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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 work in an ICU and do total care. Granted, a lot of my patients are small (infants, small children) but we do get our fair share of larger kids (the 200-300lb school agers, generally they're P-W) and teen ortho pts. Even the small guys are heavy when they're sedated and paralyzed. And, for heaven's sake, a small child can really cause ginormous "code browns" and brown rivers.
Only recently, we've begun to utilize CNAs in our unit. A good one is worth her weight in gold, but more often than not, the RNs still have to do a lot of the cares because the kids are ventilated. We really love it when we have patients ready to transfer out to the peds floor and the floor are short on beds - our CNAs just take over routine cares for us - heaven!!!!
Most of us on my unit fulfill many of the CNA responsibilities just because it's our job to care for the patient (remember that holistic stuff?). The same most of us will also assume some housekeeping tasks (emptying garbage bags, linen bags) just because we can't stand all that yuck in our rooms.
So, 2 patients with total care is a norm for us. We rely on each other (most of us understand teamwork) and when we're blessed, our CNAs.
Do I particularly like the "CNA" part of my duties? No, but I live in the real world and this is just part of my job. Somebody might have to it for me someday and I'm really just trying to pay it forward.
Your comment to the DON was out of line. As others have suggested, there are better ways to have handled this. However, as we have all come to understand, the bottom line is the almighty $$.
Just my
PS - Even though we have changed to computer charting, I am usually late leaving. Patients' needs first, charting later.
I have done CNA nocturnal work at a hospice facility and it should NOT be back breaking work. Turns go very, very quickly (and more comfortably and less invasive i might add) when there are two people doing them. at the facility i went to patients were turned every 4 hours unless there was an order for every 2. and turns are ALWAYS done with two people. Speak up and ask for help, if you are suffering silently people are going to step up and help with the added responsiblity. Even on the more acute care side of the facility at night there are up to 8 patients for an rn and cna... and usually there is still a lot of down time after stocking and cleaning responsiblities are met.
wow!! i can not beleive this post! i understand why your don just looked at you and kind of laughed. how would you like it if you were the dying patient, you already feel like @#$% because you are dying and now you have to deal with an lpn who has a bad attitude and does not give 100% of herself to the patient. i feel sorry for your patients.
sounds to like you haven't read all zoey's post on this topic, and if you did then you don't comprehend well, did you miss where she wrote
" as far as lack of attitude or caring, i am a professional, when i step into a pt rooms, it is to give the best care no matter what task i'm doing for that pt, and make that pt feel at the very least respected. none of my pt will feel disrespected or undeserved when i done with them. that's one of the reason i am leaving this job, because i am a caring and compassionate nurse who takes all task seriously and put forth full effort, and cuts no corners. doing total care for 6 pts which is equivalent of 2 titles of duties ( cna, lpn) is wearing me out. and if i feel so warn out that i can't do my best for the pt, then i need to find another job, where i can give my full potential, because its not the pt fault that we are under staffed, and its not my fault either"
so where did you get that there was a bad attitude on her part involved. i think the problem is the rn needs to jump in there in take half the pt, and do some kind of total care also.it's much easier to do that for 3 pt as opposed to 6. but, i must say if you don't like doing these duties for more then 1 pt, then a life in home health is all you maybe doing.
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 dont blame you for what your feeling right now. it sounds like your exhausted and burned out. the company's that we worked for they dont really care if the nurses and cna's will be burned out thats how business works and besides if we really wanted to keep our job we really have to stick on it and make sacrifices. in the nursing home i worked for, we have LTC and rehab on the same floor. if the census are high sometimes the company gives OT's thats makes us like 6 CNA, 2 RN, sometimes 1 or 2 LPNS. but there are times like we're only 4 cna, 1 rn and 1 lpn. for cna's theyre gonna have like 10 to 12 pts to take care for, the rn and lpn they divide there work based on census. if we're lucky to have good nurses and lpns they do our job too. in my experience nurses and lpn are given the responsibility to do the cna job when things comes to worst like 2 cna are only available. im a cna i worked this job for more than a year now, its really a tough job but what can i do? its not easy to look for another job and for the economy right now, im thankful that i wasnt layed-off.
good luck to your career and job hunting.
And IV pushes, and I think hanging blood and chemo. We're an RN-only unit, so I don't really know too well either.
Ok fine but I'V pushes are not of a big deal.I am RN student and I have done them couple of times arleady.
Like I stated before not too much of a difference between the RN and LPN.
Now NP and RN ,that is a huge difference
I think you need to re-evaluate what it means to be a nurse. I would think with a care load of 6-8 patient's per 1 LPN and 1 RN could be divided so that neither nurse feels like they are being taken advantage of. You accepted that fact that you will do the "duties" of a CNA when you graduated from nursing school. LPN's are not above CNA's in the hierarchy of things. I think it's better to view everyone on the same playing field working as a team, communicating, and collaborating to meet the needs of patients and eachother. Let's not forget, If you are feeling overwhelmed then ask your partner for some help.
I think you need to re-evaluate what it means to be a nurse. I would think with a care load of 6-8 patient's per 1 LPN and 1 RN could be divided so that neither nurse feels like they are being taken advantage of. You accepted that fact that you will do the "duties" of a CNA when you graduated from nursing school. LPN's are not above CNA's in the hierarchy of things. I think it's better to view everyone on the same playing field working as a team, communicating, and collaborating to meet the needs of patients and eachother. Let's not forget, If you are feeling overwhelmed then ask your partner for some help.
I agree - there were times when the RN and LVN working together didn't have a CNA and we just split the patient load in half. The RN does all the assessments though.
I love our CNA's and we all work well together as a team.
But I would not want to be a CNA.
I still don't think the OP is denigrating CNA work - she was a CNA and she stated she gave the best care to the patients, regardless of the role she had to play.
Many hospitals here in California have gotten rid of CNA's, Ward Clerks, etc., due to the ratio law and RN's and LVN's usually work alone now.
steph
I worked for a small rural hospital with 30 beds. At night we had no CNA's. We had many end-of-life care patients and were often assigned 6-8 pt's, per one RN (no LPN's) and this included total care. Sometimes that number would include a post-partum mom and babe!. We bathed all patient's on the night sift, we had total joint replacments, tube feedings, infant baths and education, not to mention all the admits, and labors. One RN was required to recover if there were any emergent surgeries, that ment that the other RN would take on her patients!!! I loved that Job, I learned so much.
It sounds like you have it rough, but remember it could be a lot worse. Often you run so fast and hard that your night just seemed to fly right by!!
Good luck with your interviews!!
rhondaa83
173 Posts
Wow!! I can not beleive this post! I understand why your DON just looked at you and kind of laughed. How would you like it if you were the DYING patient, you already feel like @#$% because you are dying and now you have to deal with an LPN who has a bad attitude and does not give 100% of herself to the patient. I feel sorry for your patients.