do you let unlicensed staff do "RN" things ?

[labrador4122, RN]

do you let unlicensed assistive personel do things that rn is supposed to do, if you know they are going to nursing school, or gradutated from nursing school.

i am asking, because when i was a cna, many rns who trusted me, asked me all the time "you want to put in this foley, you are in nursing school... it's a good practice"

but my answer was always the same "oh no, i am very scared to do that! i would rather watch you do it, and just explain to me what you are doing"

and that was when i wasn't in nursing school!

and once i got to nursing school, they did the same thing and again i would answer them like that, or i would say "nope, i don't get paid extra to do that! lol"

and now that i am an rn, i realize how important it is to do things myself-, to delegate correctly according to the title of the job, to make sure that my meds are given if i have an lpn, because i am responsible, and i would get in trouble if a med is not given, even if i have lpn, and to make sure to follow hospital policy. there is a list of the things that a cna can do.

anyways, i was thinking about that today, because if those nurses used to ask me when i was a student, i am sure that they used to ask other cna's the same thing. and i am wondering if the other cna's took up on the offers.

[Scrubby]

I would never delegate a task which is supposed to be done by an RN to a unlicensed staff member. It puts your own license at risk and patient deserve better. I interpret the term 'delegate' as me not standing over someone observing them, the person is doing this without me there to step in immediately if something goes wrong.

Even if the unlicensed person is a nursing student but they are working in the role as a CNA with me then i still don't want them doing anything outside of their role even if i'm available to supervise them. If they employed to be a CNA then they have to work within their role. They aren't on a clinical placement so it's not appropriate for them to be practicing outside of their scope. .

However, if it is a nursing student on a clinical placement then i'm happy to let them do things such as inserting a foley, giving medications, dressing a wound as long as i'm there with them and supervising them. Nursing students are there to learn, and the universities usually provide the nursing staff with a list of objectives, things that the nursing students have practised at nursing school that they need to learn under supervision of the RN.

I hope this answers your question.

[labrador4122, RN]

thanks for the response,

I was just wondering if other nurses do the same thing.

I honestly would never let a cna do things that I am responsible to do.

I trust my CNA's to take the vitals, and tell me if something is wrong.

last night, my patient had 100.7 temp, my order stated to give tylenol if tem is 101.5 or above.

so soon after she told me, I went myself to check the temp and it was 99.8

but I noticed that 6am vitals were 100.6 ax, I rechecked his temp and it was 101.8 so I gave tylenol.

but anywho, I used to hear stories too that one of my classmates used to give meds with the RN in the NICU and one of the parents noticed and reported her to the manager and asked why the cna was giving the meds.

I don't know what happened because we were not friends, so I never asked.

[racing-mom4, BSN, RN]

Hate to admit it since I know it is wrong--but when I was in school I would do it. With supervision of course. I would insert a foley on a sedated pt I would try once, if I couldnt get it, the nurse would attempt. Same with NG tubes, I would attempt them with the nurse over my shoulder, if I couldnt get it, she would attempt.

The only things I did with out direct nurse supervision was accuchecks.

Now that I am a nurse. I would rather have the tech get my accuchecks---than the VS. As at least the accuchecks I can see the history and the actual number. Versus Vital Signs which can be almost subjective. did they really count resperirations for a full minute. Is that temp of 98.6 oral or axillary? The HR of 110 was the pt sleeping or just walking back from the bathroom?

[november17, ASN, RN]

but anywho, I used to hear stories too that one of my classmates used to give meds with the RN in the NICU and one of the parents noticed and reported her to the manager and asked why the cna was giving the meds.

I don't know what happened because we were not friends, so I never asked.

A patient in the NICU noticed and reported them to the manager?

That must have been one sharp baby!!

[justme1972]

The two major hospital systems that we have here, have PCT (patient care technician) positions available.

These can be filled by a CNA or a Nursing Student who doesn't have a formal CNA certification.

The hospitals here ALLOW PCT Nursing Students to do anything that would normally be allowed in school. Such as start IV's, prepare medications (but not administer), insert foley's, etc. They have been told that the state does allow that practice...but it must be with direct supervision of an RN.

However, a CNA that is NOT enrolled in a program, cannot do anything that they wouldn't otherwise be permitted to do.

Other states may be different.

[Valerie Salva, BSN, RN]

A patient in the NICU noticed and reported them to the manager?

That must have been one sharp baby!!

Oops- we misread the post. It says parent, not patient.

[Ginger45]

No, I would never do that. It's not that I think that they can't, it's that they are not licensed to do so.

[emnicams]

I was a nurse intern for a year before I graduated, and I worked a LOT, 30-40 hrs per week. So yes, I was hit up all the time by nurses wanting me to give medicines, do accuchecks (only licensed personnel can do those at my hospital), insert foleys, the list goes on and on. When I first started, I would do it, because I was naive and didn't want to make the nurses dislike me, and I heard how they talked about the other interns who wouldn't "help", as they put it ("So-and-So is no help at all, she won't even put on a nitro patch!" etc.) But the longer I worked there, the more I realized that I didn't really care whether they liked me or not, and if I got caught doing something I shouldn't be and was fired as an intern, I would sure never get a job there after I graduated, so I started saying no. It took a huge weight off my shoulders.

I've been an RN for only 3 months, but I've never asked any CNA or intern to do anything they can't... and never will. It's not fair to them and I'm certainly not risking my license. They are enough help to me just doing what their job entails.

[nurseby07]

I was a cna as a nrsg student and a lot of the nurses I worked for were my instructors. As I progressed through the program they let me do more and more, under their direct supervision. It was a wonderful boost to my education.

The cnas who I worked with as an RN wanted me to let them do things, like suction out the trach, but I wouldn't do it. It was a totally different situation.

[hypocaffeinemia, BSN, RN]

The nurse practice act here in Texas has a list of specific tasks that cannot be delegated-- this includes medication administration and responsibility for care plans.

Everything else is at the nurse's judgment-- though it gives examples of stuff that probably wouldn't be delegated.

What this means is that many hospitals in this area have "professional student nurse" positions that allow them to do any skill they've been checked off in school while on the job, so long as the supervising RN okays it.

[marilynmom, LPN, NP]

I work as a nurse tech and we are allowed to start IVs, cath patients, sterile dressing changes, ETT suctioning, ABGs, accuchecks, central line/art line blood draws, postmortem care, etc. Basically anything we have been checked off in school to do.

We can't give medicines or access the accudose or give blood products, can't chart anything subjective, and even though we can assess our patients the RN has to assess as well and chart her/his assessment....we mainly do it for the practice/learning.

That is part of our job description and part of the practice act in my state. Of course it is all under the supervision of the RN we are assigned with. I don't work as a CNA and if I did my scope of practice would be different.

http://www.ok.gov/nursing/ed-guide.pdf

"Nurse Technician and the Practical Nurse Technician are allowed to perform all

duties of a nursing assistant, as well as other technical skills which have been learned

in a nursing education program and for which competency has been previously

demonstrated under the supervision of a faculty member."