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?
I absolutely agree! When I do have the time to give a bedbath or wash someone's hair, it is a luxury. I actually do enjoy that part of the job, but I have little time for it and only help the aide when needed. It is hard to balance all of the paperwork, meds, assessments, discharges, admissions, etc with the actually hands on care of the patient. Sometimes I feel like I spend so much time on the phone with doctor's, offices, pharmacies, pharmacist, family members that I hate to hear the phone ring at home. I was a nurse aide, then a medical service specialist in an aeromedical evactuation unit in the AF Reserves before I was a nurse. I can see both sides of the issue. It seems to me to be a matter of balance and attitude. I want the NA to know that I am not asking them to do anything I myself would not do if I had the time. If I am asking them to do it, then it is because I don't have the time to do it. Some NA's understand this and some don't. If you don't like your job and you are miserable enough to moan and groan and complain, then leave. Find a job you like. No one is making you stay. That is my attitude. I get really frustrated with NA's and nurses who don't want to do their jobs.
I hate when Nurses think they are too good to clean someone up. If I know my Pt is soiled or my co workers Pt is soiled im gonna clean them up. Im not gonna say oh let me get an aide to help you or I don't do that thats just ignorant. I wouldnt want my family sitting in feces & urine because someone thought they were too good or too educated to clean them up.Let's go back to when nursing fiirst started shall we? Florence Nightengale did everything and her workload was much harder than what we have now. So I think these people need a reality check or a history lesson. Nursing is about holistic care not just what YOU feel you're good enough to do. If you cant clean anyone up or do a little something thats not in your opinion in your Job description, might I suggest you turn in your license.:angryfire
P.S. Im not taking a direct hit at the person who posted this just giving my opinion on the matter :)
This is my first post but I couldnt resist this topic. I am a fairly recent nurse- I graduated about 3 years ago but here are my thoughts. The truth is we as nurses are accepting more and more everyday. Our scope of practice and responsibilities are increasing too. The point is, wiping peoples behids and helping them with ADL'S is part of our responsiblity... we can choose to delegate these tasks to others (lpn's for example) but we shouldnt see ourselves as being above these tasks. I dont think a patient sees us differntly because we just cleaned them up then went to administer meds after. I was always taught that its in these times that you can do a great assessement and really connect with the patient!
my opion on this subject is ,i wouldnt ask any one to do something i wouldnt be willing to do myself, also i believe that patient contact is vital in nursing to develope a theraputic relationship and also enables us trained nurses to fully assess our patients rather than someone else calling us to look at patients lying on a bed behind a curtain to see something we would have noticed if we were giving them the full care we are responsible for!!!!!! sorry but if i was in hospital the last thing i would want was someone telling me to lay still half naked whilst they go get a nurse to veiw my butt or summit.
Patient care is much more than just about what we learn. And no patient of mine has ever doubted my ability because I was able to care for them physically as well as just about every other faction. I think it is insulting to think nursing shouldn't include the physical aspects of patient care. Treat the whole patient with your clinical skills and your compassionate skills. Yes, nurses receive a lot of education but that doesn't put them above wiping a patients butt , ego or tear...just my opinion and observance...
I work in an ICU there are indeed PCTs, and they are hard working and always eager to help with any task. In our unit, the PCTs assist by holding the patient while the nurse does the majority of the cleaning. With most patients in an ICU setting on ventilators and assorted other monitoring devices, they are pretty much immobile. One of the very first things we were taught in nursing school is the dangers of immobility, i.e. pneumonia and skin breakdown. Breakdown happens very quickly, especially when a patient is allowed to remain with urine and feces in contact with his or her skin. Cleaning an incontinent patient is a prime opportunity to assess a patient's skin. And, if you will recall, we were also taught that ASSESSMENT should NOT be delegated.
I should also mention that if a PCT is not readily available to help with any task, the RNs help each other. Although this will be my first job as an RN ~ I am still a PCT until June 12 ~ I must say I've never encountered such teamwork in my life, not even in other hospitals where I did my clinicals during nursing school.
If this particular point of view has already been stated, I apologize. There were so many posts to this thread, I didn't get to them all before I decided to post a reply.
By the way....it's that time of year....congratulations to all the new grads out there! WE DID IT!!!
I am a CNA in a LTC. Teamwork is what makes our facility one of the best around.
On 1st shift we have four CNAs on the floor. This gives us a 10 to 1 patient to CNA ratio. Plus we have a CNA assigned as bath aide and do an average of 10 baths per day excluding Sat./Sun.
Second shift has four aides, no bath aide. The aide does the baths in thier hall or designates which aide will do baths that evening. They average 4 - 5 baths per night.
We have ONE nurse. This nurse can be either an RN or an LPN. The nurse does in room med passes twice per shift, then does various other treatments and then does charting.
Us CNA's do all the waking up, dressing, ADL, cleaning BM's or incontinence, we deal with wide ranges of emotions (depression, confusion), and family members. We take the residents to their meals, watch for irregularities, feed those who can't feed themselves, encourage those who can but don't want to or nod off to sleep at the table, we set their bed up appropriately and then tuck them into bed at night. When we dress and undress the resident we are always on the lookout for skin breakdown and report any signs immediately. We make and strip the beds and put on new linens, take out trash, tidy up the rooms, and take the residents to planned activities and exercise. We take vitals daily. We also do cleaning of the body after a death occurs for family viewing and/or for the funeral home to do pick up.
Most our nurses, whether RN or LPN, will help out willingly with any duty when asked. None of them are above doing anything. We have great communication and give the nurses all the information they need.
I've even witnessed our DON and ADON do butt wiping.
Our nurses always tell us that without the CNAs and they actually say "the quality of CNA's we have" they would be lost.
We have phenominal TEAMWORK at our facility. I'm very proud of where I work and all the people I work with!
But I also know that it isn't that way everywhere.
I worked a busy med/surg/peds floor for 7 yrs before transferring down to ER full time 5 yrs ago. For years, we didn't even have a CNA working with us. We turned, cleaned, disimpacted, changed linens and then cleaned again. That was between giving meds, hanging IVs, restarting IVs, whatever there was to do, we did it. Even when we finally got a CNA, I still did most of my own patient care. I never once thought my education was above this, still don't. Even though we have techs working in the ER with us, if a call light goes off and they need to go to the restroom, I'll unhook them and off we go. If they need a bedpan, I'm there, a diaper change, I'm there, disimpaction, I'm there. I'm a preceptor in the ER, I teach the new nurses coming in not to be too tech/CNA dependent. These CNAs are working off YOUR license. Changing diapers allows me to assess skin conditions, checking stools for blood, etc....
I recently attended an ENA conference and was talking to one of the girls working in the gift shop where we stayed. She told me that she had a CNA license but let it expire, cause she was tired of cleaning behinds all the time. She told me that she was applying to nursing school so she wouldn't have to do that again. I told her that even though she's got an RN behind her name, doesn't mean she won't have to do the dirty jobs. She's rethinking her career move.
My opinion and it's only an opinion is if you don't want to do patient care, maybe management would be the way to go.
I suppose it would be nice to delegate ALL those tasks to CNAs or other staff. The reality is though that when you're busy and it needs to be done, you might as well understand that you will end up doing it from time to time. suffering thing that nursing is for in the firt place. I'm not a nurse but I have cleaned up a messy patient or two even thought iI can't imagine letting a patient lie around in soiled underwear because there's no one around to clean it up. I think it's part of the relieving t "wasn't my job". I felt the patient's dignity and comfort were important enough for me to do it.
You may not be able to imagine a nurse letting someone lie in soiled garments, but it goes on all the time. Most of the time because nurses are given too many tasks and they have to delegate those duties to ancillary staff. I have been nursing for twelve years now, and you cannot be all things to all people nor can you do everything.
I work in a small rural hospital in Northern CA. My facility decided to follow the staffing ratio laws (sort of, since it's relatively toothless). They also decided that the nurses don't need any help (at night particularly). Night shift functions with no ward clerk and 1 aid at the most (average of 35 patients). But most nights it's just me and my pts all by ourselves in the hall.
I don't mind wiping a hiney or two. I don't mind any patient care tasks. If I thought it was "beneath me" to take care of people (and all the icky bits too) then I wouldn't be a nurse.
BUT (and i hope you guys don't beat me too harshly) I DO think that my level of education, training, knowledge, etc... is being used unwisely. Perhaps I'm dealing with an unusual pt population, but my pts (almost uniformly) expect the Nurse (not anyone else) to be their own personal slave. Example: "you're My nurse and you'll do what I tell you when I tell you and no more or less" and "You're just like my little slave for the night, I love this hospital" Both are direct quotes from pts I've cared for within the last month, and not uncommon sentiments.
We have patients (routinely) who refuse to allow any care to be done unless it's done by an RN. Apparently it takes a college degree and critical assessment skills to brush their teeth for them.
I really didn't get all this education to wipe your behind. I did it so I could SAVE your behind!
Please don't misunderstand, I have no problem doing pt care. But I often feel that my ability to care for my pts is compromised by my facilities insistance that nurses are capable of handling all the ancillary staff duties, in addition to their own.
I'm sitting here after a VERY nasty shift and I think I'm the only poster who's said this... but poop should not be My job. Answering call lights should not be my priority. Changing your linens, brushing your teeth, massaging your back, wiping your bottom... I've done these things, and I'll do them again, and I don't think I'm "too good" for it. But I do feel that it's not an appropriate use of my skills and level of knowledge. Not when I've got a full pt load of high acuity fresh post ops. While I'm fluffing your pillows and fetching your 7th cup of coffee I've got pts who need my critical thinking and assessment skills...
Specializes in Medical Surgical & Behavioral Health.
When i read that line, i instantly thought of a local 4 year school who employs a clinical instructor that i've heard say way more than once "Focus on the charting and meds. Baths and ADLs, that's what the aides are for" So thanks to an instructor like that, there might be quite a few nurses that 1) graduate thinking they'll never have to wipe a behind again or 2) get a huge reality check when they get a bedside job.
The 1st thing that we did in our clinicals was ADL's and Hygiene, no way to get around it... my instructor even said that when she was a floor nurse before teaching that she would hope for days when they wouldn't have enough Aides and would have too many Nurses scheduled and she would do nothing but CNA work for her entire shift. She said that it was the best part of her job then because it made the patient feel better about themselves and it was an important part of Holistic Healing. I have to agree with her, I always felt better about myself when I had a positive response from my clients.
I work on a busy floor with 2 LPNs and 2 RN's for a unit that holds 29 beds. I am assigned my case load, and expected to do everything along with making rounds with doctors, administering IV meds for patients that are assigned to LPN's, calling Dr's for orders that arent for my assigned patients etc. We have no support aides on our floors, so the RN has to do her own am care on her patients.
If I do not have time to do AM care in the AM, then I make it my goal to fit it in my 12 hour shift....no matter what.
I had a cardiac pt, who was on strict bedrest, who only wanted someone to shave his face.....so at 1800 I pulled out the electric shaver and did as he asked....I never saw someone smile that much, it was if I had saved his life. The LPN's looked at me like I was crazy..."An RN shaving a patient!" Its basic needs ladies and yes by having my degree does not mean Im lazy!
I really dont know what will happen...phase out LPN's so that the RN's everywhere will be doing all care or the scope of practice for RN's will change so that we dont even touch butts...all I know is that If I want the job done I gotta do it myself.
Hello Everyone,
jlizz69
17 Posts
I absolutely agree! When I do have the time to give a bedbath or wash someone's hair, it is a luxury. I actually do enjoy that part of the job, but I have little time for it and only help the aide when needed. It is hard to balance all of the paperwork, meds, assessments, discharges, admissions, etc with the actually hands on care of the patient. Sometimes I feel like I spend so much time on the phone with doctor's, offices, pharmacies, pharmacist, family members that I hate to hear the phone ring at home. I was a nurse aide, then a medical service specialist in an aeromedical evactuation unit in the AF Reserves before I was a nurse. I can see both sides of the issue. It seems to me to be a matter of balance and attitude. I want the NA to know that I am not asking them to do anything I myself would not do if I had the time. If I am asking them to do it, then it is because I don't have the time to do it. Some NA's understand this and some don't. If you don't like your job and you are miserable enough to moan and groan and complain, then leave. Find a job you like. No one is making you stay. That is my attitude. I get really frustrated with NA's and nurses who don't want to do their jobs.