RN's and LPN's working as Nursing Assistants?

SquishyRN, BSN, RN · Jun 20, 2018

I do not understand why there would be a need to assign a nurse to full CNA duties.
If there is an extra nurse, while short a CNA, why not just spread the CNA duties among all of the nurses?

At a facility I used to work, this would not happen because the nurses didn't usually want it done that way. The patients were all usually total care and ventilated so it threw eveyone's daily routine into a funk to have to do all the bedside care too, even if it was less patients. If we were short NAs, as an LVN, I'd "take one for the team" and volunteer to be the NA, which was very much appreciated by all the other nurses.

triciam888 · Jun 20, 2018

Sadly, Nurses today often have no aides to help anymore. That being said, you are absolutely right in the fact that you hold a Nursing license makes you have to function in the capacity even if you are acting as an aide.

Sour Lemon · Jun 20, 2018

Oddly, I am CNAing tonight. It's a little bit boring, actually. I've been on the internet quite a bit. I'm on an unfamiliar unit "helping out". I don't think anyone even knows I'm a nurse, so they're not asking me to do nurse things. I've just been 1:1ing a few different patients and moving beds around.

nekozuki, LPN · Jun 20, 2018

CNA duties *are* nursing duties. There is no separation between the two. For the sake of efficiency, nursing tasks that are safe for a layman to do can be delegated under supervision, but there is ZERO distinction. It's always weird to me when nurses think that wiping butts is beneath them or can hardly change a diaper. How do you do skin head to toe skin assessments without being able to roll, move, undress, and ambulate a patient?

All my patients are total care and too fragile to be handled by anyone but a nurse, so we don't use CNAs here. Our ratio is never more than 1:3, so that helps. But it's always hard to precept/orient new hires who came from places with a lot of CNA support, because I know they're going to struggle. It's not easy giving a bedbath and putting a diaper on a 150lb PVS patient who neurostorms every time you touch them, while keeping the ventilator tubing, central line, JT/GT, subrapubic catheter and multiple monitors/wires from screeching.

The joke in our facility is "How do you tell the difference between an LPN and a BSN?" "If the diaper is on sideways, the nurse has a BSN."**

**I love you, BSN nurses, don't come at me with the fury of a thousand suns

Been there,done that, ASN, RN · Jun 20, 2018

You have no choice but to agree ,it's in your job description. Legally, you are still held to your professional licensure standards.

macawake, MSN · Jun 20, 2018

The joke in our facility is "How do you tell the difference between an LPN and a BSN?" "If the diaper is on sideways, the nurse has a BSN."**
**I love you, BSN nurses, don't come at me with the fury of a thousand suns

One excellent method to avoid getting a negative reaction, is to not make condescending "jokes" in the first place. What motivated you to make this one?

It's always weird to me when nurses think that wiping butts is beneath them or can hardly change a diaper. How do you do skin head to toe skin assessments without being able to roll, move, undress, and ambulate a patient?

It's always weird to me that some nurses think that the reason some other nurses don't want wiping butts, as you so elegantly put it, to be the main feature of their work day, is because they think it's "beneath them". Beneath them sounds emotional and implies that someone thinks they're better than someone else. My personal interpretation of the division of labor is based solely on efficiency and the best utilization of available resources.

For me personally that has never been a problem since I've always been fortunate enough to have employers who staffed the floors I've worked with the correct mix of different professions. ADL's and hygiene were squarely in the CNA's domain and since they were skilled at their jobs that worked just fine. They were absolutely qualified to notice and alert me if something was going on with for example the patient's skin. They would also chart the patient's skin status every shift whereas inspecting for example intravenous and epidural catheters was my responsibility. I would only make a complete head-to-toe skin assessment on admission and on discharge if deemed necessary.

As you might have guessed I don't work in the U.S. and our CNA's go through two years of CNA school before they start working. The way my employer regards this division of responsibilites is that I as a nurse is a higher cost for them, so they primarily use me for tasks and skills that are unique to a nurse's knowledge base and legal scope.

WesClinicRN, MSN, NP · Jun 20, 2018

I have worked as an aide many times when I was pulled to another floor to help out. It was that or go home. Of course, I had no problem with it. I worked as an aide before I was a RN. In some ways, I actually enjoyed it, because I was able to be closer to my patients and felt that I was able to help them even more without having to deal with all of the paperwork of the nurse. Of course, I would help with med passes, pain meds, and charting as needed. In most of the areas that I worked in at the hospital, we worked together as a team. I would gladly get vital signs and change beds/patients on a nurse's salary any day.

1. We are there for the betterment of our patient.

2. There are no jobs that any nurse is too good for, period (or any medical professional for that matter).

3. If you work for a large organization, you do what is needed when it is needed. As long as what you are asked to do is not detrimental to the care of the patient, there should be no problem.

blackmamba123 · Jun 20, 2018

It's always weird to me that some nurses think that the reason some other nurses don't want wiping butts, as you so elegantly put it, to be the main feature of their work day, is because they think it's "beneath them". Beneath them sounds emotional and implies that someone thinks they're better than someone else. My personal interpretation of the division of labor is based solely on efficiency and the best utilization of available resources.

EXACTLY!

blackmamba123 · Jun 20, 2018

For me personally that has never been a problem since I've always been fortunate enough to have employers who staffed the floors I've worked with the correct mix of different professions. ADL's and hygiene were squarely in the CNA's domain and since they were skilled at their jobs that worked just fine. They were absolutely qualified to notice and alert me if something was going on with for example the patient's skin. They would also chart the patient's skin status every shift whereas inspecting for example intravenous and epidural catheters was my responsibility. I would only make a complete head-to-toe skin assessment on admission and on discharge if deemed necessary.
As you might have guessed I don't work in the U.S. and our CNA's go through two years of CNA school before they start working. The way my employer regards this division of responsibilites is that I as a nurse is a higher cost for them, so they primarily use me for tasks and skills that are unique to a nurse's knowledge base and legal scope.

Adequately staffed floors, and CNA's with two years of education??? I need to pack my bags and stethoscope and head your way!

jetsy62 · Jun 20, 2018

Work in a small rural hospital with no aides, no LPN's. RN's do it all. And I like it that way! Typically assigned no more than 3 patients and get to know your patients very well. But not for everyone I am sure.

marvman · Jun 20, 2018

As a Lead CNA, I've had seen one of RNs come in and work a hall during evening shifts as a Nursing Assistant (CNA),

she had 15+ years as a CNA and she was willing to work as one when we were hurting during one evening (taking care of 28 residents!).

It brought a newfound set of respect for her, as I saw she was willing to do anything to help us as a facility/team.

I will probably do the same thing, if the same thing was asked of me, when I eventually do become an RN.

blackmamba123 · Jun 20, 2018

CNA duties *are* nursing duties. There is no separation between the two. For the sake of efficiency, nursing tasks that are safe for a layman to do can be delegated under supervision, but there is ZERO distinction. It's always weird to me when nurses think that wiping butts is beneath them or can hardly change a diaper. How do you do skin head to toe skin assessments without being able to roll, move, undress, and ambulate a patient?

Nursing assistants assist nurses. That's what the position is for. I'm exasperated with aides and employers who expect me to do my job *and* assist the assistant regularly. As I mentioned in my previous posts, this is not about hierarchy or lack of humility. I do patient care when I can. But if I'm doing it regularly, what the heck do I need an assistant for? Send them home, pay me more money to do total care for my patients, and you'll have no complaints from me.

Additionally, how in the world can you say that there is no distinction between what nurses do and what aides do? Unless you are referring to the fact that nurses do everything aides do. Otherwise, I'll let the licenses and certifications of each position speak for themselves.

CEO's have secretaries and assistants to do tasks that they certainly are capable of doing, but don't have time to do because of all of their other tasks and responsibilities. This is no different, aside from the fact that we're in the business of people. Now you mentioned you do total care and you also mentioned the very low nurse to patient ratio on your unit, which leaves you more time to do total care. Not even feasible with 6 patients or in LTC with 24-30 patients.

Lastly, you listen here LPN, this BSN will challenge you to a diaper changing contest any day of the week. You can choose the place and the mannequin. Bring it on. :roflmao: :cheeky: Now don't get your undies in a bunch. I'm just joking.