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?
If the Rn is expecting you to do ALL the CNA duties it's unfair. If you are just doing your own patients and helping out the RN on occasion (since she must have to do some things for your patients) then it sounds like a great job.
I don't mind doing "CNA duties," usually. Last night, I was upset though. I had an extremely busy assignment. One of my patients was clearly septic, and another couldn't get up to the restroom himself and had prostate issues going on and needed to be toileted pretty much q2h. We had 3 aids on that night, though one was sitting with a confused patient. I went in to give the one patient his meds, and he asked to be brought to the bathroom. Okay, I was due to hang chemos on another patient, but this won't take long. So he gets up and goes, and I tell him to call when he's ready to go back to bed. I'm sitting at this nurses' station double checking the chemo with another RN, and I see the call light go off from the man's bathroom. No problem, there's 2 aids sitting right there, and one of them is shooting the breeze with a nurse and the other is reading a newspaper. The bell rang for light 2 minutes, and finally I said, will one of you please get that? Normally our aids are very good, but these two must have been having an off night, cause they acted like I was asking for the world.
Hmmmm, tonight I'm already at work since 7p, until 7a. we had an LPN call off, so I'm in an unfamiliar hall until 11p. Just got done my meds, and charting is already done. Now at 11p, I go to my hall, and do my 30 pts, and the other hall's 30 pts because the other nurse scheduled has a family emergency and called off. that makes 60 pts. We do have 3 CNA's scheduled, but all noc meds and tx's will be on me, besides the chart checks, ordering meds, g/t's, charting, and appt's for morning. Not to mention I do my own v/s, because I'd rather have my CNA's answering call lights and t&p'ing people. Oh, I also answer call lights when my girls are busy. This is LTC, get used to it.
I think I'd give my private parts for your job tonight darlin', but hey, only my opinion. Do what feels right to you, and good luck at whatever that may be.
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
Oh yeah the hierachy of hospital,the LPN is at the lower bottom,I forgot,and how is the RN more responsible,it is just the IV's,a good LPN is as just good as RN,and if not often better
It has absolutely nothing to do with "good." It has to do with education and licensure. You can get hissy about it all you want but that doesn't change the scope of practice for either type of nurse.
If the Rn is expecting you to do ALL the CNA duties it's unfair. If you are just doing your own patients and helping out the RN on occasion (since she must have to do some things for your patients) then it sounds like a great job.
Specializes in Cardiothoracic Transplant Telemetry.
Total patient care cannot be evenly divided between an RN and LPN because the RN has a higher level of responsibility and can do things the LPN cannot do. If an LPN and CNA were working together the work could also not be divided evenly.
This is not necessarily true. While the RN does have a higher level of responsibility, anyone at any level of licensure can do all of the tasks of those of all of the other levels. This is how many companies eliminate supportive personnel altogether. It is merely a matter of dividing the duties that would normally be performed by the CNA. If there are 6 patients the RN can do the total care duties for 3 and the LPN can do the total care for the others. They can even team up to do all of the turns together.
That said, you need to make sure that the company if following their own guidelines for staffing. If the staffing grid says that 6 patients calls for a CNA, then I would hold them to that.
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?
That's the one thing I don't miss about bedside NURSING, the grunt work. I did it with care and compassion, but it wasn't my most favorite thing to do, so I can empathize with some of what you said. And you only have5-6 patients? Try doing it with 7 which was the patient load on nights at the LTAC where I worked. There were times when I was in charge and had to take two or three patients myself. Talk about being overwhelmed! You're probably lucky that they called the CNA off and not you since, hopefully, you make more than a CNA so technically they should have cut the higher paid employee. Besides, with 5-6 patients, did you really have to give all of them a bath? We split baths between nights and days so no shift would get the brunt of them. Night baths also were usually reserved for the patients who didn't know days from nights. And it was usually a team of two that did the baths. I have a lot of respect for CNAs, BTW. Most of the ones I worked with, worked their tails off every night. Like someone else said, try working in an ICU or an SCU, you're on your own most of the time to do everything for the patient and where I worked, that was usually three patients which stunk. Probably not a good idea to make that comment to the DON though. Comments like that have a tendency to come back to haunt you at evaluation time. Good luck with your job hunt though. I hope you find something you like better.
This is not necessarily true. While the RN does have a higher level of responsibility, anyone at any level of licensure can do all of the tasks of those of all of the other levels.
I agree with some other posters. While it would be nice to have a CNA on hand, in the absence of one then the available staff need to make sure the proper care is provided to the patients.
I would see what your co-workers think of the situation, and then build a strong argument to bring to your supervisor as to why having a CNA on hand, despite a smaller # of patients, is absolutely necessary. A well made argument is certainly worth trying.
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canoehead, BSN, RN
6,909 Posts
If the Rn is expecting you to do ALL the CNA duties it's unfair. If you are just doing your own patients and helping out the RN on occasion (since she must have to do some things for your patients) then it sounds like a great job.