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 have been in nursing many years/bedside and mgt. If you go into this field with the expectation, you have too much education and boo-koos of letters after your name and feel too educated or wasting your time too wipe a butt, hold an emis basin, then attempt to picture down the road of life----
would you want the nurse (HCW)taking care of you or your family member have that same attitude----------- sometimes it's not the medicine that does the healing, but the simple basic nursing 101 TLC------------------
No, it does not take letters after a persons name to do the basic care yet, the education comes in the viewing of the patients face and talking with the patient in a more relaxed fashion (you learn sometimes more than you want or need to know) but the skin/access lines/wounds/general overview of the patient----thats the biggest advantage of direct patient care a REAL NUSE, (RN or LPN) can have----any one who can read and write and make a sentence or know how to check boxes on the computer can enter data on a patient
Specializes in Education, Acute, Med/Surg, Tele, etc.
I feel that a CNA is an assistant, and they are trained for ADL's, Transfers, hygeine, and other tasks as part of their duties. So when I am unable, I get 'assistance' from the CNA's to do the duties they are trained to do in order to help me tend to my assigned patients.
If I am able I most certainly do my own CNA work, but with the heavy demand on Nursing time with patients, the continued demand on documentation, the demand of MD's to do their assistance, and general facility demands...one has little or no time anymore to do what the CNA does...and that is why the CNA was made! Someone finally realized that a nurse can't do it all...and therefore found our profession to be worthy of an assistant!
The assistant and I work as a team...when one can't, the other hopefully can and so on..that is what teamwork is all about. I am happy and pleased to have CNA's, and I let them know it each and every day! :)
Caring for patients is part of nursing and so is personal hygiene. CNA's are not trained to assess skin. You learn a lot from turning a patient and cleaning them. Yes, CNA's are needed at the bedside to assist with turning and cleaning, but an RN still needs to be there to assess the pt's condition. I have my MSN and I still clean butts when needed.It provides the opportunity to talk to pt if they are able, assess skin and occiput, listen to lung sounds, rub a back, among others.
Huh??? WHY?????? As long as the hands are washed before the IV's are touched, why would this matter? I have cleaned up incontinent pts and then administered meds or IV's (with hands washed!!) and I seriously doubt their perceptions of me changed because of that.
I'm with you Tazzi......If anything, the patients I have taken care of, have been very appreciative, and HAPPY with me as their nurse(a LVN), that I CARE about them as a person, and would take the time to wipe/clean their hiney's and do all the other things I have to do...ie. IV's, Meds, Wound Care, charting...etc....My nursing instructor always reminded us....What if that was your mother/father..etc...
At the facility I work at the LNA's responsibility is to do help the patients with hygiene, clean the soiled bottoms, answer lights, and sometimes phlebotomy. We are an acute care facility and with so many meds to pass out, and so much to observe and assess, it's really difficult to do those other essential jobs. The problem is, that there are not enough LNA's (they are called PCUTs - Patient Care Unit Techs). With 10-12 patients, there are 2 nurses and 1 PCUT. We have to do what needs to be done. If it's cleaning up a patient, then so be it. I've had to give meds a bit late because I've had to clean up or help clean up a patient. Sometimes I have to stay a bit late to finish my paperwork. Ya gotta do what ya gotta do to get the job done!
I always try to put my patients needs first. I will admit that there are times though, when to a patients family it may look like I'm sitting at the desk doing "nothing", but I may be looking at critical lab values and determining course of action or taking orders from a doctor over the phone, or writing orders so that I can scan them to pharmacy and get an urgent medication.
Sue
i agree that sometimes it appears that the nurse is doing nothing, BUT first of all this nurse is an LPN that has worked at this hospital for 20+ years and is known to be VERY LAZY. the pt's daughter said that she had this nurse before and it was very obvious that she does only exactly what she HAS to. i didn't respond, but i've heard plenty of other staff members comment on this same thing. NOW, SECONDLY.... i know nurses are extremely busy (as i have previously posted), BUT cna's are too! yesterday i was feeding a pt and it took 45 min.(i can't rush the pt and i can't stop before she is done eating) if my pager goes off that someone needs to use the restroom then i need to stop feeding that pt and go assist the other pt to use the restroom. NOW, i think we can all agree that eating is essential to life, but i have to stop and go toilet the other pt...WHY? it's called PRIORITIZING!!! i learned that in my first semester of nursing school. so yes, nurses are busy, cna's are busy, but as a nurse... just like i would rather finish feeding a pt without stopping (i'm sure the pt i'm feeding would appreciate that) i have to stop and reprioritize and go toilet the pt! nurses should do the same....AND I KNOW THEY DO! BUT, some only reprioritize those task that require a license. and that i think is wrong. toileting IS the nurses job and though redressing a wound is extremely important, wouldn't placing a bedpan under a pt because the cna is extremely busy be a higher priority than doing that dressing say 15 min later?
come on..i know there are ALOT of wonderful nurses on this board and some replies have been honest i'm sure....BUT some nurses are lazy and i'm just as sure that some nurses have posted to make themselves feel better about why they did not do what they were suppose to do (take care of their pt..IE: give them a bedpan when they needed it instead of when a cna was free to do it). only YOU know which nurse you are...if you take care of ALL your pt.'s needs then i thank you for paving the way for me so that pts feel secure when i walk into the room and state "i will be your nurse today" they have know dought that i will take care of them......BUT IF you are the other nurse then i say shame on you and i hope that you get fed up and leave the profession (the one that ranks so high in TRUST year after year)!
To me there is a huge difference between a nurse that is willing to help but unable to and a nurse that is unwilling and is able to do so. Simply because her initials behind her name are different then mine. I work with particular individual that refuses to call us by our names she calls us only CNA's. She, in my opinion is one that thinks she is above basic cares. This particular nurse will have to do a skin assesment and stand there and watch us (me or a co-worker) clean a resident up so that she can see the area in question. However, she is quick to point out if I miss a spot but, never does she do any wiping she only hold the wipes so I can reach them easier. I am sure that this is not the normal behavior for most nurses but is still frustrating none the less.
I start the LPN program in August and I am so glad that I had to work as a CNA first. This way I know how vital to a team they are. We are just one person and cannot possibly be in two places at once. That is why teamwork is so crucial in all settings.
CNA training is a requirement to get into enter either of the nursing programs at the school that I attend. I have met many people who refuse to take the CNA course because of the type of work that CNA's do but, they want to be nurses. I personally think is to weed out the ones that are starting the career for the wrong reasons as patient care is everyones responsibilty. I have even had people tell me that once I am a nurse I can leave the dirty jobs to others. I guess I do not see it this way so that is why I get so frustrated by the unwillingness to help if they are able to.
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.
again, you may be one of the great nurses...you seem to be by your post, BUT...come on...change starts with a complaint. a complaint is an expression of dissatisfaction. i love nursing and as a cna/student nurse i consider myself a part of nursing (though i'm not a nurse yet). i complain because i want to see change. i want to see pts taken better care of in all healthcare settings. and nurses that feel that they are too good to toilet or that it is only the cna's job only cause more harm to the pt. there are times when i don't get to turn a pt q2h (risk for pressure ulcer?), don't get to refill water (risk for dehydration?), don't get to check leads right away (oh..pt could be dead?)..etc etc...you get the picture! and if the pt gets a pressure ulcer, dehydrates, dies and no one knows because he was off the monitor....the NURSE risks her/his license (WHY...because it is HER/HIS job to do these things, maybe?), the hospital can get sued (yes they do have a duty to the pt.) and of course the first question will be "where was the cna"...maybe taken care of one of her/his 14 pt.s., but the nurse doesn't know because well she/he paged the cna to check the leads....well that won't hold up in court....WHY?....because (let's say it all together.."it was the NURSES job to take care of the pt).
There's another side to it, tho. I worked in a hospital for over 15 years, in units that didn't use CNA's, so I've always done my own CNA work. If it was a major thing, like a particularly large patient, and I needed help turning, I would ask another nurse - we all helped each other.
I recently started at a LTC skilled facility on the night shift. It's kind of a challenge to me to have 40 patients, but I'm enjoying that part of it.
The problem is that there is only 1 CNA at nite, he's a guy who's been there for a long time. His expectation seems to be that the nurse does 50% of the CNA chores, and apparently the last two nurses have done so, just to avoid his behaving like a jerk.
My first night there, I informed him that he was to make his rounds, do all the ones he could by himself - then to call me when it came time to do those that needed two persons. He refuses to do this - he thinks I need to follow him around. I've observed that when I do spend any time with him, he's in a hurry to get done, so that he can go and sit, while I still have my work to do.
We had a big hassle about it one nite - that and the fact that he has been trying to tell me when to give PRN meds to the confused patients, and generally to be in charge.
There are plenty of things to do at nite, nursing wise, and some of them haven't been getting done, because the nite nurse is too busy following the aide around. Now, I have no problem, when I go in a room, with putting people on bedpans, and cleaning them up by myself, or doing what I can to help them. And there are a lot of them that I do.
He went to the DON and told her that I thought I was 'too good' to do CNA chores, and that I was lazy!! This, after I seldom get a chance to sit or take a break, and him sitting for an hour or more in front of the TV!
Fortunately, the DON knew me from the hospital, and knew how I worked - plus, the other nurses had had pretty much the same problem with him.
Sorry for the long rant - I am just so tired of all this with this guy. The DON told me to 'write him up' the next time he treats me this way, but for heaven's sake. I don't think it ought to be necessary to do things like that with a grown man.
i am so sorry to here about your experience. i agree that there are ALOT of bad cna's out there. one reason why nurses like to work with me is that i know that i am there FOR THE NURSE. as i stated previously, the nurse is there to help the patients and i am there to help the nurse (and yes by doing my job, i do help the pt, but that in and of itself is not my job). that being said everything and i do mean EVERYTHING that a cna does is a nurses job! the cna is there to HELP. i don't mean be in the same room, but to help by doing as much AS THEY CAN! (NOT EVERYTHING THAT DOES NOT REQUIRE A LICENSE!!!)
are there any RN/LPN's out there that understand this? if the pt to cna ratio was lower and i mean alot lower than 1:14 i could understand the cna doing everything, but when it is so high then it is not HUMANLY possible to do it all!
please someone (RN/LPN) tell me that they understand this.
i've said it before i'll say it again..."i know that nurses are extremely busy, but so are cna's" and if they are too busy to get to a pt to give them a bedpan then it IS the NURSES job to do it...not the cna's to do when he/she gets the chance...that pt needs the bedpan now!
let me put it this way....if for whatever reason there were 3 cna's assigned to the floor and none of them showed up.....is everyone really telling me that no baths will be given, pt's will urinate and defecate on themselves, no water passed etc etc etc...because after all this is not the NURSES JOB? somehow i think not! please remember your cna is a valuable asset to the healthcare team there to ASSIST you, please do not abuse them by placing unrealistic expectations to dawn a cape and clean all bodies, behindes, v/s, adl's, feedings, etc..etc..etc..
I was so angered when I saw this Title line. TOTAL PATIENT CARE, as a former tech on the same floor that I am a nurse, I think I work on a unique floor, in which nurses clean up people all the time. Isn't that apart of our compassion, for the healing patient as well? Sure, there are times that I need to delegate those tasks to my techs, but if I ever heard that comment out of a nurse on our floor, I would have to really bite my tongue and then after cooling off I would ask her why she became a nurse? I have friends that say to me all the time, "well now that you're a nurse you don't have to clean up poop, huh?" A.......yeah right, a degree does not rise me above the bedside commode duty to holistically take care of patients!
scrubster
3 Posts
Maythen: What your saying is exactly true for me too!!! Nicely said! And as a new grad sometimes I wonder how I survive through the night.....