All RN Model

I've never done it, but I don't think I'd like it, personally. Our CNAs do a lot of tasky stuff on the floor that RNs frankly don't have time for with critical pts to care for, like stocking the linen closets, running QC checks on the defibrillator and glucometers, taking inventory of admits' belongings, etc. Plus we have total care people with hardware and devices to get up into chairs, and it's nice to have help w/ that without taking as many other RNs away from their patients.

Now if they would do an all-RN model with MORE RNs, with fewer pts per RN, that might work.

I worked at a hospital that did it in the 80s. They fired all of the LPNs, got rid of team nursing and our PCAs and let the RNs do everything to "increase patient satisfaction."

RNs were unhappy that LPNs with 20+ years of experience were let go, staffing did not improve, and eventually RNs left in large groups.

To stop the mass exodus, they tried to hire back the LPNs at a low salary with no seniority, but most said no.

An all RN staff could be quite successful provided it is implemented correctly and staffing ratios are reasonable for patient acuity. It works in many pediatric models quite well.