LPNs called to come in and work as Aides? Is this common?

  1. Hello Everyone,

    I am a brand new LPN grad, a brand new LPN in LTC, and brand new to allnurses. I love this site! It has been so comforting to me as a student and now as a new nurse. I have a few questions and would really appreciate any feedback.

    Does your LTC facililty expect you to work as an aide to cover a shift when an aide calls out? I am brand new on my job (3 weeks) but I hear the aides on the phone when an aide has called out for a shift trying to get someone to cover. They first call all the aides, who usually say they can not come in to cover. And then the aide starts calling the nurses to see if they can come in to cover the aide's shift. They do pay the nurses their LPN salary to work the shift as an aide. This is on an Assisted Living floor and the aides are not certified. I was really surprised when I heard the aide, not my administrator, calling nurses to come in to cover. I think the aides burn out because they don't have enough help and they rely on the nurses to help them, rather than the nurses being able to delegate some responsibilities to the aides. P.S.- the nurses' are overwhelmed and overworked as well, but try to take on as much as they can because there just don't seem to be enough aides for all the resident's many needs.

    Also, when I work my shift on the work on the Dementia floor, I am expected to give my early morning meds, shower and dress 3 people and get them to breakfast. In the afternoon, I am to "toilet" 3 or 4 residents and either help with making beds and replacing towels in the rooms, or help clean the tables off after lunch. My first day was rough. I did my meds, and got my first resident showered and dressed and I heard a resident screaming, he had fallen. Of course, I immediately went to him. In between helping the aides, I had meds, assessments, calls to the MD, dressing changes, speaking with families, incident report, 24-hr report, my shift report and nursing notes. I have to say they have 2 aides on for 15 dementia residents. These aides must shower, serve food, clean up, do activities, toilet...all of it. So, I dont' believe the aides are lazy, just overwhelmed and need and expect help from the nurse on duty.

    Being completely new to this field, I am asking...is this a normal practice?? Thanks so much in advance for any feedback!!!!
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    About lisaannjamRN, RN

    Joined: Sep '09; Posts: 62; Likes: 49
    RN; from US


  3. by   caliotter3
    Sounds as if the facility is trying to get by on less personnel than necessary to get the job done properly. Might be a good idea to continue your job search as it seems it won't be long before this job could get to you. Meanwhile, hang in there.
  4. by   lisaannjamRN
    Thanks so much for your reply, Caliotter3. This is my very first job and most of my clinical experience was in the hospital, so I had no idea if this was normal practice. I have had other job offers, but as I didn't know if this was a common practice, I didn't want to give up too soon. Thank you for your input. I really appreciate it.
  5. by   Sierralee
    Welcome to the real world of LTC. Yep i have done it, that includes passing medications, CBSs/Insulin, Assessing falls and sending out to hospital, checking in meds and supervisoring the aides that came to work. It happens alot in LTC, PC/AL. ( I got told once to, "think outside the box" and the other saying is," its not in the budget for more staff". You think those aides are burnt out give yourself a few more years and you will burn out too and possibly question why you went into nursing. My recommendation get more educations go for the BSN/RN degree and get out of LTC!
  6. by   katrenia04
    I am a CNA, attending school for my LPN, i worked in a Nursing home, where mostly all my nurses were LPNs. Yes it was very overwhelming, never enough aides for the residents. But my nurses wouldnt help with any of that stuff, i did it all myself or had to find an aide to help. once in a great moon they would, but not usually, the main thing i saw the nurses do was pass meds. (even some slept, i worked third) but all the dressing them, toiliting, vitals, I and O's, and check and changing was my job.
    I think they are taking advantage of you a little, but as a CNA going to school for nursing, i definetley know how hard it is for the aides.
    hope this helps, and yes i would continue to job hunt
  7. by   lisaannjamRN
    Sierralee, thank you for your reply. I am currently working on my R.N. through Excelsior and hope to get through it in a year or so. I agree with you, I don't think it would take me very long at this job to completely burn out. I work three 10-hour shifts per week, which gives me ample time for Excelsior. I figured I could handle this for 3 days a week and just work really, really hard on my R.N. There is a lot of turnover where I work, and now I know why. What a shame, they lose really good, caring people by understaffing. But I notice they have a HUGE budget for activities and flower arrangements. The place is gorgeous, but what does that mean when they don't provide enough staffing for proper care. Oh well...I am not gonna change the system. I'll just do my best until I get my R.N. Thanks again!!!!
  8. by   lisaannjamRN
    Thanks, Katrenia04! You are young and yet so wise. Your words truly help me to make an informed decision. Best of luck in your nursing education!!
  9. by   Mollypita
    I haven't worked LTC for a long time, but it was a nightmare when I did. I lasted a year. I do think it's good that they are willing to pay a nurse to function as an aide, that seems to mean it's a priority to have the staffing they feel is due (even though it's not adequate). As a side note, I'm an LPN to RN grad of Excelsior, and wanted to wish you luck! It's a great program!
  10. by   deleern
    I am an RN Charge. I help on the floor all the time. I could bump an LPN or TMA to the Floor but then I am to tied to one Place. I have 4 wings to supervise. I m very mindful of the case Mix on ea wing. our facility is one of the best staffed in our area. We have 8.5 residents per Aid. 17 residents per med cart.
  11. by   DPRN
    In my LTC facility, to cover an aide call-off we first call the aides. We will often call the nurses as well because some of the per diem nurses are willing to work as an aide to replace a call-off. The nurse will be paid nurse wages for whatever job they perform. Yesterday, I, as the RN in charge of the assisted living unit, did work as an aide until the aide could get there. It was fun because the residents were telling me what to do.

    As for your dementia unit, my 14 bed dementia unit is staffed by 2 nurse aides. The assisted living nurse will pass meds for this unit. The nurse comes and goes in the dementia unit on an as needed basis depending on what is happening at the moment.

    Yes, the aides can call out other staff to cover a call-off. The aides call staff according to the union contract. The person with time available is the person to make calls for the call-off. So sometimes the nurse will call and sometimes the aides will call. Just depends.
  12. by   tewdles
    I worked for a hospice that would routinely use the LPN as an aide. I was horrified by it...we needed the nursing as badly as we needed the aide.
  13. by   readytoroll
    I am a new nurse in LTC, I haven't been called in to work an Aide shift yet, but I have heard that it does happen from time to time. Our DON usually schedules a "floater" Aide so if someone calls out we are covered and we have a handful of Aides who will pick up hours on a regular basis. I work the Alzheimer Unit, I have 33 residents ( room for up to 40) for me and three Aides, probably about 10 of them are total care, the rest have some level of independence.
  14. by   Sierralee
    Good girl!! You are smart. You know what you are doing! Go to work and school, do the best you can and remember you cannot change these facilities, but you can make a difference in the heart of those residents! Just take give good care to them, paperwork will always be there. Good Luck