Here's the situation. I'm an LPN, and work in a hospice/acute care facility, which only holds up to 16 pts. At night (shift i work) a full staff is 1 RN charge nurse, 1 LPN, 1 CNA for less then 8 pt, 2 cna if we have more then 8 pts. The census has been low lately, which makes them call off the cna's. We still may have 5 or 6 pts, and they expect lpn and the rn, to do ALL the work. And you know that's going to fall on me the LPN, because the rn has to do all the assessments. So, here I am trying to take care of my duites which consist of treatments, like, wound care, tube feedings, iv analgesics, suctioning and things like that. Lets's not forget scheduled meds and prn, because of the fact we have hospice pts, you know there are alot of prn pain meds.
Then on top of that, i have to answer all the call lights, fill water pitchers, turn q2hr, baths, diaper change,I's and O's, empty Foley's, do vitals, reposition, need I go on. All of this is duties of a CNA. Before I was a LPN 3 years ago almost I was a CNA. If i really liked that job, I would still be doing it.
I know once you become a nurse, you don't just stop all together doing some of those things. But give me a break its like being a cna all over again. I have spoke the DON, and told her, if I going to be responsible for 2 job title's worth of work, I want 2 pay checks. She just looked at me sort of laugh, like I was joking or something, and said if we had the money for that, we would have a CNA on shift. I know that makes since, but it's at my expense that there is no CNA there. I'm the one doing all the back breaking work that I didn't sign up for. Yes the RN does some, but it's mostly me.
Well I'm looking for a new job. Had 2 interviews already. Do you think I'm wrong?
I'm not going to say whether you're right or wrong. All I'm going to say is, that in the absence of legislation, the facility is going to do what they can get away with. I'm not saying be grateful for the way things are, but I can tell you that for a lot of places, the staffing for 8 patients wouldn't be one RN, one LPN, one CNA. It would be one RN, one CNA, and one pink slip for the LPN. And then when the CNA called out, there would be the pantomime of "well we looked really, REALLY hard to find someone, but there wasn't anybody" so staffing for the night would be one RN.
I've never been an LPN, but from reading some of the posts, it seems like a lot of LPN's would be willing to cut off their right arms to be one of two nurses assigned to 8 patients.
I'm not saying your situation doesn't suck - it just doesn't suck as badly as it could. (Isn't that a slogan to get you dancing on your way to work - "my job sucks less than most!!")
Yes, what you are saying is true, in alot of places. Even at my facility some times. Some of my friends work in LTC where they may have 30 or 40 pts, but then they have lots of aids, so they are only doing their job title. But, i believe people should not stay where they aren't happy, if they can help it. I am not happy there anymore so i'm leaving, lucky for me that here in Atlanta there are alot of opportunities for LPN's still. And you know what, I may find that I had a gravy job, and won't be able to find one like it again. Or, I may find a better job for me. I don't know.
Maybe I am way off base here, but my very first reaction when I read your post is YES, you are wrong.
CNA, LPN, RN.......we all take care of the patient. I am sorry you are feeling overwhelmed in your position in that you "Have to do CNA duties" and "If you wanted to be a CNA you would have done that instead of LPN".
Census goes up and down, people get called off or called in. It happens. I'm sorry you feel you are understaffed (though we have some units in our hospital that only have RN's doing total care- the way it was done back in the day).
I am a PCT in an Oncology/Hospice unit. The usual pt load is 6-8 for the RN's and for us techs it can be up to 10-12 or as low as 5. It all just depends. Honestly, I find your post very insulting, not only to me as a tech and a nursing student, but if I was your patient or patient's family.......I would be thoroughly ****** that you have an attitude that ANY task is beneath you. We all take care of the pt. The RN's have their scheduled meds, tx, and things to do, just as I do as a tech. But we work together and the few of them that "are above doing CNA work" are the ones who do not last long on the unit, the ones who are complained about to our DON, the ones the family fires because of attitude/lack of care/or lack of timely care (because they call the tech and have to wait until a tech is available instead of getting their hands dirty and doing it themselves).
No one likes to wipe butts, clean up puke, give baths, or any other task that is time consuming or unpleasant. However, we are ALL TAKING CARE OF THE PATIENT. That is why we are PCT's, CNA's, RN's, or LPN's. It is in the job description for ALL of us.
Last time I checked, under job duties for LPN or RN there was not a section titled "These are the things you no longer have to do because you are not a CNA and you are now above that level".
Give me a break.
Kelly C.
:redbeathe PCT, Nursing Student, and future RN that will still get busy, frustrated, and ***** at times.........but will still wipe butts with the best of em! Why? Because that is what nurses do.
I may be wrong, but I didn't take it as op hated to do cna duties, but rather felt that there are not enough hours in the shift to finish everything. Just my
Heck in the ICU I work for we are lucky if we have a CNA at night. We do most nights, but there are a lot of nights we don't.
I agree with MichiganRN
This is true for me too. BUT, I only have 2 patients at a time, three if it is a terrible day... I have learned to turn and clean even the largest patients by myself.
Just because you're the LVN, doesn't mean that you have to do all the work because the RN is doing the assesments.... LOOK, she needs to be doing some of the work too. Tell her that you are worn out and you need help! In a nice way of course. I'm sure if she is a good RN, then she will help you and try to split the call lights with you.
Our census is often low and we end up working by ourselves. It's just the way it is. You just need better time management/multitasking skills if you feel like you are being overwhelmed.
With only 5 or 6 patients, I don't see why 2 nurses can't handle it. I know the problem is that you want to do the nurse tasks, not the aide tasks. You might have to go back to school and become an RN. Remember, though, as someone already said, that you might wind up alone with those 5, 6, or even 8 patients some shifts and then you'll be right back to bedside care. Maybe become an NP? Or go sell real estate. Good luck whatever you decide. I know it's not easy.
Specializes in Trauma ICU, Surgical ICU, Medical ICU.
It is one thing if you are too busy to do CNA duties, but your post reads that you don't want to. Let me ask you this, would you be angry if someone told you "I don't want to do LPN duties, I'm an RN" I also think a 5-6 patient assignment is pretty good. I work in ICU and we never utilize CNAs or LPNs, all those duties are mine. Granted, we only have 2 patients, 3 at most, but I am responsible for making it work. It is my duty to my patients to make sure they have care completed for them, which includes at least one bath a night, poo duty (lots of critically ill people get tons of lactulose), oral care, q2h turnings, and many other duties that can be completed legally by a CNA
I also think if you find youself drowning and do not have time for all your duties, then you should work as a team with your RN and maybe you can come up with a solution to make sure all the work gets done and patient care isn't compromised.
If you feel that this wasn't what you signed up for, then resign. I think the snarky comment your made to your DON was also unnecessary. If you had an issue about staffing you should have brought it up in a tactful manner.
Maybe I am way off base here, but my very first reaction when I read your post is YES, you are wrong.
CNA, LPN, RN.......we all take care of the patient. I am sorry you are feeling overwhelmed in your position in that you "Have to do CNA duties" and "If you wanted to be a CNA you would have done that instead of LPN".
Census goes up and down, people get called off or called in. It happens. I'm sorry you feel you are understaffed (though we have some units in our hospital that only have RN's doing total care- the way it was done back in the day).
I am a PCT in an Oncology/Hospice unit. The usual pt load is 6-8 for the RN's and for us techs it can be up to 10-12 or as low as 5. It all just depends. Honestly, I find your post very insulting, not only to me as a tech and a nursing student, but if I was your patient or patient's family.......I would be thoroughly ****** that you have an attitude that ANY task is beneath you. We all take care of the pt. The RN's have their scheduled meds, tx, and things to do, just as I do as a tech. But we work together and the few of them that "are above doing CNA work" are the ones who do not last long on the unit, the ones who are complained about to our DON, the ones the family fires because of attitude/lack of care/or lack of timely care (because they call the tech and have to wait until a tech is available instead of getting their hands dirty and doing it themselves).
No one likes to wipe butts, clean up puke, give baths, or any other task that is time consuming or unpleasant. However, we are ALL TAKING CARE OF THE PATIENT. That is why we are PCT's, CNA's, RN's, or LPN's. It is in the job description for ALL of us.
Last time I checked, under job duties for LPN or RN there was not a section titled "These are the things you no longer have to do because you are not a CNA and you are now above that level".
Give me a break.
Kelly C.
:redbeathe PCT, Nursing Student, and future RN that will still get busy, frustrated, and ***** at times.........but will still wipe butts with the best of em! Why? Because that is what nurses do.
Don't waste time being insulted or angry with her. She just doesn't like doing those tasks that you yourself pointed out that no one likes to do.
If you don't want to do it, then you are not wrong. You are doing the right thing by looking for a new job. There are too many opportunities in nursing to do something that makes you unhappy. Good luck on your job search.
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SuesquatchRN, BSN, RN
10,263 Posts
All "CNA duties" are are nursing duties for which licensure is not required.
Six patients on nights with two nurses isn't a heavy load. A lot of places have one nurse, no aide, for that many patients on days.
I've done nights. Frankly, I don't get the problem with the ratio you describe. Sounds like Nirvana.