when is it appropriate to call CNA or LPN to do task?

[IHeartPeds87]

Another post on this discussion board got me thinking.

I am a direct caregiver at a long term care facility for adults with disabilities.

Now, it doesn't bother me when I have an RN page for me to do a bed bath, take care of incontinence, etc.

I appreciate it when the RN starts doing these tasks, pages for me, and then I take over as soon as I get there and the RN leaves.

I don't understand why people have an issue with this? I mean, look, the RN can do stuff that us as caregivers, CNA's, LPN's (not saying i am on the same level as an LPN by any means or even a CNA since I haven't taken the course yet but plan too soon. I have a lot of work/volunteer experience in caregiving with similar CNA duties however) cannot do. So i always assume that when they page me it is because they have duties they need to attend to that I can't do.

It got me thinking. As an RN, what do you guys do? I mean, as an RN if you are doing the tasks that can be delegated to CNA's and LPN's, aren't you taking away from your duties that only you can do? What do you do in that case? Do you start doing the action while you wait for the aide to get there (because I think that making the patient wait while I call for an aide or a tech isn't right). But then what happens to what you need to do?

I guess i'm just asking what the protocal is for delegating? I know that in nursing school I will learn what tasks I can and cannot delegate, but how do you handle these things?

[Jules A, MSN]

Hi there,

My techs know that there isn't anything that I won't do myself and that helps us work together and pick up slack for each other when necessary. When I do ask them I say something like, "I've got to pull a PRN for Jane Doe, would you mind to take John Doe back to the lounge when he is finished?" I like to let them know that I'm busy with something else not just heading to the nurses station to eat cheese doodles. :)

Thank you for acknowledging there are other tasks that nurses have to get done. I'd love to have you on my team. Good luck in nursing school. Jules

[RNKel, ASN, RN]

This is actually a good question. They've taught us what we can and can't delegate and who we can and can't delegate to, but have never taught us how to go about it.

[leslie :-D]

there is no protocol.

it's rn judgment.

what i can and cannot do at the time, is all going to depend on what i was in the middle of doing, how much time i have and/or how much time i can afford to spare.

lots of times, i'll remove the soiled diaper from the pt, put them on a bedpan, until the aide arrives...of course, letting the aide know that mrs. x is waiting on a bedpan.

if a pt is covered in vomit, i'll get them out of their soiled johnny and put a sheet over them until aide gets there.

if i see a full foley bag, i'll empty it and give output to aide.

of course, if they need vs, i grab them when i'm in the room and do an assessment.

if the pt is large and immobile, then i stay and help the aide.

if i can do it all, i certainly will.

there are many times i know the aides are swamped, and will hurry through my own job in order to lend them a hand.

we all need to work together.

leslie

ea scenario is different, and never respond in same from pt a to pt b.

[CoffeeRTC, BSN, RN]

there is no protocol.

it's rn judgment.

what i can and cannot do at the time, is all going to depend on what i was in the middle of doing, how much time i have and/or how much time i can afford to spare.

lots of times, i'll remove the soiled diaper from the pt, put them on a bedpan, until the aide arrives...of course, letting the aide know that mrs. x is waiting on a bedpan.

if a pt is covered in vomit, i'll get them out of their soiled johnny and put a sheet over them until aide gets there.

if i see a full foley bag, i'll empty it and give output to aide.

of course, if they need vs, i grab them when i'm in the room and do an assessment.

if the pt is large and immobile, then i stay and help the aide.

if i can do it all, i certainly will.

there are many times i know the aides are swamped, and will hurry through my own job in order to lend them a hand.

we all need to work together.

leslie

ea scenario is different, and never respond in same from pt a to pt b.

Yes, Yes, Yes. Each senario is different, but for the most part, I will help the patient and then call the CNA to help or take over. Sometimes...I will just do it myself. (sometimes I will get yelled at by the cnas for not doing it the right way, LOL)

If I am super busy, running my butt off and priritizing care for a critical pts...I will call first. In a LTC setting there is a different type of delegating. For the most part..the CNAs I work with are on the ball and are meeting needs and anticipating them so rarely do I need to ask for anything.

[GrumpyRN63, ADN, RN]

You do what you need/should do for the well being and comfort of the pt as it needs to be done. If I'm there and the pt needs whatever, I do it, if I can't do it alone, will call for help if I need it, etc.

The question the OP asks is a good one, "what happens to the things only the RN can do if we are doing other things? "Well, nothing is outside our role when it comes to pt care, so even if it can be delegated, sometimes that is not feasible or reasonable, it needs to be done. We still have our RN only duties, they get done as we can, and this can cause us to run late with whatever it may be- meds, checking orders,charting, whatever. You can only do the best you can do, there is only so much time during your shift.

Teamwork is the best way to get it all done;one hand washes the other. If you respect your PCA's/aide's and don't cop an 'it's not my job' attitude, many times the PCA not assigned to my patient will help me out just because they know I'm a team player and will help them whenever they need it, even if it's not my pt. Same thing with the other nurses. I'll help their pt if I walk by and they need help . Its whatever needs to be done.

[Virgo_RN, BSN, RN]

If it's a one person job, I'll just do it myself. If I need help, I'll call the CNA to come help me.