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?
This is the attitude that bugs me. I spent 3 years being an aid, I know how hard it is. I communicate with my PCTs, help them with baths and bedpans and they know I'll do whatever my pt needs if I'm not tied up. I know very well that when a pt says they need to go potty, they really need to go. If I can't get to it, that's because I'm in the middle of something I can't delegate. I'm dealing with something that I have to do.
by "attitude" i guess you mean a bad one! i take it you a) did not get my point and b) did not read all of my post!
you say you help the pct, that's wonderful. as i stated before there are some great nurses out there! if you put your pts first everyday then you are a great nurse. i am refering to the nurses that just use the "i have other things to do" to get out of the cleaning. let's be honest nurses will ALWAYS have something else to do....and as i stated cna's always have something to do, but we must PRIORITIZE...if what you have is a higher priority then i UNDERSTAND! however, if you have to pass a med (not stat, not now) and the cna is tied up for an hour...are you going to have your pt wait for a bedpan for that long? please answer that for me! seriously!
and i had two points...1) toileting IS a nurses job and 2) understand that cna's are extremely busy too (now yes there are alot of cna's that are lazy and do alot of sitting around, but for the ones that actually do their work...there is ALOT to get done! i truly believe that it is impossible for a cna to do ALL pt. care with the workload (cna to pt) the way it is. we have such a high ratio because it was not the intention for the cna to do ALL pt care, but rather to HELP the nurse. and as i stated before nurses LOVE to work with me because i do work my butt off, i always tell them about abnormal v/s (even if a v/s improves, i tell them that), i always ask if they need HELP with anything, i RUN room to room, i am very respectful of the RN title (i KNOW my place, i say yes ma'am, yes sir (and i am older than some nurses) and i NEVER talk back), and they know they can count on me to do my BEST. sadly, my best is not always good enough because of the high pt/cna ratio. i've worked with some great nurses and only ask that if i don't get something done that you understand that it's not because of a lack of trying but because i JUST COULD NOT GET TO IT (just like you said i may be in the middle of something that i can't delegate (because i'm a cna)! toileting one pt is just as important as toileting another...sometimes i have three pt's on the call light asking to go to the restroom,bedpan, bsc. i can only toilet one at a time...and i've had to get pts to the bsc THREE times before i could even get out of the room...SAME PT!!! put them on bsc...take off...hear "i have to go again"...put Back on bsc...take off,clean...hear "i have to go again"..put Back to bed....clean bsc...leave...this took 40 min.......now WHAT if i had three other pts waiting..two with family members and i get to the room 40 min after their loved one hit the call light...they are MAD and don't care and don't understand that i was in another room and why it took 40 min...now the nurse finds out the pt wet themselves and well...who gets dumped on...the cna....and who is to blame?....well if the nurse was truly busy with a HIGHER priority then the answer is the hospital for not staffing appropriately, BUT if the nurse was doing something that was not of a higher priority and just expected the cna to do that type of job then it is the NURSES fault...but the cna still gets blamed.....no one here get this? if the nurse and cna are both free i EXPECT the cna to do it a million times over, but if the cna is BUSY and the nurse is FREE then the nurse SHOULD DO IT!!!
my brother once joked how much more a master plumber such as he makes compared to a nurse.my response;my brother,i am a master plumber 'cause who better to make sure my pt;s "pipes" are working then me,the rn?i have always felt in my 12+ yrs of nursing that every facet of a pt;s life is my problem;albeit most may not be pleasant.from n/v to diarrhea,these are my everyday problems best addressed by the rn who is supposed to know the pt best!
my brother once joked how much more a master plumber such as he makes compared to a nurse.my response;my brother,i am a master plumber 'cause who better to make sure my pt;s "pipes" are working then me,the rn?i have always felt in my 12+ yrs of nursing that every facet of a pt;s life is my problem;albeit most may not be pleasant.from n/v to diarrhea,these are my everyday problems best addressed by the rn who is supposed to know the pt best!
what a great post nurseman99....here is yet another example of the nurse that i want to be!
Specializes in palliative care, medicine, rehab/geri.
Thank you. I totally agree. I work on a med-surg floor nights with only one aide for 20-30+ patients. I very frequently do personal care such as wiping rear ends because the aide can only do so much. I get a good look at the patient's skin that way, too, which is important. And I need to assess their stools, anyway. I've never found that doing hands-on care lessens a patient's confidence in me. If anything, it increases it as they know I'm there to take care of their needs. I have also found that the aides respect me when they see me coming down the hall with arms loaded down with linens saying "so and so GI bleeder needs a clean-up, wanna give me a hand holding them over?" rather than "So and so needs to be cleaned up and you need to do it right now" and then go sit down and kabitz with coworkers. Unfortunately I have some fellow nurses on my floor who seem to think they are above this kind of care, and it causes a lot of tension.
I totally agree! By doing basic patient care, a lot of assessments can be done without being obvious, eg. skin condition, mental status, degree of bed mobility, etc, etc. I agree also that by working side by side with the aides, it also fosters a team unity, where the aides realize that they are an important and vital part of the team and don't feel shafted with all the "dirty" work. I am lucky to work with aides that are great with the patients and I rely on them to let me know if they notice anything unusual about my patients, but I still like to help as much as I can to do my own assessments. Rather than pts. thinking this is odd, I think it develops their trust in me; they know that they can ask me anything. I've never had a patient think that I was an aide--but I HAVE heard pts think an aide was a nurse because they were doing their care!
if the nurse and cna are both free i EXPECT the cna to do it a million times over, but if the cna is BUSY and the nurse is FREE then the nurse SHOULD DO IT!!!
Yes, to answer your questions, soon enough nurses will be so valuable the average healthcare system will ensure to delegate smaller task to people with less educational training. However, that does not make that person any less valuable than you are. The bottom line is the patient, the care that the patient receives should be uppermost. If a patient has soiled themselves even if there is someone else to take care of it, a CNA or assistant, they could be tied up or busy. If you walk in on that situation you should rememdy the situation as quickly as possible. This is where passion for people come in to play. What would you want if it were you or your close family member? In alot of instances, all one has to do is to consider how would you want to be treated in the same situation. A patient knows if you mind helping them or not, and they should never feel as if you have a problem with it, or feel you would rather not. Nursing is not a job or a career, it is a calling! I have changed many soiled diapers, washed hair, clipped toenails, and bathe many adults as a volunteer. No one has to pay me to be humane, compassionate, caring and loving. This is a natural attribute that alot of nurses have automatically and then others develop it later. Be blessed in all that you do and remember, what would you want if it were you?
I think that already that basic hygiene and certain other tasks are the responsibility of CNAs, at least the ones I work with. However, I am not above doing those tasks if I'm with a patient that needs those things ONLY if there's nothing of higher priority (monitoring drip, timed med etc).
The day that a nurse refuses to do a task because she/he's trained for so much more is the day that nurse becomes nothing more than a selfish employee
ita. my thoughts exactly.
a social worker here told her sup that "i didn't get a master's degree to answer phones." ok....?:trout:
this is her first job. went from undergrad to grad. selfish (and childish) indeed.
Specializes in MR Peds, geris, psych, DON,ADON,SSD.
I think that already that basic hygiene and certain other tasks are the responsibility of CNAs, at least the ones I work with. However, I am not above doing those tasks if I'm with a patient that needs those things ONLY if there's nothing of higher priority (monitoring drip, timed med etc).
The day that a nurse refuses to do a task because she/he's trained for so much more is the day that nurse becomes nothing more than a selfish employee
I TOTALLY AGREE!! as an LPN for 9 years and an RN for 13 years believe me I've wiped my share of fannies in my career. I've been a nurse manager, DON, Social Services Designee (wearing a business suit), staff nurse and never, never, never felt it was beneath me to wipe a fanny or serve a meal tray or anything else needed by a patient. In my opinion you can learn so much from patients with that small amount of interaction and you receive so much respect from them because you are available to do the little things. I'M PROUD TO BE A BUTT WIPING NURSE!!!!!!!!
Specializes in MR Peds, geris, psych, DON,ADON,SSD.
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 TOTALLY DISAGREE TO THIS. i feel that the small things like changing briefs let the patients know that we are not ABOVE that and it is totally appreciated. Have been a nurse 22 years!! can wipe butts, change and IV, suction a trach and eat a sandwich all at the same time!!!
I TOTALLY DISAGREE TO THIS. i feel that the small things like changing briefs let the patients know that we are not ABOVE that and it is totally appreciated. Have been a nurse 22 years!! can wipe butts, change and IV, suction a trach and eat a sandwich all at the same time!!!
I TOTALLY DISAGREE TO THIS. i feel that the small things like changing briefs let the patients know that we are not ABOVE that and it is totally appreciated. Have been a nurse 22 years!! can wipe butts, change and IV, suction a trach and eat a sandwich all at the same time!!!
You have set the bar for nursing students. I start school next month and you are the type of nurse I want to become.
I recently told one of the aides I work with that she was just lazy enough to be perfect. She gets all her assigned duties done with an efficiency I can't match, usually with little or no help from me. She does call me when she needs me. When she's all caught up, she gabs with her friends or skims a magazine for a few minutes before starting her next round. This is a welcome contrast to the very few who put down-time ahead of work and act resentful if they have to move, but also to some who are always busy doing something, run, run, run all the time, and never have time to help me when something unexpected arises, like a pt climbing over the bedrails or I need a set of vitals, stat, while I run for metoprolol.
By the way, the aide I "complimented" has a sense of humor, and I think she knows I think she's great.
I do think it's important to be willing to wipe a few butts, etc. I would very rarely make a patient wait until an aide could come. I think it helps relationships with aides a lot, too, if you aren't perceived as someone who thinks he's better than they are. Then, too, I suppose they may see me as one of those nurses who is always busy, run, run run all the time, and never has time to help them. Hmmm.
jb2u, ASN, RN
863 Posts
by "attitude" i guess you mean a bad one! i take it you a) did not get my point and b) did not read all of my post!
you say you help the pct, that's wonderful. as i stated before there are some great nurses out there! if you put your pts first everyday then you are a great nurse. i am refering to the nurses that just use the "i have other things to do" to get out of the cleaning. let's be honest nurses will ALWAYS have something else to do....and as i stated cna's always have something to do, but we must PRIORITIZE...if what you have is a higher priority then i UNDERSTAND! however, if you have to pass a med (not stat, not now) and the cna is tied up for an hour...are you going to have your pt wait for a bedpan for that long? please answer that for me! seriously!
and i had two points...1) toileting IS a nurses job and 2) understand that cna's are extremely busy too (now yes there are alot of cna's that are lazy and do alot of sitting around, but for the ones that actually do their work...there is ALOT to get done! i truly believe that it is impossible for a cna to do ALL pt. care with the workload (cna to pt) the way it is. we have such a high ratio because it was not the intention for the cna to do ALL pt care, but rather to HELP the nurse. and as i stated before nurses LOVE to work with me because i do work my butt off, i always tell them about abnormal v/s (even if a v/s improves, i tell them that), i always ask if they need HELP with anything, i RUN room to room, i am very respectful of the RN title (i KNOW my place, i say yes ma'am, yes sir (and i am older than some nurses) and i NEVER talk back), and they know they can count on me to do my BEST. sadly, my best is not always good enough because of the high pt/cna ratio. i've worked with some great nurses and only ask that if i don't get something done that you understand that it's not because of a lack of trying but because i JUST COULD NOT GET TO IT (just like you said i may be in the middle of something that i can't delegate (because i'm a cna)! toileting one pt is just as important as toileting another...sometimes i have three pt's on the call light asking to go to the restroom,bedpan, bsc. i can only toilet one at a time...and i've had to get pts to the bsc THREE times before i could even get out of the room...SAME PT!!! put them on bsc...take off...hear "i have to go again"...put Back on bsc...take off,clean...hear "i have to go again"..put Back to bed....clean bsc...leave...this took 40 min.......now WHAT if i had three other pts waiting..two with family members and i get to the room 40 min after their loved one hit the call light...they are MAD and don't care and don't understand that i was in another room and why it took 40 min...now the nurse finds out the pt wet themselves and well...who gets dumped on...the cna....and who is to blame?....well if the nurse was truly busy with a HIGHER priority then the answer is the hospital for not staffing appropriately, BUT if the nurse was doing something that was not of a higher priority and just expected the cna to do that type of job then it is the NURSES fault...but the cna still gets blamed.....no one here get this? if the nurse and cna are both free i EXPECT the cna to do it a million times over, but if the cna is BUSY and the nurse is FREE then the nurse SHOULD DO IT!!!