CNA duties vs. Nursing Duties

Nurses General Nursing

Published

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?

Specializes in Cardiac Telemetry, ED.

When I was a CNA in LTC, I had twenty residents to turn, change, toilet. The nurses never answered call lights or helped me with my duties in any way. That's because the nurses each had forty residents to care for, and I could not help them with their duties either. We each had our duties and not enough time in which to do them. Maybe that is why the LPN in the original post thinks the way she does. Perhaps her experiences are similar.

As an LPN in acute care, I answer call lights, toilet patients, bring snacks and warm blankets, but there are times when I do have to walk past a call light or ask a CNA to do something. It's called prioritizing and delegating. Of course, if I walk past a call light, I look in to make sure the patient is not on the floor or climbing out of bed, and if I ask a CNA to do something it is not because I am "above" it, but because I have more urgent things to do.

Up Vote Up Vote ×
Specializes in CNA - starting LPN school January 2009!!.
When I was a CNA in LTC, I had twenty residents to turn, change, toilet. The nurses never answered call lights or helped me with my duties in any way. That's because the nurses each had forty residents to care for, and I could not help them with their duties either. We each had our duties and not enough time in which to do them. Maybe that is why the LPN in the original post thinks the way she does. Perhaps her experiences are similar.

As an LPN in acute care, I answer call lights, toilet patients, bring snacks and warm blankets, but there are times when I do have to walk past a call light or ask a CNA to do something. It's called prioritizing and delegating. Of course, if I walk past a call light, I look in to make sure the patient is not on the floor or climbing out of bed, and if I ask a CNA to do something it is not because I am "above" it, but because I have more urgent things to do.

It might be worth mentioning that this particular individual was fresh out of LPN school, and this is her first job. I think there is a huge difference between delegating responsibility to CNAs and naively thinking that nurses never do ADLs.

Up Vote Up Vote ×
Specializes in dementia.

Perfect example today: At lunch break and I had went ten minutes late. An RN comes into the break room and says that we need to start going to breaks on time and return on time so that everyone is in the dining room to pass trays. OK that's fair but, I was performing resident care and that made me late to break, whatever. So at lunch while there are members needing fed where is the RN? down the hall putting away clothes...while a member directly behind her is saying somebody help me! My butt hurts and I want to go to bed! Did she put that man to bed? Nope Did she come help feed in the dining room? Nope.

Up Vote Up Vote ×
Specializes in Cardiac Telemetry, ED.
It might be worth mentioning that this particular individual was fresh out of LPN school, and this is her first job. I think there is a huge difference between delegating responsibility to CNAs and naively thinking that nurses never do ADLs.

Point is, it's not totally outside the realm of reality that this does occur. The functional model of nursing is still in use in many, many facilities.

Up Vote Up Vote ×

you stop doing ADLs when you become a nurse?????

I have been in healthcare for more than 20 years starting as a CNA, then nurse intern and then RN.

ADLs and all the basic care that needs to be taken care of for a patient never stops-it may not be the main focus but.....GOODNESS!!

I used to work with nurses like that and despised ever last one of them-they saw themselves as only care plan makers and pill pushers and would never answer a light or give a bath....

Up Vote Up Vote ×

Hello All!

I am looking into becoming a CNA, because ultimately I would like to be either an LPN or RN. I am so grateful for these responses, because you all truly reassured me that I am definately making the right decision. I completely agree that in becoming a nurse it is all about the quality of the patient's care, not who is in charge of what, etc.

All the nurses that feel the duties are "below" themselves should picture themselves, or someone they love in that patient's position, and wonder, "would I appreciate waiting for someone that they fell is responsible for the job, or have the nurse that is right there help you?"

I want to help people, I could care less if what I am doing is in my job description, as long as the job is done.

Again, thanks for the reassurance. And thanks for being great nurses!:yeah:

Up Vote Up Vote ×

It may not be all these students/new nurses fault, I graduated two yrs ago RN after being a LPN for 14 years, and the last semester of school we had a class on professionalism-the instructors harped on deligating duties to UAPs or CNAs, as a LPN I moonlighted in a LTC while active duty in the Army and had no problem helping the CNA's- but once in my RN clinicals I was yelled at by an instructor for doing so. She felt I should have delegated such and such.:confused:

Up Vote Up Vote ×

I remember my 1st semester instructors repeatedly telling us "if you don't want to clean up poop, you might as well leave now." lol They all talked about how they helped the CNA's when they could. In clinicals, we do total pt care.. baths, linens, meds, etc. The only things we don't do are things we haven't learned yet. I can't imagine telling my instructor that I didn't change the bed or help the pt to the bathroom!:eek:

I think it's smart to work as a CNA before NS. It teaches basic pt care and it's a lot cheaper to find out that nursing might not be your thing before you finish NS! I also think it helps you to feel more comfortable in the healthcare environment. My school requires you to be a CNA before you will be accepted. I didn't work long before starting school, but I learned a lot during that time.

Up Vote Up Vote ×
Specializes in med-surg 5 years geriatrics 12 years.

I have seen nurses like that too and they irritate me beyond measure. I worked with a couple while a CNA. I help feed, walk, toilet, transfer, etc the folks I take care of. By doing so I can see changes; often very subtle changes. Just remember you can learn from everyone. In this instance you can learn how NOT to conduct your own nursing practice.

Up Vote Up Vote ×
Specializes in Telemetry, Med-Surg, ED, Psych.

Hello everybody. I am an RN in acute med-surg of five years and a CNA in Med-Surg/Peds for two years. All in all I have worked alongside CNA's, LVN's and RN's for my entire career. In most cases, the entire nursing team has been fantastic. But, I must also point out some common attitude and thinking traits I have observed in SOME of the LVN's I have worked with.

Of those I have worked with this faulty thinking pattern their basic core belief system is that their poo-poo doesn't stink, that there will always be CNA's to provide basic nursing care, that they are exempt from answering call lights because of there "Education" (had a few use that excuse). It seems to me that LVN's are the lost souls in healthcare...they are the true middleman who really cant do all that much - PO, IM, Wound Care, and Charting. Perhaps, then its no surprise that these individuals feel as entiled as they do - Like the rules do not apply to them.

IDK...I am just exploring this idea...If I offended anyone, I am sorry. This is not an all-inclusive for all LVN's.

Up Vote Up Vote ×
I have worked in LTC for many years. If I have 2 halls of medications to pass, an acute care wing with many residents who are post ops out of the hospital, charting, answering phones, attending to family needs, etc. I don't have the time to do the ADL's while the cna's are sitting back chatting, standing around the nurses station conversing with one another. Should I put my charting to the side and go do what they are paid to do while they stand and chit chat? NO!!!

I end up telling the cna's to get back to work, stop chit chatting unless it's your break, and don't go hide in the car on the phone! I have seen it too many times. I have to have complete charge of the facility and it's not easy.

There is a big difference between LTC and hospital nursing. When I am the charge nurse, I am responsible for every single resident in the facility, and I have to make sure my job is done, the LPN's job is done and the cna's job is done too, otherwise who gets in trouble? ME!

Don't mean to sound off, but there are times when a nurse just doesn't have the time to pass medications, do treatments, charting, helping feed, answering phone calls, getting doctors orders, a new admit or two, a fall,.plus toilet patients, especially when there are 6 aides and they are quite capable of doing their job. I can do their job, but can they help me in mine??? NO!..I could go on forever, but I will hush now.

Exactly!! I was an CNA for 6 years and have been a nurse for less than a year and I absolutely agree with this statement. I am responsible for soooo much, I simply do not have time to toilet people or change their clothes (unless I dirty it, then I will definitely change it). If I have some down time or am having a slow day I will answer lights and toilet people and help with transfers- no problem. But, I oftentimes the aides will have downtime sitting at the desk doing nothing. If I get busy I don't get a lunch, period. I can't take it. I am responsible for my load and I have to do it. I don't feel so sorry for aides that get their lunch late or miss one of their breaks when I've haven't been off the floor in 8 hours!! I know that aides' jobs are more physically demanding in LTC and they do need there lunches and breaks and things. However, In LTC with 30-40 patients, most nurses cannot regularly do ADLs. That's why their are so many more aides in LTC than nurses, so they can assist with these tasks while nurses do other tasks that aides can't do.

That nurse does have the wrong attitude though. Also, as an aide you learn more about the doing the task than the reasoning behind it. I always try to inform the aides I'm working with why certain things are being done so they feel like they are part of the team and the process. They certainly are- a very important part, indeed!!

Up Vote Up Vote ×
Specializes in LTC/Rehab, Med Surg, Home Care.

I don't think this is exclusive to LPN/LVNs. I've seen the attitude from RNs as well...

I think your theory is interesting though, based on the "between" status of LPN/LVN.

Hello everybody. I am an RN in acute med-surg of five years and a CNA in Med-Surg/Peds for two years. All in all I have worked alongside CNA's, LVN's and RN's for my entire career. In most cases, the entire nursing team has been fantastic. But, I must also point out some common attitude and thinking traits I have observed in SOME of the LVN's I have worked with.

Of those I have worked with this faulty thinking pattern their basic core belief system is that their poo-poo doesn't stink, that there will always be CNA's to provide basic nursing care, that they are exempt from answering call lights because of there "Education" (had a few use that excuse). It seems to me that LVN's are the lost souls in healthcare...they are the true middleman who really cant do all that much - PO, IM, Wound Care, and Charting. Perhaps, then its no surprise that these individuals feel as entiled as they do - Like the rules do not apply to them.

IDK...I am just exploring this idea...If I offended anyone, I am sorry. This is not an all-inclusive for all LVN's.

Up Vote Up Vote ×
+ Add a Comment