RN or busperson?

Alast · May 6, 2004

To me, as a RN, and yes I have and still do work LTC and Acute-care both. it is my job to do whatever is needed by both my patient/resident, other staff members, and family member. Sometimes it is hard. Pulled in 15 different directions at the same time and not enough min's in a day. But when a fellow staffer or resident smiles and says thanks for the help. It sure makes it worth while,

debRN0417 · May 7, 2004

Thank you.....I just initiated this at my facility. Everyone needs to feed, and if you can't feed, you can get water, open milk, help set up, whatever. No one should have to wait for their meal. Thank you!

QUOTE=rascalsmom]As a DON in a 135 bed SNF, I can tell you my opinion and the practice in my Center is for everyone.. including Social workers, activities, etc to be involved with mealtime. No one takes a break or goes out to lunch during the meal time. RNs, LPNs and CNAs and Speech Therapy and OT feed patients or assist in the dining rooms. The SWs and non clinical staff (including my secretary) are out passing out trays, taking trays up and helping in one of the 3 dining rooms we have going. There is a department head assigned to each dining room every day including one to come in on weekends for the mid day meal. Even our maintenance man serves lunch or buses tables. Because of the mandates put on us to serve meals hot and within a certain time frame, and because nutrition is one of our primary foci in LTC, we feel it is one of the most important things we do. I can explain to my Regional folks or the owner of my chain why an MDS might have been late (doesn't happen often by any means) but no way can I get away with a patient having unintentional weight loss or a patient going hungry. As for hiring someone to "bus tables", true.. no budget in the business can handle that. Our reimbursement from Medicare and Medicaid has been cut so much I wonder how in the world we can do what we do. My RNs and LPNs jump in and get the job done at meal times even to the point of changing med pass times to accomodate the meal schedule so they can help out. occasionally I will have a nurse say that "her work wasn;t getting done".. well, anything to do with patient care is "her work".. I do not condone the RN or LPN having to help out if the CNAs are not doing their share. I tell my nurses and CNAs during orientation that I expect everyone of them to toilet a patient, etc when needed but I do not expect that nurse to stop a med pass to toilet a patient while the CNA is sitting at the desk or visiting around the unit.

But I have been in nursing for 34 yrs and in LTC for 14 of them. I would never go back to any of the other areas I get my best feedback from patients when I sit and give them a manicure or a pedicure and they fill me in on all the happenings around the Center. I am in one of the dining rooms daily for lunch and supper and my Administrator is as well. We try to lead by example. I do not ask my nurses to do anything I would not / could not do myself.

Well, I have rambled on enough here.. think I made my point. I understand where you are coming from with feeling like you are doing things that can be done by other than an RN and there are things you need to be doing that a CNA or feeding assistant cannot do.. but if we all remember that we are here to provide care not only with our hands, but with our heart, everything will get done.. maybe not according to our timetable set in the morning, but it does manage to get done. Of course, I am fortunate to have the best nursing staff in my area and we have the best reputation for quality care and customer satisfaction as well. I have very little turnover and over 1/2 of my CNAs have been with us for over 15 yrs and many of my nurses have been for 10 yrs. have a few nurses who have been here for 20 yrs and many CNAs who have 18+ yrs in.

gonna hush now.. can you tell I am wired? Worked 15 hrs today.. had 7 am UR/QA meeting, did my DON day.. and then stayed to help new nurse on 3-11 and do some inservices for evening shift. going to sleep in in the morning.. or this morning rather.. just realized it is almost 2 am.

nice to meet you all.. Nursing in LTC is the best.

Bre:balloons:

Hellllllo Nurse, BSN, RN · May 8, 2004

Very true....I remember my hospital days.....running around waitressing, plus having to check my IV's, hang blood, draw labs, etc etc. I'd go back to hospital nursing, but I absolutely hate Med/Surg (always have, always will) But for now, LTC is where I'm at. We all work hard, in every setting! I just wish admin would get it thru their heads that we're not here to "serve", and start hiring extra people that could do all that stuff for the patients. Not budget friendly, I guess.

I agree! Except that using RNs to do jobs that can and should be done by lesser paid staff is penny wise and dollar foolish on the part of admin.

Where I work, RNs use "dollies" to move heavy boxes of supplies, we empty the trash, mop the floors, etc. The other day, two other RNs and me were staying late to clean up. There is no housekeeping.

I was thinking- having three RNs do the janitorial work probably costs the facility about $100./hr.

Real stupid.

MR. DJ · Jul 17, 2004

what's mds? do you need an rn license to do it? is it better than bedside nursing?

well, that is nice. however, we seem to have enough cnas to do the hygeine and personal care while the lpns give out the medications, do treatments, and chart notes....and i (as a unit manager) am learning how to do mds and pris, making sure all the paperwork is done, i&as are investigated or the careplans updated, talking to families and the doctors, rounding and picking up orders, etc. after all, i am responsible for that too. in other words, i do have work to do...not sit and read magazines. i also hope the nurses' aides are not reading magazines except on a break. i am not currently working in acute care, although i have very recently been working in acute care and am very familiar with how things go with primary nursing. we do/did have cnas and techs even in primary care settings. it is not that it is beneath me, but it's not part of my job description right now. however, there is one rn that currently does man the feeding room at lunchtime in my facility.

CapeCodMermaid, RN · Jul 17, 2004

MDS= Minimum Data Set. It's a comprehensive assessment used in LTC with both short and long term residents. For Medicare PPS patients, you must do an MDS on day 5, day 14, day 30, 60 etc until they are off Med A. All long term residents have an MDS done quarterly. The PPS MDS is how we get paid for what we do for the Medicare A resident. It can be a great job if you are well organized and can work well with your therapy department.

Jailhouse RN · Jul 17, 2004

As an RN you are supposed to be able to do the job of all those who work under you.

Destinystar · Jul 17, 2004

its one of those issues i have often wondered about. seems logical that cleaning up after the patients eat could easily and be done by the housekeepking staff and or the kitchen staff. the facility could have 3 of those people do it for what an rn gets an hour so it is a waste of money. an rn needs to be freed up to do rounds on pts. that are not in the dining room, etc. where i come from we always had a licensed nurse in the dining room in case someone choked and had all staff who were able assist the residents with eating. i would agree with you having us clean up the tables is the straw that breaks the camels back. like is busing tables in your job description, who told you to do it??? maybe you should bring this to someones attention that they must have made a mistake because you applied for an rn position not a table busser. why should they stop there maybe they could use you in the maintenance department (lol) :rolleyes: all joking aside from a technical stand point the facility is not supposed to add your hours into nursing if you are not using them to provide direct pt. care. the last time i looked busing tables was not considered a nursing function.

we have no feeding assistants at my facility. feeding patients is one thing (not my favorite thing, but understand it's part of the job - there just aren't enough cna's and the lpn is passing meds)---but lately i've been busing the tables!!!!!!!!!!!!!!!
anyone else have to do this? i don't feel it's part of an rn's job to be cleaning up the dining area.
thought ltc would be a "vacation" from the stress of acute care--it's more stress than acute care ever was....
looking seriously for work in a doctor's office. don't care anymore about the lower pay, inferior benefits, etc.....