Being made to work as an aide...need advice

[luvmy2angels]

I just started my job the beginning of the month. I absolutley love it there. We are in the process of opening a new building and in the process of hiring a bunch of new LPNs. The skilled unit is used to only having 1 LPN and 1 RN and they split the med passes. Now sometimes there are 4 of us and too many to be on the med carts so they are having us work on the floor as aides. Now, when we were all in orientation together one of the LPNs made it very clear that she was not doing "aide work". She uses the excuse that she never worked as an aide before therefore she wouldn't be any help. Every time someone needs to be out on the floor it always myself and the other new LPN. I don't want to come off as not being a team player and people thinking I am "above" them. My problem with the situation is that I went to LPN school for a reason. I have worked as a CNA for 18 years. People look at me and think, well your still young there isn't any reason that you can't do this work. But in reality i CAN'T do that work anymore. When I started in 1987 the facility I worked at didn't have the fancy lifts that we have today. If we needed to get a 200 or 300 pound person out of bed WE lifted them. My back can't take it anymore!! I have been on predisone twice in the past 3 weeks for tendonitis in my shoulder due to all the lifting, pushing and pulling. The RN supervisor over the weekend said that if I refuse to accept the aide assignment she would write me up for neglect and I would lose my job. I realize that this is only a temporary situation. Our new building is to open Aug 1, but I don't think my body can take much more of this work. Any suggestions as to what i should do?? I think I should talk to the DON and explain my situation, I just don't want them to think I'm not a "team player". Any help???

[caroladybelle, BSN, RN]

Not sure how correct this is, but I thought that once you became a nurse, you could not be an aide, just like when you have your RN you cant work as an LPN, and once you have your AP, you cant function as an RN. Maybe this is just in my state.

As far as I know, there is nothing that an aide does that is unique to aides, no matter what state that you work in. Virtually every duty that an aide has is something that is done by a nurse on many units - especially in that many units do not have aides, whatsoever.

What is notable is that if you hold a job position, designated as an aide(hired exclusively as an aide and working exclusively as an aide) while licensed as an RN/LPN, and something untoward occurs, legally you may be held to a higher standard of care, than the standard aide without a license.

I know a number of NPs that still work per diem as floor RNs.

As a traveler RN and a team player, there have been times when it is appropriate and fitting for me to step up and work in the "LPN" or "aide" roll. Big Deal!!!!!!!! As long as I am doing nursing, the assignment is fair, and I am being paid my RN wage, there is no problem. It is really silly when there are too many "captains" and not enough "soldiers", and the battle fails because of this. And you lose "soldiers" because they are overworked, and they see the tacky ego battles of who will work with them, who won't....when it is all nursing care.

If it occurs occasionally, it is no problem. If it happens too often, notify your boss and examine why you do not have enough aides (could it be the put downs they see, when Nurses don't want to do "aide" work?). And all need to share the wealth, no LPN/RN should get off by saying, "But I've never worked as an aide".

As far as back problems go, there should be safe lift guidelines in place. If there are not, this is a separate issue and should be addressed. ALL pesonnel (aides, RNs, LPNs, orderlies) deserve safe lifting assistance.

[NYCRN16]

Not sure how correct this is, but I thought that once you became a nurse, you could not be an aide, just like when you have your RN you cant work as an LPN, and once you have your AP, you cant function as an RN. Maybe this is just in my state.

You are partially correct. There is no law that says that you "can't" do CNA work, HOWEVER, you are still held to the higher standard of LPN by law. If something happens during your care you would be held more responsible than the CNA if the same incident happened. You could lose your license and the CNA would just lose her/his job. The state board of nursing website addresses this, or at least it does in NY. As for NP's that work part time as RN's, they too would be held to the standard of an NP if something were to go wrong, and IMO it is foolish to put yourself at risk like that. If this is what this facility wants to do, then you shoudl just find another job. If you dont want to tell them why, just lie and say that you are going back to school right away and you cant work. Good luck!