Certified nursing assistants not welcome!

[Barbie8808]

So first let me say I myself am a certified nursing assistant so this will not be a blog discriminating against CNA's. But more of a venting session if I must. I was recently invited to a SECRET black nurse organization on one of the most popular social media sites on the web. I was ecstatic to be invited and love every moment of it as I saw it as a chance to receive a wealth of information and access to resources as I am a learning nursing student as well. But this quickly faded as the swarms of members joined and it turned it into a Picture gallery of single sexy nurses across the nation. I'm leading to an event that prompted the admin to make a list of rules one of them being if your not an actual NURSE (lpn or RN) or a nursing student you cannot be apart of this group. Now in my head I'm like whats the discrimination for; cna's are the back bone to nursing itself.As more and more time goes by CNA's are not just helping with toileting and feeding needs (Which to me nursing should be a holistic approach and contributes the overall treatment to the patient) we possess phlebotomy skills and more on the job more skills such ng tube feeds iv and more. It lead to comments being thrown around like "no offense to CNA's but I work hard for my nursing license" "They can join when they become an actual nurse" which never lead to my question which is "SHOULD CNA'S NOT BE INCLUDED IN THE REALM OF NURSING?"

[Susie2310]

Techs cannot run Fluid's as it is a medication. Also If I'm your tech I think its important to tell me whether that person is a dialysis patient so I can avoid that particular arm as well. I think that people are taking my words a little to literal and assume that As a tech I just go to work and say "hmmm I wonder who I'm going to blindly stick an iv or foley into today" I cannot perform any task unless the nurse delegates it to me. We have open communication. Nurses have far more education then a tech TRUE , but dat does not stop iv's from infiltrating.that does not stop catheter's that are left in to long or not clean properly from getting infections. So No I do Not want Nurses to sell themselves short.I appreciate everything nurses do. But I will not let Nurses take all the credit. I will not be made to believe that the only attribute I make to the nursing world is to do grunt work. Because I believe wiping *** is in both of our job descriptions. If we were not needed trust me Im sure I would not have a job.

My comment was addressed to nurses, not techs. You have taken it out of context. If you read my first paragraph my first sentence said: "I really believe we sell ourselves short as NURSES if we say that IV insertion and foley insertion are just tasks that can be done by anyone."

[Barbie8808]

This is your most logical, accurate post in this thread.

Excuse me???? I been saying the same exact thing from jump start its sad I have to break down everything I say into remedial terms to be understood by providers who supposedly do this stuff everyday. I say Start an iv someone says mediport. '_' I say Needle for iv insertion someone says maybe your meant lancent LMAOOOOO

[Barbie8808]

My comment was addressed to nurses, not techs. You have taken it out of context. If you read my first paragraph my first sentence said: "I really believe we sell ourselves short as NURSES if we say that IV insertion and foley insertion are just tasks that can be done by anyone."

Deepest regrets if I hung on to the word "anyone" Who were you talking about when You said anyone? I assume you were talking about the techs.

[OCNRN63, RN]

Deepest regrets if I hung on to the word "anyone" Who were you talking about when You said anyone? I assume you were talking about the techs.

Anyone who is not a licensed nurse.

[ixchel]

Excuse me???? I been saying the same exact thing from jump start its sad I have to break down everything I say into remedial terms to be understood by providers who supposedly do this stuff everyday. I say Start an iv someone says mediport. '_' I say Needle for iv insertion someone says maybe your meant lancent LMAOOOOO

My condolences for commenting in agreement with your post.

[OCNRN63, RN]

Excuse me???? I been saying the same exact thing from jump start its sad I have to break down everything I say into remedial terms to be understood by providers who supposedly do this stuff everyday. I say Start an iv someone says mediport. '_' I say Needle for iv insertion someone says maybe your meant lancent LMAOOOOO

I said "start an IV (or in my case, a mediport)." I said that because I don't have IVs started peripherally; nurses use my mediport. If I don't think it's safe for a CNA to start an IV, I for sure wouldn't be OK with a CNA accessing a mediport.

[JustKeepSmiling, ADN, BSN, RN]

Here is the problem.

Tasks that have POTENTIAL to become complicated and require further nursing and/or medical action should NOT be delegated. (source RN BON)

IV insertion: you stick an artery. The patient unbeknownst to you, because you are not the nurse and not reviewing the medications, is on multiple blood thinning medications. Now further nursing action is required to attempt to achieve hemostasis.

Hopefully it wasn't an 18g.

Foley insertion: you perforate the urethra or bladder. Now the patient needs emergency surgery.

Nasogastric tube insertion: you enter the lung and a pneumothorax occurs. The patient rapidly declines and requires emergent intubation, needle decompression, chest tube insertion.

Put PATIENT SAFETY above your own interests and desires to "just put in a simple "

[Barbie8808]

Here is the problem.

Put PATIENT SAFETY above your own interests and desires to "just put in a simple "

Above my own desires and interests?????

I have never done anything that I was

1. Not trained to do

2. Delegated to performed.

3. not in my job description under what ever facility I 'm working at

So what your saying is all the tasks that has resulted in all the extreme out comes you have named has never been performed by a registered nurse or doctor???

I never Said I insert ng tubes. I said I hang the feeds and water bolus. The nurse will first check placement.

[JustKeepSmiling, ADN, BSN, RN]

I have never done anything that I was

1. Not trained to do

2. Delegated to performed.

3. not in my job description under what ever facility I 'm working at

• RN BON prohibits a RN from delegating a task with potential for further nursing intervention. The RN allowing you to do these tasks is taking a risk and will be held legally accountable as will you. If you perform bodily harm to another human being you cannot just say the RN told you to do it then it's not your problem anymore. You can refuse to perform a task just as a RN can refuse to perform an order. BON trumps facility.

So what your saying is all the tasks that has resulted in all the extreme out comes you have named has never been performed by a registered nurse or doctor???

• They absolutely have, and that is exactly why the RN should not be delegating them. The RN should be executing the nursing process and be prepared to act if things go wrong. You are not licensed nor trained to act if things go wrong.

I never Said I insert ng tubes. I said I hang the feeds and water bolus. The nurse will first check placement.

• Inappropriate, that is carrying out an order. The RN cannot delegate orders. Enteral feeds and water bolus can be harmful. How do you determine if they need to be held?Electrolytes and volume status need to be reviewed. What if you get resistence? What if the patient is ESRD and has crackles? That water bolus may indeed be the last thing they need.

I fear you are trying to blur the lines between licensed nurses and CNAs to justify your personal issue with feeling CNAs are not valued enough.

I don't see where you are concerning yourself with patient safety.

[Barbie8808]

I have never done anything that I was

I fear you are trying to blur the lines between licensed nurses and CNAs to justify your personal issue with feeling CNAs are not valued enough.

I don't see where you are concerning yourself with patient safety.

I fear that you are putting words in my mouth. You keep stating personal. The only thing that I am taking personal is nurses who accuse me of lying. Not cool!!! From the beginning Ive stated I am not trying to attempt falsify myself as a nurse or do things that I havent been trained to do. Maybe you missed that by jumping to what could go wrong if I performed a task. I stated tasks that I am allowed to do at the two hospitals I work at to support my argument on whether cna's should be included in the realm of the WORD Nursing.You keep mentioning board of nursing. EVERY STATE/FACILITY IS DIFFERENT! I attached a Link to the state of Ariziona that also supports what me and other nurses having being saying on this thread. It is up to a nurse on whether or not she feels comfortable to let me complete a task because ultimately it does fall underneath his or her license. If you do not trust a tech to perform such tasks that she has been certified or trained to do.That's your right as an RN.You stated that A nurse cannot delegate orders requiring RN intervention???? What do you mean how often I check vital signs and activitites such as turn q2 are place in orders so I dont understand that one? Something as simple as vitals may need RN intervention. Thats why all the tasks I perform are to be Supervised under a RN. When A new nurse steps on the floor how does she gained proficiency in a task????

She is taught by A RN the proper procedure the do's and donts the what if's and She practices it.

"You are not licensed nor trained to act if things go wrong."

HMMM how do you know what I am trained to do out of curiosity????

https://www.azbn.gov/documents/advisory_opinion/AO%20DELEGATION%20OF%20NURSING%20ASSISTANT%20TASKS.pdf

[JustKeepSmiling, ADN, BSN, RN]

I fear that you are putting words in my mouth. You keep stating personal. The only thing that I am taking personal is nurses who accuse me of lying. Not cool!!!

From the beginning Ive stated I am not trying to attempt falsify myself as a nurse or do things that I havent been trained to do. Maybe you missed that by jumping to what could go wrong if I performed a task. I stated tasks that I am allowed to do at the two hospitals I work at to support my argument on whether cna's should be included in the realm of the WORD Nursing.You keep mentioning board of nursing. EVERY STATE/FACILITY IS DIFFERENT! I attached a Link to the state of Ariziona that also supports what me and other nurses having being saying on this thread. It is up to a nurse on whether or not she feels comfortable to let me complete a task because ultimately it does fall underneath his or her license. If you do not trust a tech to perform such tasks that she has been certified or trained to do.That's your right as an RN.You stated that A nurse cannot delegate orders requiring RN intervention????

• You do not have the proper education (yet) to have the foresight for what could go wrong and know how to act. There are certain tech/assistants I trust more than some RNs and others not so much. What I'm saying has nothing to do with picking a fight over levels of education and position titles. It has everything to do with a person executing a task to a humam being for which they are not adequately trained to handle the potential problems that may ensue. Are you prepared to handle a perforated bladder?

What do you mean how often I check vital signs and activitites such as turn q2 are place in orders so I dont understand that one? Something as simple as vitals may need RN intervention.

• The actual TAKING of the vital signs does not require a RN. The RN is only delegating the performance of obtaining the numerical values and then the RN is responsible for nursing process, not you.

Thats why all the tasks I perform are to be Supervised under a RN. When A new nurse steps on the floor how does she gained proficiency in a task????

She is taught by A RN the proper procedure the do's and donts the what if's and She practices it.

• irrelevant.

"You are not licensed nor trained to act if things go wrong."

HMMM how do you know what I am trained to do out of curiosity????

• irrelevant.

https://www.azbn.gov/documents/advisory_opinion/AO%20DELEGATION%20OF%20NURSING%20ASSISTANT%20TASKS.pdf

• You supplied an advisory opinion, an incomplete summary. I researched the ABON Rules. Here is the exact wording.

Delegate nursing tasks to UAPs. In maintaining accountability for the delegation, an RN shall ensure that the:

a. UAP has the education, legal authority, and demonstrated competency to perform the delegated task;

b. Tasks delegated are consistent with the UAP's job description and can be safely performed according to clear, exact, and

unchanging directions;

c. Results of the task are reasonably predictable;

d. Task does not require assessment, interpretation, or independent decision making during its performance or at completion;

e. Selected client and circumstances of the delegation are such that delegation of the task poses minimal risk to the client and

the consequences of performing the task improperly are not life-threatening;

f. RN provides clear directions and guidelines regarding the delegated task or, for routine tasks on stable clients, verifies that

the UAP follows each written facility policy or procedure when performing the delegated task;

g. RN provides supervision and feedback to the UAP; and

h. RN observes and communicates the outcomes of the delegated task.

•If you will carefully review E. If you injure a patient during insertion of a device and say the RN delegated it to you. A lawyer will use that and have a field day. Again, patient safety is paramount.

- Task does not require assessment, interpretation, or independent decision making during its performance or at completion.

• you meet resistent during an enteral feed. This now requires assessment. What if the tube is misplaced in the abdominal cavity?

e. Selected client and circumstances of the delegation are such that delegation of the task poses minimal risk to the client and

the consequences of performing the task improperly are not life-threatening

• perforated urethra, bladder, bowel - potential to get septic from this. Arterial bleed that will not stabilize. Pneumothorax.

•You have loved ones? How would you feel if something terrible happened because a nursing assistant did something and didn't know what to do when things went wrong. That's failure to rescue.

And it could have gone differently if done by the nurse.

[edited due to error in copy & paste]

[ixchel]

Barbie:

You need to relearn adverbs.

You are taking things personally, not personal.

You mean things literally, not literal.

Proper grammar distinguishes you as a professional.