CNAs no longer doing vitals on our floor

Nurses General Nursing

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I work on a med/surg floor where I guess some CNAs complained that nurses abuse them and our manager has now made it where the RNs will be doing all vitals on top of everything else. Is this normal for other hospitals? I understand that everyone is busy, but CNAs used to be able to do so much more. Now at night, they will only be taking patients to the bathroom and changing patients, which the RNs do as well.

I didn't read all of the posts ahead of mine, do I'm not sure if someone else said this. I used to work as an aide and the hospital where I worked didn't allow us to do vitals (but we could do POC and phlebotomy, figure that out) because they said vitals are an assessment and only nurses can assess.

Just another side of it. I'm not sure what I think about your situation though. I do believe that pressing a button on an automatic Bp cuff is really not that hard. If you only use manual bp's (which another hospital I worked at did) than aides should not be doing that.

It is more than pushing a button. In acute care, I often need to know vitals before I can give meds. I need to know someone's blood sugar if I need to give insulin before a meal, or interevene for a low blood sugar. It is not that a CNA is not capable of obtaining this information, but can not treat variables that a nurse is responsible for.

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While I am not yet an RN, I am a PCT and have prior done CNA work. I know and respect that RNS have difficult jobs, but so don't CNAs. They are busting true backs to lift the patients just to put a brief on them, getting covered in poop, getting kicked and spit on, and much much more for a measly $10-$12 (where I live).

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Specializes in Med-Surg.

Well let me tell you...I never worked as a CNA, but as an RN, I do have to turn and position patients, bathe them, bring them to the bathroom, change their briefs, get covered in urine and feces, not to mention vomit, respiratory secretions, and all other things. I get yelled at too, I get hit, spit on, scratched. I get to deal with being a team leader, so being responsible for a CNA and LPN. I get yelled at by doctors, families, and all the other specialists. I get that nurses get paid more than CNAs, really, I do. But I really wish you guys would stop thinking its all sunshine and lollipops for the RNs....

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Specializes in Nursing Education, CVICU, Float Pool.

The truth is there are cons to each job. At this point in time I will not say that either job is necessarily more difficult, but the role and actions of the nurse are more high risk.

High risk as in the fact that as a nurse your and independently functioning practitioner who is providing a higher level if care, all of that means that if the nurse messes up in regards to their practice it can result more extensive damage than if a CNA slacked on reporting a vital sign. If I said that right.

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Specializes in Nursing Education, CVICU, Float Pool.
While I am not yet an RN, I am a PCT and have prior done CNA work. I know and respect that RNS have difficult jobs, but so don't CNAs. They are busting true backs to lift the patients just to put a brief on them, getting covered in poop, getting kicked and spit on, and much much more for a measly $10-$12 (where I live).

I think what this poster is saying is, Some CNA may very well suck! Some nurses may very well suck! All in all, if their is nothing you can do about either one sucking personally, other trying to redirect and report them, then suck it up, and move on. Somebody has to care for patients, regardless of how difficult it is to do so.

I don't remember seeing anywhere in anybody my textbooks that I have the right to always have Help every time I felt I needed it. This poster is saying, do what you can till you can do better. As a nurse you bust your but to manage patient care, pass meds and advocate for pt, doing ADLs and CNA tasks as necessary however you could always be busying your put making the RNs and MDs direction are carried out, ensuring you've charted what they need to correctly, ensuring the pt has the thjngs they need, etc...... all while working for $10-$12hr or $8-$10hr ( where I Live and work), and Vice Versa. Be thankful.

The RN scope of practice encompasses the CNA scope, not the other way around. Nurses are responsible for it all, and deserve the cooperation Of all staff, licensed and UAP, and so does the CNA. In the end, as I stated earlier each nurse is their own CNA. Because if you go a place where they don't employ many UAP, your employer will expect for you and your workmates to figure out how to get the job fine safely anyway.

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It seems that many of you are unsatisfied with the working conditions in your facilities. As a CNA, and a student, I would like to ask you all to please get to know your CNAs before lumping them into these stereotypes that are posted here. I've been told by many nurses that I am a good CNA, BUT it felt as if I had to prove myself to them because some of them assumed that I would be one of "those CNAs" before they even worked with me. I've had to defend myself for being blamed for things that I didn't do, and I've even been lied on before some of the nurses realized that they could trust me because I was there to provide the best care possible. I love my job because I get to learn so much everyday. However, there are some CNAs that hate their job. THESE are the CNAs that you should watch out for. THESE are the CNAs that are making up vitals, disconnecting IV pumps, screwing up I & O numbers, neglecting patients, and "disappearing" from the unit. I have seen my fair share of bad CNAs, BUT please do not assume that every single CNA falls into this category.

Again, I don't think that this is an incompetence issue because, as I stated before, these basic skills ARE taught in CNA courses. This is a matter of people being dissatisfied with their jobs, and yet not having the balls to go back to school and find something else to do. I've never met a CNA that didn't know how to identify/report abnormal vitals, but I have met CNAs that failed to do so because they hate coming to work (for personal reasons), feel rushed and overwhelmed, or unappreciated by nurses that assume that they are stupid. I have never lied about vital signs. I work on a med/surg/tele unit, and too many of my patients have had wacky vital signs that need some sort of intervention. Failing to do my job properly can harm someone.

AND some of you may actually be really good nurses that do it all, BUT (as displayed by one of the previous posters) there ARE nurses that do not provide direct patient are except for passing meds, assessments, and dressing changes (basically things that CNAs aren't supposed to do...... however, there's always that "know it all CNA" that WILL function outside of their scope of practice, and the RN/LPN will allow them to do so because it saves the RN/LPN some energy and effort. Yes, it happens). We all know that there are some nurses that refuse to help clean incontinent patients, and anything else that involves poop or urine. Touching a urinal is OFF LIMITS! lol. And it's funny that we are discussing CNAs taking vitals because I know some RNs that refuse to obtain vital signs themselves because it's "beneath" them. They will literally hunt down a CNA for as long as it takes (even in critical situations). As I said before, we can play the blame game all day, but some people really, REALLY should not be working in health care regardless of their title.

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I didn't read all of the posts ahead of mine, do I'm not sure if someone else said this. I used to work as an aide and the hospital where I worked didn't allow us to do vitals (but we could do POC and phlebotomy, figure that out) because they said vitals are an assessment and only nurses can assess.

Just another side of it. I'm not sure what I think about your situation though. I do believe that pressing a button on an automatic Bp cuff is really not that hard. If you only use manual bp's (which another hospital I worked at did) than aides should not be doing that.

I am an aide and I do manual BPs all the time. I'm honestly curious why you think an aide should not be doing them? They are not difficult. If I am unsure of what I got ot it's crazy low or high, I get the RN to check.

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I do believe that pressing a button on an automatic Bp cuff is really not that hard. If you only use manual bp's (which another hospital I worked at did) than aides should not be doing that.

No the automatic BP cuff isn't hard, but the CNA should be taught that the machine may give very inaccurate readings r/t irregular pulse or excessive pt movement.

Sometimes the machine, itself, is in need of maintenance... in which case the aide should be perfectly comfortable with rechecking with a manual BP cuff.

CNA's absolutely should know how to do a manual BP and there is no reason why they cannot.

When I became a CNA there was no such thing as an electronic BP machine.

I have re-educated aides on accurate reading, recording and reporting.

I'm seriously annoyed if the aide does not immediately report a vastly abnormal vital sign.

The aide should know, for example, that if you have 20 pts to get BPs on, and you get a crazy reading like 210/100 that you DO NOT keep pressing along until all 20 are complete and then say nothing... you need to let me know NOW and then go back and finish.

We need to stop dumbing-down the CNA's.

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Specializes in Transitional Nursing.

Welp, I work acute rehab and as a CNA don't get vitals. I have 8 patients the RNs have 4-6. We (cnas) don't have time to get vitals or blood sugars so the nurses do it. Seems to me if your going to administer Bp meds you'd want to take the pressure yourself anyways. There are many things I can do as a cna that I don't do because of the high acuity of our patients. I don't take any of it personally or look a it like a dig on my education Just my two cents.

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Every facility is different. Even different units within my hospital have different regulations on what CNAs can/cannot do. On my unit, the RNs have 2-4 patients, the LPNs have 5-6 patients, and the CNAs have 12-30 patients. And we (CNAs) have to obtain vitals, fingersticks, I & O (all drains including urinary, wound drains, ostomies, rectal bags, NG canisters, basically everything except for wound vacs), bladder scans, foley/condom catheters, ADLs, turning/repositioning, specimen collection, assistance with ambulation, simple dressings, assistance with admissions/discharges, and EKGs if a tech is unavailable. Some other units in my hospital allow CNAs to administer tube feedings, perform phlebotomy, and hang NS (only), but they have to demonstrate competence and attend refresher courses. Some units do not allow CNAs to do fingersticks or catheters. Every unit has their own set of rules.

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Specializes in Nursing Education, CVICU, Float Pool.

I am an aide and I do manual BPs all the time. I'm honestly curious why you think an aide should not be doing them? They are not difficult. If I am unsure of what I heard (happens about 1 time in 20 or so), I get the RN to double check what I got.

So do I. In fact, that's how I was trained to take it. My high school CNA instructor said manual, although not theist convent way of getting a BP, it is typically the more accurate type of measurement. All CNAs where I'm from, NC, are taught to take a manual BP and palpate the radial pulse. We also learn what normal VS ranges are so we can report anything outside of normal.

The whole reason I know how to take a BP and know when to report abnormal Measurements as a Student Nurse id because I learned it as a CNA student. Idk, where some of the other posters went to school, for I know that all nursing programs are different, but my school didn't teach us CNA skills like making a bed, taking VS, Bed Baths, enemas, finger sticks, foley catheter emptying and post insertion care. We have to know it and had to Be State Certified as a CNA before we set foot in class the first day!

My program director and faculty made it very clear that we had a lot to learn in 2 years and that they there to teach us how to be amazing nurses! Not CNAs.

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