Should nurses still be making beds, delivering trays, giving baths and doing bedpans? Or should these tasks be delegated to nursing assistants?
I'm in nursing school and I can see the value of these duties as opportunities for pt assessment, but the physical demands of these duties wear me out and at times lead the patient to see me as a servant. On days when I've had a nursing assistant to perform these duties I've enjoyed nursing and my workload felt managable.
What do you think? Should nurses duties be redefined?
I want to work with adults so med-surg seems the place to start, but I worry about how I'll physically manage it.
You raise the bed to start with. I'm shocked at how many people don't do the simple act of raising the bed. It was understandable when I worked at the nursing home with the crank beds, but at the hospital where they're electric? Starting an IV? Bed's going up. Assessment? Bed going up. The extra seconds will add years to your career.
You don't be afraid to ask for help. I learned at the nursing home to change just about anybody's bed by myself. But it's stupid. Ask for help and be willing to help them when they need help with theirs. It goes quicker having the extra hands=more comfortable for the patient. You ask for help getting them out of bed. You ask for help walking them if you need to. No patient need is worth hurting yourself. If they're falling, slide with them. You CANNOT stop a falling patient singlehandedly, but you can hurt yourself. No reason for both of you to be hurt. If it's a combative or bariatric patient, you get ALL the help you need, even if it means calling for help from other floors. Even if it means, bariatric patient is crapping in bed instead of the bedside commode at night because there aren't enough people to SAFELY get them up.
This topic came up in our nursing class and most students argued that we should continue to perform these duties. I was in agreement with their rationales. Until I thought about looking for my first job.
As a nursing student doing 12 hour clinicals in med-surg, I was exhausted from these duties. I injured my back and was in constant pain. (I'm an older student) My peds rotation, on the other hand, was so much more managable because the parents helped with bathing/bedpans etc. I didn't suffer the injuries or physical exhaustion.
I want to work with adults so med-surg seems the place to start, but I worry about how I'll physically manage it.
Also, working as a tech before becoming a nurse will toughen you up and teach you some time managment. In nursing school, we will only get three patients max, but as a tech I've had 45 before!
We may not have been giving meds, but changing 300 lbs pts. and trying to turn and clean contracted patients is good practice.
This topic came up in our nursing class and most students argued that we should continue to perform these duties. I was in agreement with their rationales. Until I thought about looking for my first job.
As a nursing student doing 12 hour clinicals in med-surg, I was exhausted from these duties. I injured my back and was in constant pain. (I'm an older student) My peds rotation, on the other hand, was so much more managable because the parents helped with bathing/bedpans etc. I didn't suffer the injuries or physical exhaustion.
During nursing school. I do think that bed baths and bed pans should be the students duty to do. I'm wondering how many patients you have that u are exhausted?? When i did my clinicals in school we had a max of 3 patients and did all care on them.
Now when you become a nurse, you are able to delegate to nurses aides. However, when I did med surg I still did a few of my own baths or I helped the aide with the baths so they were done quicker.
As for your back, nurses are notorious for bad backs, and you need to be careful! As another poster mentioned, raise the bed for bed baths. Get help rolling/turning patients.
Start doing stretching exercises or even yoga daily to help strengthen your
back muscles. If you are still sore, I recommend a chiropractor. Just be careful with your back.
And if you need to, ask for help during clinicals with repositioning of a patient. If you dont think you can turn a patient by yourself, dont. Even if it means waiting 5 minutes for some help, use that time to talk to your patient.
Your job is to do what you have education and training to do. So if you know how to wipe a ---- then do it. If your expertise is needed elsewhere, delegate the job. Better yet, figure out a way to do it together to make it go by faster.
As a student, you need to know how to make beds, pass and set up trays, make beds, feed pts, etc.
Even if you get a nursing job where you won't be doing these things yourself, you need to know how to do them correctly so that you can make sure your subordiates are doing them correctly.
If you have apt with dysphagia, or hemiparesis, blindness etc., their trays will need to be set up and prepared in special ways and you need to know how.
Nurses also need to know the different ways to make up a bed for different conditions.
I personally enjoy doing these type of little things when time permits. But when I have other priorities, of course I delegate all of it.
Nursing is tough, physically, emotionally and every other way that you can think of.
Also, working as a tech before becoming a nurse will toughen you up and teach you some time managment. In nursing school, we will only get three patients max, but as a tech I've had 45 before!
We may not have been giving meds, but changing 300 lbs pts. and trying to turn and clean contracted patients is good practice.
I was a CNA for 3 years and I agree.
Also, working as a CNA helped me be able tell when a CNA is trying to pull a fast one on me.
Also, working as a CNA helped me be able tell when a CNA is trying to pull a fast one on me.
Oh, yeah. Like when someone tries to say that patient hasn't been lying in a wet bed for 8 hours, but they have dry brown rings on their pads and there is a STRONG ammonia smell in the air--almost bad enough to knock you out.
Specializes in ER (new), Respitory/Med Surg floor.
Too many people, especially new grads are intimidated by delegation and take on more than they can handle and if there is a tech culture that isn't nurse friendly wind up doing it themselves while the techs good off.
That's exaclty how I am and it's killing me. I had a hard time delegating to the point now some of the techs I work with expect me to do things such as I+Os all the time. Part of it is I know sometimes stuff is not done and I feel it has to so I just do it. As a result I have a very difficut time getting out of work on time or feel very stressed. Same issue with the unit clerk. She'd miss stuff to write on the Kardex so I'd fill it in and now it's like that all the time. I'm intimidated by her b/c she goes on and on and on about what a good job she does and how bad others do it. It was just little stuff so I'd let it slide. Then it led to I'd scan orders all the time just to make sure pharamcy got the orders quickly. so then when I'd put a chart if I didn't scan it sometimes the clerk wouldn't do it b/c she just expected me too!!! I've created a horrible hole for myself. What I'm getting at is I used to feel guilty delegating which is pathetic.
I'm not afraid of delegating someone their job descripition. I've very good at it in fact. Delegation isn't lazy, nor bossy, nor a bad thing.
This is true. The techs and unit clerk are there to assist you. You help out too but don't feel guilty, intimidated or afraid about delegating when you have too. That's all of our jobs.
Specializes in Psych, Assertive Community Resource Team.
I think it seems rather selfish that some posters are saying that they do not feel they should have to perform those kinds of duties because it "wears them out". Nursing is work and work, by definition, will "wear you out". That is why someone pays you to go there and do your job. Pawning off parts of the job that some might find more offensive is extremly self centered. Where I work patient care is a team effort. If you have the time then you help the patient, no matter what little initials follow your name. I know that as nurses our jobs will include so much more than basic bedside patient care and that at times nurses are just too busy to complete those tasks without assistance from the techs. This is perfectly understandable and the reason that techs are hired. What I have issue with is the mentality that some people seem to have that upon graduation they become too good to do these simple tasks. Just think about it this way, If you go home wore out at the end of a shift from doing those tasks a few times a shift, think how your techs feel. They do those tasks all shift long and have much higher patient to tech ratios.
Instead of thinking "How can I delegate my work to make my shift easier?" try thinking "How can the work on this unit be divided in a way that benefits all those who work here and keeps the patients the most comfortable?" I gaurantee you a much happier and more unified workplace for everyone.
I think it seems rather selfish that some posters are saying that they do not feel they should have to perform those kinds of duties because it "wears them out". Nursing is work and work, by definition, will "wear you out". That is why someone pays you to go there and do your job. Pawning off parts of the job that some might find more offensive is extremly self centered. Where I work patient care is a team effort. If you have the time then you help the patient, no matter what little initials follow your name. I know that as nurses our jobs will include so much more than basic bedside patient care and that at times nurses are just too busy to complete those tasks without assistance from the techs. This is perfectly understandable and the reason that techs are hired. What I have issue with is the mentality that some people seem to have that upon graduation they become too good to do these simple tasks. Just think about it this way, If you go home wore out at the end of a shift from doing those tasks a few times a shift, think how your techs feel. They do those tasks all shift long and have much higher patient to tech ratios.
Instead of thinking "How can I delegate my work to make my shift easier?" try thinking "How can the work on this unit be divided in a way that benefits all those who work here and keeps the patients the most comfortable?" I gaurantee you a much happier and more unified workplace for everyone.
Well said. I am not a Nurse yet, but I have been a CNA for about 7 years now. I have worked in many different Nursing Homes and I have only had maybe 2 nurses the whole time I worked there who were willing to lend a helping hand. Never did they help bathe a patient or toilet them, it was help to turn, or lift more often. But I did work with the Nurse who said " I cant help you thats not my job" I made a vow from that day foward that when I become a Nurse that I will not do that to my aides, they do so much hard work and until you have done that job all day long you dont realize how tiring/hard it is. So lending a hand to make a bed or change a patient is SOOO much appreciated. And when you have aides that respect you then you will get a better job done all around. Sorry I am going on and on and on.
I think it seems rather selfish that some posters are saying that they do not feel they should have to perform those kinds of duties because it "wears them out". Nursing is work and work, by definition, will "wear you out". That is why someone pays you to go there and do your job. Pawning off parts of the job that some might find more offensive is extremly self centered. Where I work patient care is a team effort. If you have the time then you help the patient, no matter what little initials follow your name. I know that as nurses our jobs will include so much more than basic bedside patient care and that at times nurses are just too busy to complete those tasks without assistance from the techs. This is perfectly understandable and the reason that techs are hired. What I have issue with is the mentality that some people seem to have that upon graduation they become too good to do these simple tasks. Just think about it this way, If you go home wore out at the end of a shift from doing those tasks a few times a shift, think how your techs feel. They do those tasks all shift long and have much higher patient to tech ratios.
Instead of thinking "How can I delegate my work to make my shift easier?" try thinking "How can the work on this unit be divided in a way that benefits all those who work here and keeps the patients the most comfortable?" I gaurantee you a much happier and more unified workplace for everyone.
I disagree with some of your line of thinking.
I am in nursing for the long-haul and have probably realistically 20 to 25 more years to work. I disagree with the notion that nursing by definition will "wear you out". I fully intend on being self-nurturing enough to not be worn out. While I've come pretty close to physical and mental exhaustion, it hasn't happened. yet. Nursing is a tough and demanding job physically and emotionally, and I work hard and know and expect that I will work hard for the money. But it isn't going to wear me out. I refuse to let that happen.
Read the post above yours to see the problems inherent without becoming a master at delegation.
I totally agree with the idea that patients comfort is first and foremost. As the patient care manager it is my job to see that the patient is cleaned, turned, and physically comfortable in a timely matter whether I do it myself, as a team together or delegate it to the tech.
However, in a unit with techs, the techs cannot assess, teach, pass meds, do procedures, chart, discharge, evalute, etc. etc. and while I certainly am capable of doing their job, as I learned how the first quarter of nursing school, and have been there and done that, it isn't fair, that I should put aside my job when I can delegate. That's not effective time management.
I agree pawning off tasks because you find them offensive is wrong. No Rn should be above intimate and dirty care, and it should be a team approach.
However, asking a tech to do things in their description while I have my job to do is the right thing to do. I don't see it as selfish if I'm giving 100% to my job that I don't "make it easier on myself" by not taking on someone elses job.
Too many new RNs feel they have something to prove to the techs that they aren't too good to do techwork and take on more than they can handle in the interest of getting in good with the techs. But I definately have a problem with those who as soon as they graduate think they are never going to have to wipe a but again.
New Hampshire has no laws, rules, or regulations mandating nurse/patient ratios. In my last job, I had 30 patients to take care of, 60 while the other nurse was at lunch. Our CNAs had 10 residents each, sometimes up to 20. The facility was a combination rehab/long-term-care facility. Approximately 1/3 of my residents were also Alzheimers and/or psychiatric residents. These residents required almost continual supervision. Even if I wanted to, there was no way I could do bedmaking, bedpans, etc. It was logistically impossible to do two med passes, assess residents, assist residents and family, monitor lab/radiology/consult results, talk to doctors, take new orders, do treatments/woundcare/cath care and deal with emergencies or admissions/discharges. I'm posting this as a new thread wondering about nurse/patient ratios in other New Hampshire facilities, in other states, and what NURSES think nurse/patient ratios should be. :uhoh21:
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:nono:
wooh, BSN, RN
1 Article; 4,383 Posts
You raise the bed to start with. I'm shocked at how many people don't do the simple act of raising the bed. It was understandable when I worked at the nursing home with the crank beds, but at the hospital where they're electric? Starting an IV? Bed's going up. Assessment? Bed going up. The extra seconds will add years to your career.
You don't be afraid to ask for help. I learned at the nursing home to change just about anybody's bed by myself. But it's stupid. Ask for help and be willing to help them when they need help with theirs. It goes quicker having the extra hands=more comfortable for the patient. You ask for help getting them out of bed. You ask for help walking them if you need to. No patient need is worth hurting yourself. If they're falling, slide with them. You CANNOT stop a falling patient singlehandedly, but you can hurt yourself. No reason for both of you to be hurt. If it's a combative or bariatric patient, you get ALL the help you need, even if it means calling for help from other floors. Even if it means, bariatric patient is crapping in bed instead of the bedside commode at night because there aren't enough people to SAFELY get them up.
Make your back a priority. Nobody else will.