Just wondering if other hospitals are doing this....

Nurses General Nursing

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Starting next month in my hospitals we are changing the roles of the RN and UAP. The RN will have 5-6 patients (not uncommon) and will be responsible for all their normal nursing duties of assessing, medicating, and implementing orders but will now be responsible for taking all of their patients vital signs Q4 hours and blood sugars as ordered. The UAP's used to be responsible for the vitals and blood sugars. The UAPs only duties are to provide ADLs, turn patients, and stock the unit. Many of the nurses including myself feel we are already stretched very thin with our normal nursing responsibilities and that taking our own vitals and blood sugars will only stretch us thinner. My question is, are other hospitals adopting this role change and has this worked well or not?

Specializes in Inpatient Oncology/Public Health.
Why is it that when ancillary or support staff don't do their jobs the answer is always to add the task to the nurse's workload under the guise of safety and accuracy? God forbid if we actually address the root cause.[/quote'] This. Also, I'm spoiled. I've got great PCAs on my unit. Reliable, hard working, even thinking critically(gasp.) I would be continually overwhelmed and behind without their help. My previous hospital had one CNA on the unit who didn't help much and we had up to 8 patients. Not safe. Also, probably paying such low wages for such backbreaking work doesn't help much with job performance.
Specializes in Med-Surg, NICU.

Here is something I don't get. First nurses complain about being overburdened. Now some of you are wanting to eliminate or diminish the role of the uap completely.

Make up your mind, people. If you can't trust us lowly unlicensed workers, then do everything yourself. But don't come here whining about how overworked and underpaid you are.

Here is something I don't get. First nurses complain about being overburdened. Now some of you are wanting to eliminate or diminish the role of the uap completely.

Make up your mind, people. If you can't trust us lowly unlicensed workers, then do everything yourself. But don't come here whining about how overworked and underpaid you are.

I do. And I would rather do so than deal with the additional stress of having UAP that can't be counted on.

Specializes in Med-Surg, NICU.

I'm sorry you feel that you can't count on a uap. You might want to find a place with higher standards and expectations in patient care. At the magnet hospital I work, we would be fired for not doing our job as aides.

Specializes in Pedi.
Here is something I don't get. First nurses complain about being overburdened. Now some of you are wanting to eliminate or diminish the role of the uap completely.

Make up your mind, people. If you can't trust us lowly unlicensed workers, then do everything yourself. But don't come here whining about how overworked and underpaid you are.

Honestly, the aides I worked with in the hospital didn't decrease my workload or burden AT ALL so I was overworked with or without them. I'd much rather have had more nurses/better ratios than have had aides who just ended up creating more work for me.

Specializes in Medical Surgical.

I just had a aide take my vitals manually recently... I watched her write down that my RR was 18, and that my blood pressure was high. lol. I know for a fact that I run 90/60 always, and I know I wasn't breathing more then 12 a min, so um..yeah, I guess my point is.. I would rather get them myself.

Specializes in Pediatrics, Emergency, Trauma.
Here is something I don't get. First nurses complain about being overburdened. Now some of you are wanting to eliminate or diminish the role of the uap completely. Make up your mind people. If you can't trust us lowly unlicensed workers, then do everything yourself. But don't come here whining about how overworked and underpaid you are.[/quote']

I understand your view point being one who started as a CNA/Tech/UAP position...

One day you will understand the viewpoint of nurses once you become licensed and get you legs in the business...the more knowledge you take on, the more responsibility.

I worked in a place with a 1:6 ratio and no responsibilities to UAPs; pretty hair pulling and sometimes they were excellent; the middle of the road I could get the best out of them, the ugly, nothing but complaints and inner WOOSAH I needed; my school of thought was based on my expectation because to the UAP I was; however those adepts helped create the nurse I am, but I digress.

Working in Critical Care with a 1:2 ratio UAPs were "an extra pair of hands"; floated and stocked the unit; leadership was trying to have them take on more tasks to help the unit especially when it was full; total care was the responsibility of the nurse. I didn't mind it, for most of the time, I was used to including vital signs with my assessment.

I'm sorry you feel that you can't count on a uap. You might want to find a place with higher standards and expectations in patient care. At the magnet hospital I work we would be fired for not doing our job as aides.[/quote']

Some UAPs are unreliable and some are worth their weight in gold. If my hospital would hold UAPs accountable for their actions then I don't think my hospital would be going through this issue right now. I don't want this post to turn in to a UAP bash session because I definitely appreciate the ones who do their job correctly and put patient safety first.

Specializes in Nurse Scientist-Research.
If my hospital would hold UAPs accountable for their actions then I don't think my hospital would be going through this issue right now.

This.

Problem is; in general UAPs don't have any accountability beyond losing a barely above minimum wage paying job; whereas the licensed nurse is looking at losing his/her entire livelihood. The only way to remedy this is to either have UAPs who are internally motivated (not a measurable way to hire for that) or have management that will monitor and follow up; yea; they have bigger fish to fry when in the end someone (read; licensed nurse) will assure all cares are given. Because their license depends on it.

When I spoke earlier how our hospital eliminated most of our UAP positions (or moved them out of patient care), it was probably largely brought on by the observation that many of the UAPs made themselves scarce when it came time to do patient cares; so the nurses had learned how to do without them; so why not eliminate their positions. . . Just saying. . .

I know the UAPs that actually care are the ones that read these boards; I'm sorry I didn't get to work with you guys. All the worthwhile UAPs I've ever worked with have now finished nursing school. Maybe that's a solution, that there should be some internship agreement between nursing schools and hospitals to employ all their students for 4-12hrs a week. I don't know. Very frustrating, but less so when every person in the care of the patient takes personal accountability for how that patient is doing.

I'm sorry you feel that you can't count on a uap. You might want to find a place with higher standards and expectations in patient care. At the magnet hospital I work, we would be fired for not doing our job as aides.

I chose my facility with intention. I have enough experience and credibility that I was able to choose where I wanted to work and didn't have to take any job offered to me. They *wanted* me. The teamwork is excellent and people treat each other with respect and courtesy. The patients consistently give us high marks because of our excellent service. As I said, we don't have UAP in my ED, and I'm satisfied with that.

When I work as a "UAP" I have to admit I feel like a fifth wheel sometimes. As someone else pointed out, its WAY more inefficient and time consuming to have one person going room to room getting 15 sets of vitals, having to gown up in isolation rooms and rearrange tables and fight through family members just to reach the patient. I also think you develop bad habits as a tech because you aren't thinking independently and are kind of forced into a subservient role, and the longer you do this the worse it gets, so it can actually be detrimental for a future in health care.

The other day I worked with an RN who had worked at the same ambulance company I worked with as an EMT. Her nickname was Crash because she had zero ability to either safely drive or navigate an ambulance during her extremely brief time as an EMT. It finally occurred to me at the end of the shift that I had pretty much blindly followed the orders of someone who a few years prior I didn't even trust to safely back an ambulance into a bay.

I feel like I spend every shift running around non stop, and yet at the end of it all I accomplished very little.

Specializes in Med-Surg, NICU.
I chose my facility with intention. I have enough experience and credibility that I was able to choose where I wanted to work and didn't have to take any job offered to me. They *wanted* me. The teamwork is excellent and people treat each other with respect and courtesy. The patients consistently give us high marks because of our excellent service. As I said, we don't have UAP in my ED, and I'm satisfied with that.

You work in ED so I can see why you don't feel the need to have an aide, but on a busy med-surg floor where some nurses have up to seven patients....

I'm just glad I work at places that don't find my unlicensed self useless!

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