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?
It is a real problem: NAs generally don't have a clue about the nurse's responsibilities. Wish there was a way to inform, but don't know how that could happen.
And, employees that sit around and read magazines instead of working: fire their butts. There are lazy NAs and lazy nurses. We don't need them.
Oh yeah, and I don't judge a nurse based on how much hands on she does. I figure you have your responsibilities, I have mine. Now, an unwillingness to get your hands dirty would give me pause, but I would also be concerned if you ran behind in your responsibilities because you were unwilling to delegate the less technical tasks. Circumstances vary a lot from place to place, and the defining characteristic of a good employee is the ability to adapt to the best team approach to meet the needs of the patients.
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?
Wait....are you saying that there are nurses in hospitals now who have time to sit and talk to a patient or hold their hand? Most of the hospitals I've been in are already in the place you are describing.
Interesting thread... :) I work in an all RN hospital, for some reason they decided that it would be better because of the acuity of our pts that an all RN staff would be better over 15 yrs ago or so.
I believe that RNAs ( that's what they were called at the time in Canada ) have a valuable role in the healthcare team and there are many days that I and my patients would benefit from having them with us.
Personally, I enjoy for the most part taking care of my patient's hygenic needs, it is an opportunity for me to interact with my pt an a different level. It is part of nursing that ensures that my pts have their dignity and respect to be taken care of .
I get very upset when I get patients that because they are unable to complain or don't have family advocating for them that are in a mess and have not been bathed or groomed. I had a poor little 12 yr old who was unresponsive following a cardiac arrest suddenly after receiving anethesia a the dentist . His family lived far away and after the child being in the hospital for weeks at that time had to go home as they were in the process of selling their home. Anyways, I received this poor boy, and when I went to lift him up, he had sticky fluids that stuck from his back to the bed linens! People were basically washing his face and his front.
I hate lazy nurses!
Anyways, that said, when we are so busy doing the medical side of things, esp in the ICU ( where I work now) I feel badly when the physical 'cares' cannot get done. I feel the best when I leave work feeling that I made the pt and their families were given complete care.
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. .
in no way do i want this interpreted as sarcasm, but this is so unfortunate, i would think someone needs to step in and do some advocating, for the nurse and the patient.
over the years i have grown used to speaking up for myself, mostly for two occasions as related to the work force 1) when i see someone sitting on their bum while i'm running. no, i don't think i would say 'go and do this', rather, come with me, it's time to do this 2) when i see patients being negleted, nothing gets me more fire, suddenly i have a voice.
Also, having worked both, the roles are vastly different in acute care compared to long term care, mostly because of the amount of ADL's in the nursing home, they are not really sick and need to go about their daily lives, that puts the aide in charge of everything from socks to sneakers to teeth, bed making, tv fixin, you name it. also--this means more patients for the nurse! just a matter of assessing priorities and values of the nurse/aide and formulating a plan of action.
in no way do i want this interpreted as sarcasm, but this is so unfortunate, i would think someone needs to step in and do some advocating, for the nurse and the patient.
over the years i have grown used to speaking up for myself, mostly for two occasions as related to the work force 1) when i see someone sitting on their bum while i'm running. no, i don't think i would say 'go and do this', rather, come with me, it's time to do this 2) when i see patients being negleted, nothing gets me more fire, suddenly i have a voice.
Also, having worked both, the roles are vastly different in acute care compared to long term care, mostly because of the amount of ADL's in the nursing home, they are not really sick and need to go about their daily lives, that puts the aide in charge of everything from socks to sneakers to teeth, bed making, tv fixin, you name it. also--this means more patients for the nurse! just a matter of assessing priorities and values of the nurse/aide and formulating a plan of action.
good thread!
This is frustrating to me, because I have handled heavy loads of patients in LTC, but have not been able to get employment in a hospital because they said that I could not multitask since I have no hospital experience. I have been in the hospitals enough (visiting) to see the kind of things NAs in hospital, and frankly it doesnt look like rocket science to me. I am used to doing "soup to nuts" for my patients (no pun intented!)
Forgive the rant! Any how, I just applied for a cleaning job. Hope they consider me able to adequately multitask for that. Housekeeping is good honest work, and it is good enough for me!
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.
As a CNA myself, I have much more respect for nurses who do not feel that it is below them to wipe behinds, or help in a sticky situation. I am the only aide on my shift, and when it gets messy and overwhelming its nice when a nurse jumps in an helps. I really respect that. After I graduate nursing school, I know it won't be below me, because I know where I came from.
Valuable advice!! I learned that in nursing school from my experiences with some nurses in clinicals (those nurses/nursing instructors who would take you under their wing, let you jump in on procedures, and those BAD nurses who snubbed you because "you're in your last semester and you don't know how to ________!)
I remember(ed) that when I graduated and I strive to treat PCA's and SN's the same as I wanted to be treated when I was in that position. Don't EVER forget where you came from.
Not blasting you at all but what will be left for nurses to do if CNA's or PCA's do nursing skills? Paperwork?? Blech.
Can't get my mind around a CNA pulling a PICC line - I realize it isn't "rocket science" but there is a science to watching for signs of a problem.
steph
I understand your point. Our unit is very "educational" and "hands on" with our techs/PCA's as far as helping with procedures (hence, the word "helping"), but I am not saying that they should be able to do all nursing skills, just a few (and I do understand the complications of pulling
IV's, PICC's). Of course, if even our hospital were to put in-services in place to train our techs, some of them would fight it (they enjoy just doing v/s, baths, linen changes, peri care, etc.). NOW, of course those techs that work for us that are nursing students (which there are several) would jump at the chance to get more experience.
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!!
i cannot imagine any nurse not knowing how to do peri-care! even without the benefit of cna experience, nurses learn this basic skill in nursing school.(at least we did 21 years ago!)
those nurses whom you deem "not knowing how" are probably busy with med orders, treatments, md rounds,etc. i did have the benefit of being a cna before attending nursing school and when i worked ltc i also did my share of peri-care and assisting with position changes and answering call lights. more often than not, however, because i took the extra time to assist cnas( and often then it was expected by the cnas that i offer maore and more of my time), it put me behind in my duties, causing me to clock out late and then get heat from the don for overtime. there is only so much time to get the job done. cnas should not be so judgemental (which is often the case in ltc) of the nurses until they walk a mile (or two or three) in the nurses' shoes.
I cannot imagine ANY nurse NOT knowing how to do peri-care! Even without the benefit of CNA experience, nurses learn this basic skill in nursing school.(At least we did 21 years ago!)
Those nurses whom you deem "not knowing how" are probably busy with med orders, treatments, MD rounds,etc.
learning something in nursing school does not make a person adept. it doesn't take a rocket scientist to see that someone is busy, i wouldn't just leap to the conclusion that 'they don't know how,' i've seen it with my own two eyes. many times (but not always) (and more often in the LTC), the nurses get used to not having to do it because there are always aides to do it. generally everything runs like clockwork (ie. chances are, the patient requesting this or that was probably next on my list anyway) so they are not comfortable jumping in. in fact many of them say, i would have done it myself, but i would have made a bigger mess...most of us good aides who would contribute opinions such as mine know what is going on with our nurses when and what we can do to help them out, they are at the top of my list under direct patient care and they know it. when i do what i can to help get a nurse 'out on time,' they generally return the favor.
:yeah: 
even without the benefit of cna experience, nurses learn this basic skill in nursing school.(at least we did 21 years ago!) 
i did have the benefit of being a cna before attending nursing school and when i worked ltc i also did my share of peri-care and assisting with position changes and answering call lights. more often than not, however, because i took the extra time to assist cnas( and often then it was expected by the cnas that i offer maore and more of my time), it put me behind in my duties, causing me to clock out late and then get heat from the don for overtime. there is only so much time to get the job done. cnas should not be so judgemental (which is often the case in ltc) of the nurses until they walk a mile (or two or three) in the nurses' shoes.
chadash
1,429 Posts
It is a real problem: NAs generally don't have a clue about the nurse's responsibilities. Wish there was a way to inform, but don't know how that could happen.
And, employees that sit around and read magazines instead of working: fire their butts. There are lazy NAs and lazy nurses. We don't need them.