this. I know what the roles of an RN and Aide in my state are.

Wow, you can't even maintain an IV line in your state as an LPN? Remind me never to move there!

[Up2nogood RN, RN]

When she said "teamwork," she was referring to talking to the physician about the patient. That is not working outside scope of practice.

Yes, I was referring to speaking to physicians, I apologize for not being clear.

While there are many instances in many states that a cna can have extra training and be delegated tasks that may not be what the OP practices in a HH setting which may be more limited. I sincerely hope the OP would look into this further by either speaking with an RN or the NM in the facility where her grandmother is a pt about her concerns. If it was my family member and I had concerns I certainly wouldn't be asking an Internet forum but getting the facts right from the source.

[elprup, BSN, RN]

As a new/old RN, BSN graduate who "finally" recently found a job at a tiny rural clinic, I see this problem everyday! Medical Assistants (who are not even certified) calling themselves "nurses". It is so frustrating because even the doctors and other staff call them nurses! And here I am a new employee, new graduate, trying to learn everything quickly while biting my tongue everytime they call themselves nurses. I know I am going to say something soon, but I know it is going to really **** them all off and make them feel like I am being a know it all. I think I am going to talk with Dr. who is medical director and voice my concern. Any other ideas for not becoming the newbie that everybody hates...when they are ones who are breaking the law?

Elp

[redhead_NURSE98!, ADN, BSN]

Having the same trouble on my floor. The CNA in question(whose certification has expired), has incorrectly explained diagnoses to pts, pushed buttons on the ivf's, placed foleys in a non-sterile fashion, changed dressings to surgical sites, burned an elderly pt with an unapproved heating pad that she made in the microwave, refused to place a pt back on telemetry because that pt was "too feisty, riding the call light, and didnt want to wake her up" (her words). BTW, that pt coded an hour later and died. She has been told by our nurse manager twice, to not go outside her scope, and each time, does exactly that. I am reluctant to have her go into any of my rooms and prefer to do primary care because I cant trust her to do ONLY HER job and to keep her incorrect interpretations of a diagnosis or plan of care to herself. While I have spoken to the manager several times about this, it keeps happening. I understand that the manager does not have to share how she has disciplined this individual, but it is quite frustrating to observe no change in the CNA's ways. I suppose I could utilize the next step in the chain of command (my boss' supervisor) but Im sure you can guess how that will go.

I'm awfully new, but I am seeing this as a compliance issue. The NM is aware of a non-nurse performing duties outside the scope of practice, INJURING and KILLING patients, and is doing nothing about it. In my facility you could call the compliance hotline anonymously about this. And I would document the snot out of these things with her name and position stated in the note. It also shows that you wasted your time gathering supplies etc. for a dressing change and finding that it had been done without your knowledge or consent. She is downright dangerous. If there was an order for telemetry and she stated she knew it was not on and didn't put it on and the lady died, that's a lawyer's wet dream. I say this as a lawyer. :)

[~Mi Vida Loca~RN, ASN, RN]

Ask them what exactly? Why they're doing things they shouldn't be? The role of an aide is not to maintain the IV pump and flow. That is a job for the RN. Like I said before, I'm an LVN and I'm not even allowed to do this. I know what the roles of an RN and Aide in my state are.

LPN's at our hospital are allowed to do IV stuff, some, they can't hang blood or do IVP but they can change bags and do volumes and stuff. Piggy back meds as well.