Aides being "nurses"

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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! :mad:

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

Specializes in Transplant/Surgical ICU.
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.

And we are worried about the recession? Oh nursing :smokin:... There are graduate nurses out there that cannot find work, and what do we do we keep increasing the CNA scope of practice to the point that we are left with nothing else to do but wave our 'mighty' degrees in the air arguing that we have more critical thinking skills!!

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Don't the aides and nurses wear different color scrubs/uniforms? Where I work we all wear different colors depending on our position, and have actual nametags with our titles on them :idea:.

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I work in the ED and the aides start IVs, draw blood with the IV, hang an initial bag of normal saline (when delegated), insert foleys, connect/disconnect cardiac monitors, apply temporary casts, etc. One of them is even ACLS certified and is allowed to transport patients on a monitor to the stepdown unit.

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Specializes in School LVN, Peds HH.

I asked!

ACA = Acute Care Assistant ... so yes, this person was an aide. There was a different aide when I went in last night, and they stuck to their duties. Never went outside them once.

I've been reading your responses, and to clarify, I never said that a CNA talking to a MD is wrong, just that I found it odd because I've never seen it before.

Also, I've never heard of CNA2... which states employ them?

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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.

Here in NC we have a CNA II certification and it does allow aides to do sterile procedures and many other procedures.

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The main issue here is not the fact that they are capable of doing some things a nurse can do, it's a matter of these aides are not suppose to be taking on that role. If it were my family member I would now allow a person who is not a nurse to be handling things a nurse should be doing.

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Specializes in Telemetry, OB, NICU.

I'm feeling your hospital is soon to be sued. If that's really what happens there and nothing is done about it, you all are going to get in trouble.

I don't understand why you see all that and only get shocked but don't even know what to say to your aide about this! It sounds scary. All these should be reported, for the patients' sake!

Yes, my comment is harsh, but what if the patient was your loved one?

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I'm an aide and I talk to our doctor if she is around and I've been noticing something about a resident's mental status that's causing combative/dangerous behaviors. I mean most of the nurses wouldn't even know that the days that this resident wakes at 4am, he tries to kill everyone in sight.

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I'm an aide and I talk to our doctor if she is around and I've been noticing something about a resident's mental status that's causing combative/dangerous behaviors. I mean most of the nurses wouldn't even know that the days that this resident wakes at 4am, he tries to kill everyone in sight.

Why wouldn't they know?

I would think this is information that you need to report to your nurse and not wait until you have the chance to speak to the doctor. In long term care facilities doctors are usually not in on a daily basis. If you notice behaviors by a patient report them. Honestly, if you have noticed something chances are the nurse has also noticed, but on the off chance they have not, this could be a very important piece of information.

As an RN I wouldn't mind an aide speaking to a doctor..... but would be extrememly upset if the information was not also reported to me as soon as it was discovered.

We all need to work together for the best interest and safety of our patients, but keep in mind your scope and always practice within it. :nurse:

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Specializes in Oncology; medical specialty website.

What we're seeing is the gradual dumbing down of nursing as bit by bit CNAs/UAPs/HCAs are being allowed to increase their scope of practice. It saves facilities money by hiring lesser educated staff who can be paid far below what a licensed nurse would require.

Any aide who would talk to a physician about a change in a patient's condition without letting me know about it would be having a "come to Jesus" meeting with me the minute I found out about it.

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What we're seeing is the gradual dumbing down of nursing as bit by bit CNAs/UAPs/HCAs are being allowed to increase their scope of practice. It saves facilities money by hiring lesser educated staff who can be paid far below what a licensed nurse would require.

Any aide who would talk to a physician about a change in a patient's condition without letting me know about it would be having a "come to Jesus" meeting with me the minute I found out about it.

Sometimes doctors ask me stuff, knowing that I am most likely to know if a patient ate, is drinking, peeing, etc. I wouldn't even think to let them know about changes in patient condition, unless they happened to be RIGHT there near the bed and it was an emergency.

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Damiere, as an aide you work directly under the direction of the nurse, not the doctor. You share changes you observe in the patient with the nurse first. You'll get into a world of trouble deliberately reporting to the doctor and leaving the nurse out of the loop.

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