Forcing nurses to work as aides

emeraldjay · Dec 23, 2004

No I am really not kidding. I worked 5 years in LTC as aide and nurse. I loved being a aide and spending some quality time with my patients. And if they are paying me that much more money than the aides get I would do it with a smile on my face. And like I said earlier. Its a nice break! :)
Besides the fact that in most LTC facilities I have seen the nurse is responsible for 30-40 patients where as the ratio for the aides is much less. So yes, what a nice break to be able to give some special time to the patients.

You got to spend quality time with your pts when you were an aide? Several thoughts are going through my mind; mainly where did you work as an aide and are they hiring. The facility where I work as a CNA believes that two aides can wash, dress, and transfer five to six residents each in addition to chasing bed alarms, call bells, and complete a full set of rounds for the other 28 pts all in two hours time, oh and I can't forget completeing the paperwork for I&O and repos.

I've dealt with nurses that treat aides like they are less than dirt, our DON seems to be one of them. I've heard of a few nurses who consider aide work as beneath them. No nurse should act like this, ever, pt care is pt care, whether you're pushing pills or wiping hineys.

In regards to the original poster, get yourself to your OB/GYN or your physician and get them to write a work limitation for you, if your facility balks at the idea, go to the labor board and file a complaint. Pregnancy plus aide work is a bad equation all around if you ask me. LTC pts can and _do_ get violent on occasion, some pts seem to think that you as the aide will do all the standing work for them and refuse to do anything that requires effort on their part.

Every facility has some piece of equipment that is different from another. If yours has CNA training classes, see if you can go in with them on your day off to learn the equipment. My CNA class instructor made each of us use the hoyer lift and the stand-up lift as both the aide and the pt, to give us a real feel for the machines. There should be some videos instructing the use of the machines too, but don't count on it.

findingmywayRN · Dec 23, 2004

Thanks again for all the responses to this topic. I had no idea it would be such a "hot button."

As far as posters who think I don't know basic nursing care, again, that is not the case. When I stated I was told by management that bathing someone is common sense it was said by management in response to my concerns as a way to give me the impression of how "easy" it would be to do an aide's job (no one can convince me that an aide's job is "easy").

Unfortunately my facility has no formal training for nurses on how to use this equipment - their orientation consists of work policies and fire drills. It blows my mind that they don't consider nurses when they train them for their jobs, and I have always stated that the CNA orientation (where they learn how to use the equipment) should be a part of basic nursing orientation. It frustrates me that people think nurses just know everything the moment they walk in the door each day. I don't ever like feeling like there is something I should know, but don't. I am definiately going to learn how to use this equiptment and won't hesitate to ask anyone to show me.

Again, thanks for your replies. I appreciate your insight.

cjkes78 · Dec 23, 2004

I just finished Funds 1 in PN school. We didn't actually learn some of the things that are taught in CNA classes. For example: we didn't learn how to put a "brief" on a patient, we didn't learn how to put on those hose (ted hose?), we didn't learn how to operate lifts, and I know there is more that I can't remember.

When I took my CNA class a few years ago, we were taught those things and we actually had to get in the lifts to know how the patient would feel.

Some of the skills that we were't taught in Funds 1 are skills that are on the state board test for NAs. One of my skills for the state board test was putting on those hose. Now, its not like its a complicated task, but those things are hard as H*** to put on and I don't think that if I hadn't been taught and had the practice before that I would have passed that skill, especially since the state wants it done a certain way.

Anyway, sorry to get off the topic but this thread made me wander if there are other nursing schools that don't teach students what a CNA learns in their class? :confused:

BTW: We did learn some basic skills: transfers, oral care, TPR, BP, bed making, bed baths, peri care, etc., but it was no where near as thorough as the basic skills I learned in my CNA class. :)

mattsmom81 · Dec 23, 2004

My nursing program started us out with CNA skills...and then we were given the opportunity to work for pay (if we chose to) during our student years. But this was a now defunct hospital based diploma program...I don't know how it is done today.

Those who haven't done CNA work, or have never watched what they must do for am cares in LTC obviously don't KNOW how hard it IS. It is a skillful art involving hard physical work...with the CNA's working together like a well oiled machine to get all these totally dependent folks up, cleaned, and going for the day. I sure would NOT want to 'step into' that new role during MY pregnancy.

MtnMan · Dec 23, 2004

Perhaps spending a little time with the lowly aides and finding out what they do besides take breaks would be in everyones best interest. Since you are held responsible if they screw up I should think you would want to know what thry do. In the Marine Corps everyone knows as much about each others job as possible. They do it in case of mortality but I believe it applies to any workplace as a sort of healthy checks and balances.

CoffeeRTC, BSN, RN · Dec 23, 2004

I work in LTC as an RN...started as a CNA while in nursing school for my BSN. I took the job as a CNA while in my second year in order to learn pt care and get a step ahead in nursing school. Let me tell you this helped! If it wasn't for that CNA experience I would have never really learned basic care.

Getting back to the OP...your facility should have trained you on lifts etc. Once you get the basic inservice (should only take less than 8hrs) you should be good to go. Now weather you should have to work as a CNA...different story.!

emeraldjay · Dec 24, 2004

I work in LTC as an RN...started as a CNA while in nursing school for my BSN. I took the job as a CNA while in my second year in order to learn pt care and get a step ahead in nursing school. Let me tell you this helped! If it wasn't for that CNA experience I would have never really learned basic care.
Getting back to the OP...your facility should have trained you on lifts etc. Once you get the basic inservice (should only take less than 8hrs) you should be good to go. Now whether you should have to work as a CNA...different story.!

I think most prospective nurses should work as CNAs before jumping in to nursing school. I had always believed that the first thing taught after handwashing is pt care. Apparently this is not the case anymore, beyond cleaning. Scares me to think that NYS still allows someone who has gone through at least one year of RN or LPN school is allowed to take the written and practical for NYS Nurse Aide.

The frightening part is that an ER nurse does a lot of aide work, unless they have aides for that. I didn't see any aides in the ER where I did my time for EMT, my preceptors joked about putting me on code brown duty but they all knew I wasn't even taught how to place a bedpan.

I don't believe anyone should be thrown to the wolves without proper training in using the lifts. Any LTC facility that believes in "learn as you go" for nurses is just asking for a mountain of incident reports. I also believe that anyone on "light duty" should be limited to feeding and taking vitals. A pregnant woman's body is under enough strain being pregnant, it doesn't need anymore added by lifting pts or moving lifts and med carts.

Hairstylingnurse · Dec 24, 2004

Thanks for your responses. I sense that the impression of my post was that I do not want to "work as an aide." This is not the case. My concern is that I have not been trained on the equiptment they use on a regular basis, which I am expected to just learn as I go, combined with the physical demands of the job and my limitations. I have told my boss this and she said the nurses should all be trained on this equiptment, but there has not been any training provided so far. Just to make myself clear, I do know basic nursing care, how how to wash residents, take vitals, etc. I do not, however, know how to use a shower chair, or how to transfer a resident into or out of the tub/shower, using lifts, etc. and this worries me about liability as pointed out by nursemaa.
chris_at_lucas_RN I agree it is important to always ask for help, which I always do.

Findingmyway, there would be nothing wrong with it even if you didn't want to do cna work. I for one don't want to do it. I'm much more comfortable in my LPN skin so to speak. I'm terribly uncoordinated and not nearly as efficent as an cna. I worked as a cna for 6 weeks while I waited for my nclex results and was horrilble at it.The other cna's were always trying to help me catch up:uhoh21: and I'm as hyper as hell. I've been ADD all my life. I don't want to do cna work and I respect the h#$$ out of the good cna's( they should be paid more) and I know plenty of cna's tHAT SAY THEY WOULD NEVER GO BACK FOR THIER LPN OR RN, BECAUSE THEY WOULDN'T WANT MY JOB FOR ANYTHING. So each to his own.