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Can they make an RN work as a CNA?

Updated | Posted
by Nurse Beth Nurse Beth, MSN (Columnist) Educator Columnist Innovator Expert Nurse

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

Dear Nurse Beth,

I have a friend who is a RN and works in a hospital. My question is, if they are short on cna’s can the charge nurse make my friend (the RN) work as a CNA?

Dear Friend,

RNs can be assigned to work as a nursing assistant if needed. RNs are trained to perform all duties typically performed by CNAs.

Many hospitals are desperately trying to stay afloat until COVID restrictions lift, elective surgeries resume, and the census returns to normal. Nurses are being asked to float, and even cover positions of others who have been furloughed.

Here's an example. If a hospital unit has a census of 6 patients, say, and the hospital staffs 2 RNs, they are very likely to not also staff a nursing assistant and a secretary. The 2 RNs will perform all care, and answer the phone!

These are actual scenarios that are happening right now. But there have always been occasions here and there where RNs are asked to serve as a nursing assistant for a shift, or provide total patient care. In many ICUs, it's the norm for RNs provide all care.

It's not something a nurse should take as an affront. It's a matter of being flexible. It can even be a nice change of pace. As a nursing assistant, you can connect in a different way with your patients and connect with the part of yourself that likes to provide comfort.

Best wishes,

Nurse Beth

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Hoosier_RN, MSN

Specializes in dialysis. Has 28 years experience.

yes, as it falls under the job description of "and other duties as needed". In nursing school, all of us were taught all of the tasks that the CNA does, so that we can direct. It's not beneath us, and it's definitely not out of our scope of practice. Also, some hospitals/depts don't even have CNAs, it's called primary care.

BabyCatchr, ADN, ASN, RN

Specializes in OB/Gyn, L&D, NICU. Has 20 years experience.

Of course an RN can be the CNA. We do it all the time, and we act as our own secretary as well. They are always canceling or floating our aids and secretaries to other units.

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 40 years experience.

I don't even see it as "being the CNA". You are simply performing the tasks that you are allowed to delegate, if there was someone to delegate them to. Look at it this way: you are still being paid as an RN but you will not be responsible for a patient load. Score! Instead of feeling demeaned, enjoy your respite.

Enarra, BSN, RN

Specializes in Ambulatory Primary Care. Has 9 years experience.

Short answer is yes. It’s within your scope of practice if taking vitals is your assignment Then you’re doing vitals until you’re assigned something else. I did vitals as well because I got floated to the ER and I am neither trained or skilled in that area so taking and entering vitals was safest assignment to give me. It’s not an insult it’s a matter of using man power properly.

RNs have greater scope of practice than CNAs, but everything a CNA can do, an RN can do, too. In my hospital, sometimes an RN will be designated as a "helper" RN, and be the jack of all trades on the floor. Yes, she can do tasks generally designated to CNAs like toileting, feeding, ambulating, taking vitals, etc. But the RN can also pass a med, do a wound dressing, etc. It's really nice to have a helper RN because I can designate more than the basics, and I like being a helper RN because I don't have to chart or give report so I get out on time.

The only thing that could be troubling is what the responsibility the CNA-role-RN has. Like if a CNA takes vitals, and the BP is out of range, his/her responsibility ends with reporting it to the RN. If the RN doesn't act on it, that's on him/her. But what if a CNA-role-RN takes vitals and finds something really out of range, and the assigned RN doesn't do anything about it, could it come back to the CNA-RN for not acting on it? I could see someone throwing the CNA/RN under the bus for not doing something about a BP of 200 because, after all, s/he is still an RN, even if she's acting in a CNA role for that shift.