Graduate asked to work in PCA position?

MiladyMalarkey, ASN, BSN · Jul 27, 2020

Did you do CNA work prior to this job? I ask this for a reason, because I did not and just as often as my RN preceptor taught me something, so did the CNA's I work with. In my opinion, as long as you get your 3 months of RN orientation complete with a preceptor and bonus if you are getting RN pay doing CNA work, why not? You may not think it, but doing CNA/PCT/PCA work will teach you a lot. And you will still be able to observe, learn and ask questions from the other RN's. I respect the PCT's I work with, they taught me tons and I always remember to treat them well and never look at them as "my tech"...no, we are partners in care. They work incredibly hard.

With that said, I understand wanting to jump right into your RN role. You are right, you worked hard for this for awhile and being asked to do something else can be a bummer. I would start feeling upset maybe if this last longer than a month or 2 because like I said, I understand wanting to start learning what it is to be a RN. But if this is going to be for just a small amount of time, I would look at this as opportunity to gain valuable experience.

Royal_RN, BSN, RN · Jul 27, 2020

I disagree with many of the opinions here. I am a new nurse just starting orientation as well and I would never compromise - if I was hired as an RN, I want to work as an RN...Period. Contrary to what people are saying, many places I applied to are pushing hard to find new nurses. I would not settle. And I would definitely not take a reduced pay and a shortened orientation. As I said I am new, but I worked as a nurse intern on a MS floor for 2 years and have 4 nurses in my immediate family, and I never heard of this scenario occurring.

At the end of the day, if you don't mind the proposition, go along with it. It is your choice. However, know that this is not normal and there are plenty of opportunities for a proper nurse residency out there, so do not feel like your scenario is happening everywhere or choices are limited.

londonflo · Sep 1, 2020

On 7/26/2020 at 11:53 AM, ACNH_PRN said:

do you not think that preparing for boards while under quarantine during a pandemic is a bit stressful?

What about the quarantine made your studying for NCLEX harder than usual? You couldn't go to movies, restaurants, or bars? Studying for NCLEX is Inherently stressful for everyone. Everyone stays home and studies.(Actually, with online clinicals as case studies, you and your peer group probably had more time to study than graduating classes previously).

On 7/26/2020 at 11:53 AM, ACNH_PRN said:

And yes, my unit is 100% COVID so I am trying to transition into this new role while being exposed to a deadly virus.

You accepted the position, I believe with it's risks. (At least you are aware that you are dealing with a known virus present and with adequate supplies of PPE.)

On 7/26/2020 at 11:53 AM, ACNH_PRN said:

It's okay to be nice to new nurses sometimes, I promise. We're really struggling right now.

You are probably thinking I am a mean old nurse. Hopefully that is not true (except for the 'old' part) but I have seen 45 years of nursing graduates feel their experiences are tougher than anyone else.

Your "new nurse" experience is not any different or more difficult than any other new nurse at any other time. Playing the victim or feeling your are under undue hardship will alienate those who endured the same educational track as you. Every new graduate feels their schooling and first post-graduation job is much harder than any nurse before them.

harvestmoon, RN · Sep 1, 2020

I, too, took the NCLEX during COVID and honestly I think we got a good deal on that. Ample time to study, lots of accomodations, fewer questions - I saw all that as positives.

I took an NA job before I passed boards (and by happenstance got a MUCH earlier testing date and started the job already RN (by a few days). AT first I kinda felt like you, that I was "wasting" my RN by being an NA but a month in I have to say that I have learned SO MUCH. Some of the RNs know I have my RN and some don't. Yesterday I "helped" with a blood transfusion. I've also "helped" with NG placement. My hospital is very restrictive, even for students, on what be performed in terms of tasks.

However, yesterday I also had an RN (different one) thank me heartily because I caught a patient who was declining - solely because I'd been taking care of him for a week and I knew that even though his labs were good something wasn't right.

I get lots of education, simply by being present, on how to prioritize your day, things to look for and techniques. If you do your job well and first, you'll have many opportunities to "help" your RN and get a great education on being an RN and structuring your day. Plus you'll know where all the secret stashes are located. ?

We just DXd our last COVID pax (on our floor/section) yesterday but I suspect we're looking at a mountain looming in the distance and we'll be in the thick of it again. I have learned more in the past month than I did in all of nursing school (clinicals included). I'm really glad I was able to work as an NA.

londonflo · Sep 1, 2020

10 minutes ago, harvestmoon said:

I, too, took the NCLEX during COVID and honestly I think we got a good deal on that. Ample time to study, lots of accomodations, fewer questions - I saw all that as positives.

Great positive attitude. Congratulations!

10 minutes ago, harvestmoon said:

Some of the RNs know I have my RN and some don't. Yesterday I "helped" with a blood transfusion. I've also "helped" with NG placement.

13 minutes ago, harvestmoon said:

I get lots of education, simply by being present, on how to prioritize your day, things to look for and techniques. If you do your job well and first, you'll have many opportunities to "help" your RN and get a great education on being an RN and structuring your day.

Great rewards for being positive and receptive to sharing experiences with the RNs!

13 minutes ago, harvestmoon said:

Plus you'll know where all the secret stashes are located. ?

A secret we all want to learn!

Nunya, BSN · Sep 2, 2020

I hope you update us and tell us if you really got that promised 3 month RN orientation....cuz I'm not going to bet any money that you will. Call me cynical...

Dragonfly.RN · Sep 3, 2020

Nothing is more annoying than a graduate RN who is "too good" to do patient care. I've seen graduate RNs (and senior RNs) spend 10 minutes looking for a PCA because they can't be bothered to put a patient on a bed pan, or clean up an incontinent patient. When I started my new position I would get nervous PCA's asking if I would help bathe my patients. Apparently a lot of other nurses are "too busy" (I'm sure some are). My current manager, if she hears a new grad or gets reports about a new grad (or any of her nurses) saying how "they became an RN to do RN stuff!" or in general complaining about having to do basic patient care; you're going to be spending your next shift being our "patient care coordinator". Which means you, the RN, get to help PCA's with baths, feeding, answering call lights, toileting... all the "fun stuff".

PCA's are Patient Care Associates. Patient care (toileting, bathing, feeding, changing, etc.) is part of the RN role. It's not outside your scope. Your license is not suddenly jeopardized. You're not working as a PCA, you are working as an RN and providing patient care.

Guest219794 · Sep 3, 2020

On 7/20/2020 at 9:33 PM, ACNH_PRN said:

Hey everyone. I’m a recent BSN graduate who has already passed NCLEX. I’m hired at a hospital as a graduate nurse as part of the hospital’s nurse residency program. Initially, the orientation portion of the residency was intended to be 3 months long and about a year of nursing practice before we finish the program.

For the first week, I was able to follow my preceptor as anticipated. However, today my manager informed me that they are trying to do something where rather than following our preceptors, the graduate nurses will be asked to help the PCAs. She assured me that every day that I am to work with the PCAs will be kept track of and added to my time in the residency program so that I won’t lose time out of my residency.

This is all new to me and I don’t know how I should feel about all of this. I didn’t study for 4 years and take NCLEX during a pandemic to miss out on having a proper residency experience (especially with all of this C*VID stuff going on). I have all the love in the world for PCAs and what they do but I’m worried that accommodating for this shortage will hurt my residency experience or cause my orientation to become too prolonged.

How would you react? Do I even have a choice? My manager told me that this is per the CNO’s request, so I’m not sure if I can say no. I have no nursing experience so any insight from more experienced nurses is well appreciated.

I don't really understand the "graduate nurse" thing. Have a license? You are a nurse. That being said....

"I didn’t study for 4 years and take NCLEX during a pandemic to miss out on having a proper residency experience"

This worldwide pandemic has been pretty inconvenient, and impacted nursing an learning in a lot of ways. If you think your organization lacks integrity and is planning on taking advantage of you, start looking around. But, this may be an valid educational choice, or staffing reality. It is hard training newbies in this environment, but if you think you can do better, go for it.

"How would you react?"

Like a professional. If I had concerns, I would voice them to my supervisor, and gain some perspective.

"Do I even have a choice?"

You always have a choice. But, as a nurse, your job duties can change at at management discretion, any time. You can float to units you don't like, get pt assignments that seem wrong, etc.. You can choose to comply, argue, or leave.

"is per the CNO’s request, so I’m not sure if I can say no."

Of course you can say no. But, generally speaking, when it is new grad vs CNO, most bets will be on the CNO.

"I have no nursing experience "

You are about to get some with the PCAs.

Some advice from an experienced nurse, as requested:
We work in an environment where most factors are out of our control. The one factor %100 within our personal control is our attitude.
As a new person in a new environment you have the power to shape how people see you. How you react to change and challenge, and what attitude you display will shape how you are perceived. Your call. If you say, or do, anything that even implies that PCA roles aren't inherent in nursing practice, you will lose the respect you haven't yet earned.

JKL33 · Sep 3, 2020

6 hours ago, Dragonfly.RN said:

Nothing is more annoying than a graduate RN who is "too good" to do patient care.

Interestingly there is no one on this thread who has said that or even implied that the role was beneath them. This thread seems to be about someone concerned as to whether s/he will receive a proper RN orientation.

6 hours ago, Dragonfly.RN said:

I've seen graduate RNs (and senior RNs) spend 10 minutes looking for a PCA because they can't be bothered to put a patient on a bed pan, or clean up an incontinent patient.

Yes, I've seen very experienced RNs do the same, because they are lazy.

As for me I sometimes spend 30-60 seconds or so seeing if the techs are available not because it's beneath me to provide personal care to a patient but because I am already behind on performing duties that they can't help me with. Pretty straightforward.

6 hours ago, Dragonfly.RN said:

My current manager, if she hears a new grad or gets reports about a new grad (or any of her nurses) saying how "they became an RN to do RN stuff!" or in general complaining about having to do basic patient care; you're going to be spending your next shift being our "patient care coordinator". Which means you, the RN, get to help PCA's with baths, feeding, answering call lights, toileting... all the "fun stuff".

I suppose if it's on an individual level where there is a particular bad attitude that has been stated outright and could stand to be corrected that's fine.

Otherwise, I call absolute bull. A major underlying issue is that RNs don't have enough time to do the work that PCTs/PCAs cannot help with.

6 hours ago, Dragonfly.RN said:

PCA's are Patient Care Associates. Patient care (toileting, bathing, feeding, changing, etc.) is part of the RN role. It's not outside your scope. Your license is not suddenly jeopardized. You're not working as a PCA, you are working as an RN and providing patient care.

And in the case of this thread we're talking about someone who was promised a residency.

I agree completely that, so long as the intention is that s/he will still get the residency/RN orientation, it would be good to go with the flow of this present situation for a time.

But let's not get off-topic or be disingenuous, here. The major topic of this thread is simply about someone hoping to get what they were promised, which is a thing that would be really beneficial for their transition into the RN role.

As far as "nothing is more annoying..." -- it's pretty darn annoying the sheer number of RNs who seriously think that RNs shouldn't want anything in particular! And in this case, they shouldn't even hope for what they were promised; they aren't allowed hope that the person they made an agreement with will uphold it.

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