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CNA duties vs. Nursing Duties

Posted

Specializes in CNA - starting LPN school January 2009!!.

Yesterday, I had an inservice at work (LTC) and I sat next to a new LPN. (I'm a CNA.) During one of the breaks, we struck up a conversation, and I asked her where she had done her LPN. I also mentioned to her that I was currently in the lottery at the two local technical schools in our area to get into their LPN programs for the 08-09 school year, that I was considering taking a look at the private (and very $$$$) LPN school she went to, AND that I had an application in at the RN-ADN program at our local community college, which is very competitive selective admissions.

She asked me why I decided to become a CNA before LPN/RN, and I said, "Because I wanted an inexpensive, quick way to get basic training so I could get out in the healthcare setting, and see whether nursing was a good fit for me." (I'm a career changer.) and, that I wanted to learn the basic ADL stuff, and get that over with, so that I woudl feel that I had that part of it under my belt before I started NS.

Her response: "I didn't. I don't really see how CNA is relevant to being a nurse. I mean, you have to do all those things when you are in nursing school, (referring to ADLs) but you stop doing them as soon as you become a nurse."

I have noticed this type of attitude a lot since I started down this journey to go from corporate cube jockey to nurse. I've noticed it ith my LPN coworkers, and I have also noticed it a lot here on the boards. Is this a relatievly new phenomenon? Where are these new nurses picking this up? In school? Media portrayal of the nursing profession? What gives?

No, it's not a new thought, and it is in the mind of the nurses who think they are above the "dirty duties". Not all of us think that way. Working as a CNA is a wonderful way to start your profession. It does give you a foot in the door as well as an opportunity to observe nurses to see if it's right for you. CNAs are an important part of the nursing team, and people like that LVN are not team players. Stay away from those like her, you will be worked to death.

RN1982

Specializes in ICU/Critical Care.

Love her attitude. Let me tell you that once you are out of school, no you don't stop doing those duties. I work in ICU and do most if not all of the CNA "duties" myself. I learned them in nursing school after all. Remember that as a nurse, you are not above doing those duties just because they can be delegated to a CNA. I think the fact that you chose to be a CNA before school was a wonderful idea. I did it myself and when I entered nursing school, I felt like I was a step ahead of the other nursing students who didn't have bedside experience. I also resented the fact that some of my fellow students treated the CNAs in our clinical areas as if they were their slaves. For example, one fellow student helped her patient to the shower then left all the patient's used linen and gown in the shower for the CNA to clean up which she expected her to do. That student was reported to and reprimanded by our instructor.That LPN is not someone that I would recommend you look to for guidance. SHE is not a team player. Remember when it comes down to it, it's your license. Not all nurses have her attitude.

casi, ASN, RN

Specializes in LTC. Has 3 years experience.

Ugh, those are the nurses that I hide from. I love being a CNA and I enjoy doing CNA work, but certian nurse's have decided that I'm their personal servant.

most of the best nursing schools require that you be a cna before you can get into your program.............I have seen lpn get 'knocked' down to cna duties more than once. I have worked with a nurse or two like that and quite honestly .................they aren't something I aspire too.

BearyPrivate

Specializes in LTC. Has 15 years experience.

I want to make myself very clear here, this is my opinion only.:twocents: The nurse that stops practicing basic patient care no matter how small or dirty, is only in this for the $$$$$$$:down:. To all of us real nurses that truly care how the pts we are working with are treated and cared for, we do continue the menial labor of working side by side with our CNA's regardless of the title that follows our name:nurse:. She is new:confused:. Hopefully she will get a clue:confused:. If not, it will only be a matter of time before she moves on.:argue:

BlueRidgeHomeRN

Specializes in Home Care, Hospice, OB.

okay, i have got to tell my favorite story from my l-o-n-g year as a don at a 120 bed snf...

i was pretty new, and was walking down a patient hall when a light came on. went in to answer it, the resident needed help to the toilet. got him comfy, handed him the callbell, told him to call when he was done.

continued down the hall, reaching the nurses' station about the same time the same resident rang again. it was mid-afternoon, the meds were all passed, treatments done, and the cna's were clearing out the late lunch trays. nurses were charting and chatting.

i looked at a nurse, and said , "that's mr. jones. he needs help off the commode."

she looked at me like i was crazy, and said ,"i don't do that, i'm an rn. get a cna to go.":angryfire

i drew myself up to my full 5'4'', stepped right up to her, held up my badge and said "hi. we haven't met. i'm blue ridge, rn.....bsn.......don.....

...and if i can get him on the toilet, you can go get him off!"

need i add that we had a few personnel changes after that. :clown:

some of the nurses didn't care for my "attitude", but the cna's threw me a tearful goodbye party when i left!!:D

Tait, MSN, RN

Specializes in Acute Care Cardiac, Education, Prof Practice. Has 14 years experience.

I tend to answer calls as much as humanly possible. Maybe it is because I am a bit of a control freak, but I love to see how my patients move, how their skin looks, and to be honest I want to be the person they see the most of each night!

I feel like my patients trust me more, and talk about more thoughts, concerns, and feelings when they know I am not afraid to help out with whatever they need.

We currently have a new grad on the floor who has some intense tunnel vision. She is wonderful at the nit and grit of nursing, charting, assessment etc. But apparently refuses to help patients clean up after using the bathroom.

I just don't know where people suddenly decide "here is the line, I no longer have to touch my patients anymore".

It's just not me.

12 hours sleepy.

Gnight,

Tait

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

joolia. . .I worked as a nursing assistant (we didn't have CNAs back then) in LTC when I went to nursing school and I thought, and still think, it was valuable experience. I learned how to do ADLs in LTC better than I ever learned about them in any acute hospital.

I have to say that I understand the value and importance of digging in and doing basic nursing care with patients. I was doing acute hospital nursing at a time when primary care was the trend and nursing assistants were not hired and being utilized by hospitals. We were happy to have LPN staff to help out. But, I saw many RNs who ignored doing a lot of basic care on patients and we heard stories of patients who weren't getting turned or getting baths or linen changes by their RNs (other RNs would actually put some kind of marks on the sheets to see if they were getting changed or not). When we had LPNs working side by side with us, we had LPNs complaining that some of the RNs were leaving all the dirty work to them, and some of them were.

Its all about attitude. Some RNs, and I suppose some LPNs in LTC, see themselves as managers of the staff. I was taught that I was primarily a manager of the patient and the care they were getting. However, I was also taught that to assess my patients there was no substitute for my own eyes, ears, and other senses. If I depend entirely on others to do my assessing for me, what does that say about my decision making skills? And, one of the best ways to assess patients is by getting in there and helping them with their basic care. One of the things I notice on the student forums with care planning is that assessment of ADLs is almost routinely ignored. When did nursing become something other than helping patients accomplish their ADLs?

Maybe it's because of the nursing era that I came from. Primary care seems to be an old idea as costs soar and facilities are trying to save every penny they can. But, I was also taught that tasks among all the staff can be fairly redistributed and shifted around. But, then again, some RNs aren't willing to give up some of that nice easy sit down work to their subordinates every once in a while. When I did this and it was discovered by my supervisors I got scolded for it. What do you care, I argued, as long as all the work is getting done and no one is operating outside their license or job description? Geez! (I was always getting in some kind of trouble with my managers.) Talk about task masters! So, when I went into management and supervision myself, do you think I could find many staff nurses who thought the same way as I did? Nope. I often had to intercede when staff got heated over unfair patient assignments and the licensed people ended up angry when I assigned them to some actual hands on patient care to help relieve the burden on their aides.

MikeyJ, RN

Specializes in Peds, PICU, Home health, Dialysis.

When I decided to pursue nursing school, I thought it was common knowledge that RN's are to do the "dirty work" as well (heck, most floors I have done rotations on do not have CNA's).

The nursing class ahead of me (they actually just graduated) had a horrible reputation with the hospitals around us and actually have a poor reputation for the entire school. They did and said many things in the hospital that are down right shocking. One thing a few of the students said that ended up in their dismissal from certain hospital clinicals is when a nurse walked up to them one day and asked them to help with bed baths on the floor -- the students response "we are BSN students -- we do not do bed baths -- we assess and give medications." :nono: :eek:

I wonder where student nurses and nurses get that notion that RN's no longer have to do patient care. Wasn't that the entire purpose of pursuing nursing???

Her response: "I didn't. I don't really see how CNA is relevant to being a nurse. I mean, you have to do all those things when you are in nursing school, (referring to ADLs) but you stop doing them as soon as you become a nurse."

You don't stop doing them as soon as you become a nurse and she is in for a shock. I hope her employer holds her accountable.

However, I didn't take a CNA class prior to school, I learned ADL's in nursing school at the very beginning, I think CNA's are an integral part of the team, I help and would never say "that is a CNA's job". We are partners. As we make first rounds together to do vitals and I do my first assessment, I help the CNA. When she takes the pt to the shower I make the bed. I get the pt up to the BSC and empty urinals. I do all this when I can, as much as I can but not forsaking my RN duties.

And I did not go become a CNA first.

I truly think that this has more to do with the kind of person you are than if you were a CNA.

I've told this story before but the laziest RN I've ever worked with started as a CNA, became an LVN and then RN. She had the attitude that it was not her job to help the CNA.

I wouldn't ever say that all CNA's who become nurses are lazy, just because of this one person.

Really - there are many RN's and LVN's out there who take their "patient advocate" role seriously and appreciate the CNA's.

Your "friend" needs to get a heart.

steph

RNperdiem, RN

Has 14 years experience.

CNA experience is more than "dirty work". You are gaining experience in patient interaction in a healthcare setting. The skills you are doing are the basic skills.

Some settings do not use CNA's; it is the RN's who perform all the care.

My brother was once a CNA and said it was very helpful when he started med school clinicals. He had gained specific people skills that many of his classmates lacked.

racing-mom4, BSN, RN

Specializes in ICU/ER.

One of the great reasons to be a CNA before you become a nurse is you can see 1st hand and role model the type of nurse you want to become and the type you DONT...

I worked with an LPN one night while I was a CNA who put the patients call light on while she was in the room giving the patient her pm meds, I go to answer the light and say to the nurse "Do you need some help?" and her reply was "she needs to use the bedpan". then the nurse finished her med pass and walked out!!!

Ya~~I learned who I did not want to turn into~~~

I posted about this same nurse on a post yesterday, she handed me a syringe and asked me to give it to so and so. Still to this day, she works harder to get out of work than doing the actual work itself!!! and ya know what---she gets away with it~~ hmmmm who has the right idea here????

Her response: "I didn't. I don't really see how CNA is relevant to being a nurse. I mean, you have to do all those things when you are in nursing school, (referring to ADLs) but you stop doing them as soon as you become a nurse."

Gotta love her attitude.

If she learned it in nursing school what gave her the idea that she no longer has to do it? I'm sure she learned to give medication in school but does that suddenly mean she can forget it once she's a nurse?

I'd love to see her attitude when she's on a floor with no aides. Poor patients.

loriangel14, RN

Specializes in Acute Care, Rehab, Palliative.

Some of those nurses would get a rude shock up here. Canadian hospitals don't use aides,everyone does their own care no matter what your designation.

deleern

Specializes in LTC, MDS Cordnator, Mental Health. Has 9 years experience.

I also became a CNA 1st, my reasons were two fold, I wanted to see if this was something I could do, and they offered health insurance for full time employees.

It was a great learning experience. I am now an RN, That is not afraid to toilet a resident.

Perhaps that attitude is more prevalent in LTCs. After all, the nurses have so many patients to pass meds to and do endless paperwork on that they don't often have time to assist with ADLs. The floor nurses might have 30 patients (each with 5+ meds, several diabetics, BP meds, with two marathon med passes and all CMS documentation during an 8 hr shift) while the CNAs might have 8 to 10 patients each (for whom they assist with AM care, dressing, toileting, feeding, etc). So the CNAs most definitely see more of the patients than the nurses do and the bulk of ADL work falls to them. That IS their primary responsibility.

The nurses also HAVE to rely on the CNAs to report subtle changes in status as there's just no time for them to do a thorough once over on every patient on their shift - eg look at all 30 patients' sacrums - plus, with that many patients, they may not pick up on subtle changes as well as the CNAs.

Perhaps the nurses get so accustomed to this splitting of functional responsibility, that they begin to think that ADL assistance is not in their job description at all. I'm not saying it's right, just that it may not be total mystery.

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