CNA as a NURSING SUPERVISOR?

allnurses Guide · Jul 28, 2008

Not being from the US I do sometimes struggle with the different levels of nursing, but I have to be honest there would be no way in the UK a nursing assistant would ever be in a position to be in charge of a qualified nurse.

There would be so many things about this situation i find unacceptable, as your supervisor would she not be responsible for ensuring your practice is OK, also if there is a nursing problem that you need support or advice on then she should be able to help and provide that support as a Nursing assistant how can she do that.

It is a situation that would worry me greatly

Lovely_RN, MSN · Jul 28, 2008

I would make a phone call to the regulatory agency that governs your facility and make some inquiries. In NYC the department of mental health and hygeine "the state" determines these things in LTC and frankly it would be unheard of here. I have never even heard of an LPN supervising RNs in the facility I am currently employed in or any place else that I have worked at in the past.

I know that in some areas LPNs supervise RNs but not in a clinical capacity. It might be that this CNA can be a supervisor but that she cannot supervise LPNs/RNs in a clinical capacity.

This is very interesting please let us know what you find out.

cardiacRN2006, ADN, RN · Jul 28, 2008

Wow, just wow.

This is inappropriate, plain and simple.

Atheos · Jul 28, 2008

I am responding but I do not truly understand the situation as you described it.

Let me tell you my situation...

I am a CNA. I am currently in RN school. I am also the staffing coordinator. In my current position, I am directly under the DON as well. I do supervise the LPNs, RNs, supervisors and everyone else in the nursing department.

We have 2 ladders in our chain of command. Anything clinical goes to unit manager and then directly to the DON. Anything non-clinical, and this includes pretty much everything else, goes through me then to the DON.

I am not the DON's longtime friend. I do, however, possess something that puts me above the LPNs and RNs in my facility. Military leadership experience. In the leadership/management role I exceed the majority of even our employees. This is one of the main reasons the changed the CoC. One RN does not like it because she's been in the field for 20+ years. DON basically told her 'Too Bad.' Being an RN doesn't qualify someone to manage and lead.

In a purely management/leadership function the title of the manager does not matter. Your nursing license does not put you above the CNA. They may have extensive experience that you are not going to get in nursing.

Basically, if your problem is that the CNA is above you then you are out of line. If the problem is that the CNA is above you clinically then you have a valid point.

Being worried would be appropriate. Being unsure would be appropriate. Somehow your post comes across as merely not liking the CNA because she is not 'in her place.'

Just my :twocents:

TheCommuter, BSN, RN · Jul 28, 2008

I am in Texas, and every single nursing home where I've been employed utilizes experienced CNAs to serve as 'staffing coordinators' or 'staffing directors.' It is much more cost-effective for these healthcare facilities to pay a CNA to fill this role, as opposed to an LVN or RN. I have never had any grievances with this type of setup, because I personally wouldn't want to deal with keeping the place staffed anyway.

In addition, a CNA is permitted to supervise an LVN or RN administratively in my state, but not clinically. For example, the CNA 'staffing coordinator' can discipline nurses for not showing up to work three days in a row. However, the same CNA staffing coordinator cannot discipline nurses for medication errors, etc.

militarymom06 · Jul 28, 2008

First of all, I DO NOT have a problem with the cna. She is a sweet girl, and personally I have nothing against her. However, I DO have a problem with any cna being pulled off the floor, doing resident care, and becoming a nursing supervisor. For one thing, she has been a cna for 7 yrs. She has had no previous experience in management nor is she remotely qualified to be a nursing supervisor. She is a high school graduate, nothing more, other than being a cna. Don't get me wrong. I have alot of respect for cna's, especially since I was a cna while I was going to nursing school, that's not the issue here. I simply do not believe a cna should be an LPN's or RN's supervisor...period. Staffing cooridnator's, in my past experience, have mostly been an LPN and only so they could fill in as an LPN if a replacement was not found. Never have they been a nursing supervisor. Like I said, I don't have an issue with her, but I do have an issue with her being my "immediate" supervisor. She "comes" off to people as being an LPN, that's a problem in itself.

BBFRN, BSN, PhD · Jul 28, 2008

I am in Texas, and every single nursing home where I've been employed utilizes experienced CNAs to serve as 'staffing coordinators' or 'staffing directors.' It is much more cost-effective for these healthcare facilities to pay a CNA to fill this role, as opposed to an LVN or RN. I have never had any grievances with this type of setup, because I personally wouldn't want to deal with keeping the place staffed anyway.
In addition, a CNA is permitted to supervise an LVN or RN administratively in my state, but not clinically. For example, the CNA 'staffing coordinator' can discipline nurses for not showing up to work three days in a row. However, the same CNA staffing coordinator cannot discipline nurses for medication errors, etc.

This is my understanding of how these situations work, too.

militarymom06 · Jul 28, 2008

Most facilities do utilizine cna's to be the staffing coordinator, but NOT nursing supervisor. Staffing coordinator is responsible for making out the schedules, making sure each shift is covered with appropriate staff, handle call out's, tardiness, etc. But, that's where the line should be drawn. What right does a cna have to tell a nurse HOW to do her job? She doesn't.

TheCommuter, BSN, RN · Jul 28, 2008

By the way, it is also legal in my state for an LVN to supervise an RN administratively, but not clinically. In every nursing home where I have been employed, LVNs are utilized as ADONs (assistant directors of nursing). These LVN ADONs are also responsible for supervising RN floor nurses in a purely administrative capacity, and if any clinical issues should arise with the RN, the DON (always an RN) would be the person to provide the counseling or disciplinary action.

TheCommuter, BSN, RN · Jul 28, 2008

What right does a cna have to tell a nurse HOW to do her job? She doesn't.

If the CNA is supervising the nurse in a clinical capacity, then I fully agree with your sentiments. The line has been crossed.

Atheos · Jul 28, 2008

Most facilities do utilizine cna's to be the staffing coordinator, but NOT nursing supervisor. Staffing coordinator is responsible for making out the schedules, making sure each shift is covered with appropriate staff, handle call out's, tardiness, etc. But, that's where the line should be drawn. What right does a cna have to tell a nurse HOW to do her job? She doesn't.

I would as soon tell a lawyer how to do his job as a nurse. I have no problem handling discipline or any other issues. That said, administratively the CNA is ok. While the nurses run circles around what I have learned in school, administratively I own them. Shrug. Of course, it was a case of experience. If the CNA only has the position because she is the DON's friend that could cause some problems.