mixed staffing, all-RN or not?

StrwbryblndRN · Mar 12, 2008

You may want to search All Nurses for previous debates. May not be exactly what you want but could help.

It has been a hot topic and many people do not want to open the can.

jessiern, BSN, RN · Mar 12, 2008

:wlcmblks:

Nice to meet ya.

Can't really give you a lot of input. I've only worked on a med-surg floor with RN/LPN/PCT's. Never all RN staff. I would think it would be very expensize for a facility though. Not very efficant.

cardiacRN2006, ADN, RN · Mar 12, 2008

I work in an all RN ICU and I prefer it that way. Sometimes I wish we had a tech to help out with turns and stuff, but otherwise we manage.

I prefer to be the only one involved in my patient's care. I don't want to manage other staff and keep tabs on what they are doing, and if they are doing it right. I don't like giving up any part of my care to anybody. I want to know everything about my patient based on my personal observations/assessments, not someone else's.

So for me, in the ICU, I prefer all RNs.

Antikigirl, ASN, RN · Mar 12, 2008

Hmmmmm...I have always worked mixed staffing and couldn't imagine not. To care for people you need specific people for specific things in this fast lane world! To deal with time constraints on any one person to do all the things necessary, and the ongoing and ever spreading responsiblity in documentation load/liablity...any facility that chooses not to have a mixed group of specialized staff is insaine IN CERTAIN DEPARTMENTS!

I work with OT/PT, RT, MD specialists, Hospitalists, RN, LPN, CNA, RN techs, Speech therapy, Wound/Ostomy RN's, Specialized IV teams, Dietary, Diabetic teaching, Discharge planners, Social services, post hospital education groups, many levels of management RN's, computer techs, HR, Employee health, imaging techs and staff, transportation, in house education RN's (right now big time on a new project in before home education on CHF...it is making a large difference in frequent flyers!!!), and MORE!

I could NEVER do all this with the variety and patient load I have as a med/surge nurse daily!!!! We work as a team to help the patient have the best care and information they can get! Yeah, patients get a little put off by so many people...but that is their choise to take the opportunity of great services provided or not!

RN1989 · Mar 12, 2008

I've worked both. I prefer all RN staffing. Less headache. Less delegation. YOU know what is going on with your patient and don't have to worry about someone under you having screwed something up because you are the only one involved in your patients care. The patients at the all RN places I have worked were also happier.

racing-mom4, BSN, RN · Mar 12, 2008

I work in an all RN ICU and I LOVE it...I came from a med surge floor where sometimes CNAs did vitals, and sometimes they did not, sometimes I even wondered did they just copy an earlier set?

I like doing full care and I think the families like knowing I am their nurse today. No confusion. I will help walk them to the bathroom, I will give them their meds, I am the one talking to their Dr. I am the one that will call respiratory for their breathing treatments. I am the one that is going to draw their labs and then be sure to be looking for their results on the fax. Etc etc etc. This list is endless, but I would not want it any other way.

We do on occasion get a CNA from the med surge floor to help with baths if they are low census and we have a heavy load. Besides that, we work as a team and get it done.

pickledpepperRN · Mar 12, 2008

While every patient must be assigned to a registered nurse our colleagues who are LVN/LPN or non nurses provide invaluable help in caring for our patients.

I work in critical care on the night shift. From 7:00 pm until 11:00 pm we have a secretary. From ii:00 pm to 7:30 am we have one or more nursing assistants depending on the needsof our patients. Physically heavy patients often need four to five people to get uo or even to be repositioned. Then we may use up to three CNAs. Our CNAs can use the computer to input orders and access results for us.

We staff at 2 or fewer patients per RN.

When I float to telemetry/step-down it is common for an RN to be assigned to four patients. If the patients are stable we are only assigned to three.

But if the patient is trached and/or on a vent but stable we may assign two RNs three or four patients each with an LVN to assist both RNs. This is a big help when they need frequent suctioning, dressing changes, accuchecks, and such.

Stable telemetry patients will generally be staffed at 1:4 with a CNA working with 2 RNs so he or she has 8 patients.

There is a monitor tech to report any abnormal rhythms or alarms to the RN.

On both units the charge nurse only takes a patient assignment when providing meal and break relief or to transport a patient.

I we didn't work with other caregivers we would need many more RNs to provide the effective and compassionate care we do our very best to provide.

pagandeva2000, LPN · Mar 12, 2008

I am an LPN. While the hospital where I work still continues to use LPNs, I am hearing (from this site, actually), that there are plenty of hospitals that do not. I believe that there is room for everyone at the table to eat, so to speak. From what I see, RNs are so loaded down with paperwork and other procedures that we, as LPNs cannot perform due to our scope of practice. Therefore, I strongly advocate to have a mixture of titles. I believe that team nursing made the most sense in most med-surg units. I have seen it happen, and it seems appealing to me; the RN picks up orders, does the other procedures that cannot be done by CNAs and LPNs, does discharges, admissions. LPNs will administer most medications, do treatments, insert foleys, etc, the CNA or technicians do the basic ADLs, specimen collection (including phlebotomy). And of course, we all help each other if patient care is falling behind or if time allows. That's just me, though.

leslie :-D · Mar 12, 2008

yrs ago, our nsg staff was comprised of rn's only.

i totally enjoyed the experience of providing total care to my pts.

we now have nsg assts, but i still provide a lot of the cares that normally our cna's would do.

admittedly, it just doesn't make $$ sense to employ only rn's.

leslie

pagandeva2000, LPN · Mar 13, 2008

yrs ago, our nsg staff was comprised of rn's only.
i totally enjoyed the experience of providing total care to my pts.
we now have nsg assts, but i still provide a lot of the cares that normally our cna's would do.
admittedly, it just doesn't make $$ sense to employ only rn's.
leslie

What area in nursing do you work in?

renge1 · Mar 13, 2008

hello,

I am an LPN and I work with RN and CNA's. The LPN and RN work the same pt load 6-7 pts (vent/trach pts) and work load. the RN hangs my blood if i have and and of course the rn does any new admissions but other than that there isn't much differnce in the work/pt load.....I am very greatful to have the CNA's..........I just don't see how it is possible not to have mixed staffing.....at least thats how i see if for my setting.