Did the title catch your attention? Good, I was hoping it would.
I've seen people talk about this attitude on allnurses quite a bit, and I find the reactions fascinating. I'm amazed at the passion, care and professionalism of the nurses on this board and really about every nurse I've ever met.
BUT, everyone-from the most seasoned nurse to the student- knows that nursing is changing and will probably continue to change dramatically over the years to come. There are CNAs and MAs who seem to have an increasing role in the healthcare system and nurses themselves have more responsibility (all the charting etc.) and demanding jobs as new diseases, new medicines and standards of care make their way into our lives.
My question is, do you think their should be a change in what nurses do? Will there come a time when basic hygiene and certain other tasks often done by nurses in the past will be the responsibility of CNAs and others in similar roles? Would this be a good thing for nurses? Is there really anything wrong with nurses who feel that four years of education + all of their other demands and responsibilities should mean that they shouldn't have to do these tasks?
im not above performing personal care however i think it does somewhat distract the patients view of our ability to asses, and assist in their care plans. if a patient sees us changing their briefs and then admin ivs they tend to doubt our ability
i've had just the opposite problem, patients thinking that i am the nurse. i am very clear about my limits for that reason. i am careful to introduce myself to new patients, identifying my role in their care.
Can I just say that I do not expect the nurses to do my job. I take great pride in my job. However, that being said I do expect a nurse to answer a bed/fall alarm and not come find me to tell me one is ringing. I do expect a nurse to stay with a resident (at risk for falls) who is climbing out of bed to stay there until help comes or lay them back down reset the alarms. Not leave them at risk to come find me so I can do what she could have done. I find this personally to me negligent (sp?). I do expect a nurse to help look for a resident who has gone missing not sit on her chair and tell us where to look. I do expect a nurse to help answer lights/alarms when the aids are all running like mad and cannot keep up on them. Now in all of these instances the nurse is sitting in her chair either watching us run or reading a book/magazine while the rest of the staff(4 aids on NOC) are with other residents who all need assistance. I realize that nurses have lots of responsiblities so they cannot always help but, if they have the time isn't better to help? Skin concerns, broken bones (from falls) all take extra precious time to document and care for. Precious time that no one has.
Ill go ya one farther,, not only do most of the CNA's do those tasks now but i seriously think in the future patients families will take a more active role in hygiene and daily care in the acute care setting.
Do i think i shouldnt do those tasks,heck no, im right along with the others in there cleaning, turning, etc. But i do know between the growing elderly population and no increase in nursing numbers there will be a great need for families to get even more involved in their families care.
Good Luck! Families want to be less involved in doing things for patients ,but want to have more of a say in what we do for them.
you're know what i know a couple of places that would write the nurses or cna's up if they had the attutude saying its not my job to wipe butts and the possiblilty the door.
However 'white-collar' nursing eventually becomes, there will be 'blue' stains that no amount of education will ever wash clean.
Simply put, if you don't want the 'side-effects' that come with intimately dealing w/ people; there are plenty of jobs out there that don't require it.
Nursing . . . does.
CNAs only do 'delegated' tasks. That means that it is YOUR responsibility, delegated to them. Hint: YOUR RESPONSIBILITY.
The moment we choose to define nursing in a way that leaves those responsibilities behind; that is the moment bedside nursing becomes the province of non-nurses.
Here, here!:yeahthat:
What better way to assess a patient and to establish rapport than to assist with an intimate, caring task like helping them to eat a meal or take a bath or helping someone to wash their hair (in my opinion one of the most heavenly experiences after a few days of being ill :) ). Nurses CARE for pts. It's our job to ease their discomforts - whatever they may be. Meds & procedures are only a piece of the puzzle. Caring - the hands-on stuff is the critical piece - even if it doesn't always smell or look so nice.
Do we want hospitals to go the way of long-term care where nurses often spend the majority of their time doing meds & charting for dozens of people and seldom get the time to do personal care, let alone sit and talk to a patient or hold their hand?
However 'white-collar' nursing eventually becomes, there will be 'blue' stains that no amount of education will ever wash clean.
Simply put, if you don't want the 'side-effects' that come with intimately dealing w/ people; there are plenty of jobs out there that don't require it.
Nursing . . . does.
CNAs only do 'delegated' tasks. That means that it is YOUR responsibility, delegated to them. Hint: YOUR RESPONSIBILITY.
The moment we choose to define nursing in a way that leaves those responsibilities behind; that is the moment bedside nursing becomes the province of non-nurses.
Here, here!:yeahthat:
What better way to assess a patient and to establish rapport than to assist with an intimate, caring task like helping them to eat a meal or take a bath or helping someone to wash their hair (in my opinion one of the most heavenly experiences after a few days of being ill :) ). Nurses CARE for pts. It's our job to ease their discomforts - whatever they may be - physiological or psychological. Meds & procedures are only a piece of the puzzle. Caring - the hands - on stuff is the critical piece - even if it doesn't always smell or look so nice (including the emotional stuff! ).
Do we want hospitals to go the way of long-term care where nurses often spend the majority of their time doing meds & charting for dozens of people and seldom get the time to do personal care, let alone sit and talk to a patient or hold their hand?
okay, fine...i'll let the cat out of the bag...the reason nurses don't want to wipe a butt....
they don't know how!!!
okay, so that's not all of them, but yeah...a lot of them did not work as aides before (i think it should be a requirment), and they are intimidated by doing something and looking like they don't know what they are doing. we aides just do it better. the nurse i respect is the one who knows that things will go better for the patient and i both if they pop in for a second to help roll & lift, assess to poop and bottom and maybe show me a thing or too. it's like the nurses (in the ltc) that want to hand you creams, powders, ect to do. it's like, hello? isn't that a nurses tx for a reason? don't you need to be assessing this?
i'm just a student, but in the hospital for my mentorships and whatnot, i like to do some care myself because 1)i don't delegate assessment tasks and 2) i don't trust anything has been done (or done right) unless i've seen it with my own eyes. been burned too many times, and nothin' pisses me off more than poor patien care. (like the patient with the texas cath and sore on his back in the previous response.)
oh, wait, i'm not a student anymore, i get pinned next friday!!!! w00t w00t!!
What better way to assess a patient and to establish rapport than to assist with an intimate, caring task like helping them to eat a meal or take a bath or helping someone to wash their hair (in my opinion one of the most heavenly experiences after a few days of being ill :) ). Nurses CARE for pts. It's our job to ease their discomforts - whatever they may be - physiological or psychological. Meds & procedures are only a piece of the puzzle. Caring - the hands - on stuff is the critical piece - even if it doesn't always smell or look so nice (including the emotional stuff! ).
Do we want hospitals to go the way of long-term care where nurses often spend the majority of their time doing meds & charting for dozens of people and seldom get the time to do personal care, let alone sit and talk to a patient or hold their hand?
I only wish I had the time to feed, wash hair and give a bath.
While I don't pass meds and chart for dozens of patients, between doing a head-to-toe assessment, passing meds, looking up meds, discharge planning, addmissions, teaching, and passing endless amounts of pain medications on patients who complain that it takes me too long to get to them, on and on and on, I seriously have to leave the feeding and baths to the CNA's and help them when I can, and do baths when I can. Sometimes I do have to just throw it all away when a patient is in emotional distress (which often trauma patients are as their world is thrown upside down), and stop and listen to them, hold their hand and listen to them vent and cry. I'm not an orgre.
Do I do intimate care? Do I wipe butts? Absolutely I do! I'm not one of those who run to find an aid to do dirty work when I'm in the room. Do I say to mayself "I'm going to give you a bedbath and feed you because it's such a thorough assessment, a good way to establish rapport and I love the hands on nursing, because that's what a real nurse is." Sorry, but no I don't.
okay, fine...i'll let the cat out of the bag...the reason nurses don't want to wipe a butt....
they don't know how!!!
okay, so that's not all of them, but yeah...a lot of them did not work as aides before (i think it should be a requirment), and they are intimidated by doing something and looking like they don't know what they are doing. we aides just do it better. the nurse i respect is the one who knows that things will go better for the patient and i both if they pop in for a second to help roll & lift, assess to poop and bottom and maybe show me a thing or too. it's like the nurses (in the ltc) that want to hand you creams, powders, ect to do. it's like, hello? isn't that a nurses tx for a reason? don't you need to be assessing this?
i'm just a student, but in the hospital for my mentorships and whatnot, i like to do some care myself because 1)i don't delegate assessment tasks and 2) i don't trust anything has been done (or done right) unless i've seen it with my own eyes. been burned too many times, and nothin' pisses me off more than poor patien care. (like the patient with the texas cath and sore on his back in the previous response.)
oh, wait, i'm not a student anymore, i get pinned next friday!!!! w00t w00t!!
nurses don't know how? really?
never been an na, and i am quite capable of providing basic care, have never felt intimidated doing it either, in fact i know i do it better than the nas i work with. i will have wiped more butts, emptied more urinals, ran for more water, changed more beds, turned and positioned more people, ambulated more patients, put more patients on bed pans, emptied more commodes, etc, etc, etc, etc in the first four hours of my shift than any of the 3 nas that work evenings will have done in their entire 8 hour shift. i've went in to initial assessments on patients that were soaked from their ears to their toes, despite the fact that when they were admitted 2 weeks ago they were incontinent, like they need to be reminded each day that this patients needs to be changed. frankly i'm so fed up with their nonsense that i want to spend 5 minutes looking for them to get them to change a patient that they neglected for the last 4 hours.
afraid i don't find that little joke funny.:stone
originally posted by crazymomma
now in all of these instances the nurse is sitting in her chair either watching us run or reading a book/magazine...
actually that pretty much what the nas want to do, except they would rather surf the net instead of reading. oh yeah, they also make snide remarks about the nurses not answering the call light when they are outside the room (charting or checking the mar) while perched in their chairs.
it easy to say that it should be a requirement for nurses to have to be nas first, in fact it would make a nurse more empathetic towards the nas position. however, how on earth can you create the same empathy from the nas towards the nurses? unless you do the job, you really have no idea what it is like.
chadash
1,429 Posts
quote:
originally posted by rn2bkatie
im not above performing personal care however i think it does somewhat distract the patients view of our ability to asses, and assist in their care plans. if a patient sees us changing their briefs and then admin ivs they tend to doubt our ability
i've had just the opposite problem, patients thinking that i am the nurse. i am very clear about my limits for that reason. i am careful to introduce myself to new patients, identifying my role in their care.