Nursing assitant levels

caroladybelle, BSN, RN · May 22, 2004

First, why is a nursing student starting this program, regarding the legalities involved?

Second, the permitted duties vary widely from state to state, and from facility to facility. You would need to speak to risk management to determine legal issues.

Third, what do the staff RNs think of this, as it will be THEIR license on the line if something goes wrong, not the tech or the facility?

Chaya, ASN, RN · May 22, 2004

We do have levels. Our upper level CNA's (especially the nursing students) can do glucoscans, change a dry,sterile dressing and some do perform intermittent catheterization, according to training/ orientation. However, there's no increase in pay if they are already at the top of the pay scale so many of our CNA's choose not to advance to the higher level.

woolhatsue · May 23, 2004

I am a nursing student who happened to have a good Idea. That is why I am pursuing it. I am overseen by my unit manager and if these levels were implimented, the techs would recieve training for each new task. I'm am excited to get started. Does anyone else happen to have any ideas? Thanks so much.

-Susan

caroladybelle, BSN, RN · May 23, 2004

And I repeat:
The permitted duties vary widely from state to state, and from facility to facility. You would need to speak to risk management to determine legal issues.
What do the staff RNs (not the unit manager) think of this, as it will be THEIR license on the line if something goes wrong, not the tech or the facility?

What you are discussing has many legalities and risk management of THAT FACILITY would have to outline them to you. Until that is done, there is little use to even contemplate what tasks to train for.

And the staff nurses would have to accept responsibility for those delegated tasks by unlicensed personnel...and many staff do not feel comfortable delegating those tasks to personnel that they may not know very well. If the manager staffs thinking that the tech will do" x "duties and the staff nurse is not comfort with tech doing "x" duties, the staff nurse will be overworked doing the additional tasks, thus causing hostility with the system.

And many of us prefer doing some of those tasks, as it is easier, more conveniant, useful as an assessment tool, or we have had people screw it up, with us having to fix it or having our license bear the brunt. We get tired of hunting the tech for vitals, finding that questionable ones have not been rechecked manually, etc. I have seen too many questionable practices by "experienced well trained" techs/Nursing Students to want to put my license on the line.

The unit director can say what she wants...but it is the staff nurse's license that bears the brunt of problems and the staff nurse will have to clean up any difficulties that arise. And if the staff are not on board, the plan is doomed to fail.

When things like foleys can get screwed up - tech cuts foley to deflate balloon and leaves latex in patient, breaks off IV cath in patient...recently a experienced nurse was in trouble for placing a foley and causing an injury..the family felt a urologist should have placed it (yes, like you could get one to come in to place a foley) - do we really want to add an unlicensed person in the mix?

These are staff concerns that need to be addressed. And, no, talking to unit director is not good enough.

Who will be training them? And it should be someone with a license and several years of experience.

zacarias, ASN, RN · May 24, 2004

We do have levels. Our upper level CNA's (especially the nursing students) can do glucoscans, change a dry,sterile dressing and some do perform intermittent catheterization, according to training/ orientation. However, there's no increase in pay if they are already at the top of the pay scale so many of our CNA's choose not to advance to the higher level.

At my hospital, we have CNAs but they can't do anything glucose checks, any catheterizations etc. It's primary nursing. That's why our ratios are fairly good.