Patient Care Tech duties..replacing Nursing duties?

Nurses General Nursing

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I recently had a friend/ PRE nursing student (not in the program yet) mention that she is Patient Care Tech which allows her to run IV's ,g-tubes, caths. and so forth. To me this seem that these would be the responsibility of the nurse or at least someone with more than a couple of weeks orientation? Are hospitals trying to crosstrain lower level positions to do this with the lack of RNs? I would think this is beyond the scope of a PCT? But then again I am just a green newbie?

Is this in MO?

From my understanding....

Yikes! I wonder what type of education qualifies them to do all this. Kinda scary.

Specializes in Acute Care Psych, DNP Student.

Is she at a VA facility? VA hospitals are not bound by state nurse practice acts, but their own federal regulations. I know someone who purposely chose a specific nursing program because she would do her clinicals at the VA hospital. She's doing IV's, blood transfusions, etc in her first semester. She can do whatever her clinical instructor is comfortable with, and presents in clinicals. Interesting how much students can do at the VA. (Not just nursing students either!) I know a psychologist who chose the military for her internship because she could just do SOOO much there, that she wouldn't be able to do in a civilian internship.

You do not have to have a license to work in any federal facility at all!!

Federal regulations? I didn't think there were any! This means, a doc who lost his lic. can work there amongst other things! A dermatologist can perform heart surgery, etc!!!

I'm not a nurse but a Certified Medical Assistant and CNA. We had a thread on one of the MA forums about whether PCTs were replacing LPN's. The sad part of it is this: at least where I am (PA) there are next to no jobs for LPNs outside of the LTC arena. The PCTs are performing many of the services in hospitals that used to be the LPN's job. The aspects of the job that can NOT be performed by PCTs are then being dumped on the already overworked RNs. So the RNs end up doing what they've traditionally done PLUS any aspect of LPN work that the PCT isn't capable of. Which would be fine IF the hospitals would hire more RNs to compensate for this, but I don't think they do. Meanwhile, the hospital is saving a good deal of money because they're paying PCTs instead of LPNs and not giving any additional pay to the RNs they're dumping the additional duties on. Not a good situation for anyone in my opinion, the PCTs are operating IMHO on a slippery slope as far as scope of practice and the RNs are getting (for lack of a better term) scre*ed.

Just my 2 cents.

Lorraine

CMA, CNA

Specializes in Maternal - Child Health.
You do not have to have a license to work in any federal facility at all!!

Federal regulations? I didn't think there were any! This means, a doc who lost his lic. can work there amongst other things! A dermatologist can perform heart surgery, etc!!!

Just want to clarify this. In federal facilities (VA and military) nurses, doctors and other healthcare professionals are allowed to practice on a VALID license from any US state or territory. That means I can use my IL license to work in a federal facility anywhere in the US or overseas. It does NOT mean that unlicensed and unqualified people are staffing these facilities.

As far as a dermatologist performing heart surgery, that is another misconception that is not limited to federal institutions. Most states do not limit the practice of physicians to the specialty in which they were trained. In most states, one must graduate medical school, complete 1 year of internship, and pass a board exam to become licensed and have virtually free reign to practice any chosen specialty. Completion of a residency is required for board certification, but is NOT a requirement for MD or DO licensure. Physicians are limited in their scope of practice by hospital privileges granted to them and by their malpractice insurer far more than any state regulations. This is NOT unique to the federal healthcare system. It is the system that exists in virtually every state of the US.

Specializes in OR, Med/Surg, Renal, Oncology.

We allow PCT's, who are in their last year of nursing school, to start IV's, insert NG's, if they have a skills check-off that they have completed that task and met the goals in their nursing program. BUT...they are still accompanied by, and monitored by, an RN when performing those task in the hospital.

Doing so allows them more opportunities to develop their skills--and it helps build their confidence level.

Specializes in Geriatrics.

As a new LPN I have a small problem with the PCAs in our hospital. I understand that they took a 6 week course in learning how to do procedures such as caths, tube feeds, etc. BUT I have already heard PCAs giving WRONG medical advice to patients!! They shouldn't be teaching patients how to give insulin or giving advice on medical conditions and medications!! When I intervene to try and give the correct response the PCAs throw a tantrum! It is a real mess if you ask me. We are told to practice "within our scope" so PCAs should do the same.

Specializes in MICU, SICU, CICU.

I think an important thing to take note of is that, at least here in NC, patient care techs function under the direction of the RN. We delegate tasks to them, for example if there is an order to put in a foley as the care nurse I will get the order, not the tech. If I decide that I need to place the foley due to a low platelet count or an elderly man with BPH then I will place the foley end of story. If the patient has no urology history and the tech has demonstrated competency and knowledge of the importance of aseptic technique then I may delegate the task.

It truly is up the discretion of the RN what tasks can be performed, a tech should never independently make the decision as to what they will or will not be doing for a patient.

We've been taught in school that an unlicensed person (tech etc) can NOT perform sterile procedures (caths, IV's etc) also they can NOT pass meds. Is this specific to NYS?

I worked as a tech and one of my jobs was to cath people. We were given three practices w/ an RN and were then considered trained. It was hair-raising watching some of the other techs and I felt it was against the Nurse Practice Act and was one of the reasons I left shortly after starting there.

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