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?
Families are going to have to pitch in as there is not enough of us to go around.
Have you really seen a family pitch in and help out?? We do not encourage that as a society of nurses, at least not the experience that I have had, possibly because I worked in an ICU setting and therefore physical care of the patient was at all times an ongoing assessment of skin, secretions, etc.
I have had only a few families help out and then of course YOU as the nurse need to know what they did and what they found also so you are all on the same page.
In Europe I know that families help out much more. I am not seeing that trend here in the USA
To me it's a shame that people are going into nursing now with the attitude of "I don't want to wipe butts.". They only want to work with the technical things not the bedside things. I think it's sad that many nurses will go out of their way to avoid wiping up a bm or answering a call light. My dream to become a nurse has always been due to the idea that taking care of someone else is the biggest privlege allowed. I don't know... Maybe I'm just archaic with my thinking and am wrong :stone
I want to be a nurse because I want to do the bedside thing. I have had many AWSOME nurses. they made me want to do for others what they did for me. sounds corney i kno but there you go
To me it's a shame that people are going into nursing now with the attitude of "I don't want to wipe butts.". They only want to work with the technical things not the bedside things. I think it's sad that many nurses will go out of their way to avoid wiping up a bm or answering a call light. My dream to become a nurse has always been due to the idea that taking care of someone else is the biggest privlege allowed. I don't know... Maybe I'm just archaic with my thinking and am wrong :stone
And here is the rub----the techs/CNA whatever you call them ONLY want to do the "tech"work also, like the glucoscans, vital signs, pheblotomy, in/outs etc. They don't want to do the bedbaths, bedpans, comfort care either. So then WHO is doing it????
Keep giving them more "tech" work to do and see what happends
And here is the rub----the techs/CNA whatever you call them ONLY want to do the "tech"work also, like the glucoscans, vital signs, pheblotomy, in/outs etc. They don't want to do the bedbaths, bedpans, comfort care either. So then WHO is doing it????
Keep giving them more "tech" work to do and see what happends
Venous access and in-outs are not done by CNA's...perhaps techs, but not CNAs. And I have never seen a CNA refuse to do personal care for a pt, unless it was one who did not want to work at all.
i have to say, i hope i never, never, NEVER become a nurse that does not do total pt. care! i see how it can happen. no one really likes it, then you graduate and actually have the "option" to tell a cna to do it. does it happen? YES, all the time. i've worked at three different hospitals and one nursing home and boy have i seen it happen!
at my current hospital (magnet status!) it is a tele/renal floor. nurses have 4-5 pt. a piece and cna's have 10 - 14. cna's do v/s q4h, beds, baths , changing, d/c pt.s, lead checks, etc. we do have some great nurses, but we also have our share of those that will walk out of a pt.'s room to find you the cna to say "room so-and-so needs a bedpan."
i graduate in a year and i truly pray that i will never become that nurse. as for now, the only thing that i ask is...i know that nurses are extremely busy passing meds, charting, etc. but please, please understand that i, as a cna, am also extremely busy. if i have 12 pt's and three of them need to use the restroom, two need to be feed, 6 of them have family members wondering when their loved one is going to get a bath, and it is now time for v/s...it can get a bit stressful. you can only toilet one at a time, i've actually had pt's use the restroom(bm) three times before i could even get out of the room. i am not making this up. it is a daily struggle to give great care. and that is what i want to do give GREAT care, but it is hard with out the help and understanding of the nurses! i've went through days like this to have a nurse walk up and say why hasn't room ### been turned yet?
as for the nurses that value and help answer the call light...i say THANK YOU!! we are all part of the same team. for those that run from the call light or tell a pt "i'll get the tech for you" (as if you are doing them a favor)...i ask that you think "what if that was my loved one in there waiting 30 minutes on the tech because he/she is busy in another room" if that doesn't make you go in there and help that pt. then i don't know what will.
It may be my rehab focus, but my duty is to my whole patient, including his/her butt and what comes out of it. RNs are the ones who assess. That task can not be delegated. Unless the techs are going to save bms and urine for my "viewing pleasure" and I'm going to go in and tell my patients to drop their drawers just so I can look at their bums, I think that helping with such things is part of my patient assessment and that skill is a utilization of my education.
Specializes in Happily semi-retired; excited for the whole whammy.
i have to say, i hope i never, never, NEVER become a nurse that does not do total pt. care! i see how it can happen. no one really likes it, then you graduate and actually have the "option" to tell a cna to do it. does it happen? YES, all the time. i've worked at three different hospitals and one nursing home and boy have i seen it happen!
at my current hospital (magnet status!) it is a tele/renal floor. nurses have 4-5 pt. a piece and cna's have 10 - 14. cna's do v/s q4h, beds, baths , changing, d/c pt.s, lead checks, etc. we do have some great nurses, but we also have our share of those that will walk out of a pt.'s room to find you the cna to say "room so-and-so needs a bedpan."
i graduate in a year and i truly pray that i will never become that nurse. as for now, the only thing that i ask is...i know that nurses are extremely busy passing meds, charting, etc. but please, please understand that i, as a cna, am also extremely busy. if i have 12 pt's and three of them need to use the restroom, two need to be feed, 6 of them have family members wondering when their loved one is going to get a bath, and it is now time for v/s...it can get a bit stressful. you can only toilet one at a time, i've actually had pt's use the restroom(bm) three times before i could even get out of the room. i am not making this up. it is a daily struggle to give great care. and that is what i want to do give GREAT care, but it is hard with out the help and understanding of the nurses! i've went through days like this to have a nurse walk up and say why hasn't room ### been turned yet?
as for the nurses that value and help answer the call light...i say THANK YOU!! we are all part of the same team. for those that run from the call light or tell a pt "i'll get the tech for you" (as if you are doing them a favor)...i ask that you think "what if that was my loved one in there waiting 30 minutes on the tech because he/she is busy in another room" if that doesn't make you go in there and help that pt. then i don't know what will.
sincerely,
jay
In my personal experience, nurses don't refuse to jump in and help when the aide is overwhelmed and when the nurse is able to. Sometimes the nurse is overwhelmed, too.
I didn't have time to read all of the replies, so sorry if I repeat.
I think that the bottom wiping and ADL kind of things allow a nurse to use her all of her education in assessing the patients status. How are you ever going to know what C-diff "presents" like if you never clean up a patient with it? What about a GI bleed? A UTI? How about assessing your patients peri-area? Checking for sacral pressure ulcers? Hemmorhiods? (sp?) Assessing their ability to properly clean themselves?
It may be my rehab focus, but my duty is to my whole patient, including his/her butt and what comes out of it. RNs are the ones who assess. That task can not be delegated. Unless the techs are going to save bms and urine for my "viewing pleasure" and I'm going to go in and tell my patients to drop their drawers just so I can look at their bums, I think that helping with such things is part of my patient assessment and that skill is a utilization of my education.
~Jen RN, BSN (with an NP in process)
I think this is great Jen. I don't want you to do my work, if it is because I am not working hard enough, or efficiently enough...guess it is a pride thing. BUT I am so glad there are nurses like you who want to see for themselves, cause, frankly, I just don't have the assessment skills. I try very hard to alert the nurses to concerns, but sometimes I worry about things that don't matter, and then might miss something that does. My experience has helped me to wise up a bit, but it has its limits, and lacks the education to back it up.
So, just saying, I have great admiration for you hands on nurses. You catch stuff that would not get dealt with in a timely manner otherwise. OOORAH!
Venous access and in-outs are not done by CNA's...perhaps techs, but not CNAs. And I have never seen a CNA refuse to do personal care for a pt, unless it was one who did not want to work at all.
What kind of responsibilities do hospital CNAs have? I have worked LTC and home health. I have changed and bathed more folk than you can shake a stick at, have done simple blood sugars, vitals, some dressing changes ( I love wound care!) changed out ostomy bags.....you know, the basics.....I have done intermittent caths in home health, just clean, not sterile....
The question here as I see it isn't "are you willing to wipe butts as a nurse" but do you think that eventually this task will essentially become the primary domain of other health personnel?
As it currently stands, the nurse is ultimately responsible for such patient care and may delegate it to assistants if their facility so provides. It would seem that a major restructuring would have to take place for that to change.
However, as patient complexity and acuity increases and as medical technology advances, nurses are responsible for more and more aspects of care, making it seemingly impossible in some settings to realistically take care of everything he or she is responsible for. Even with assistants, the nurse still must monitor their work. And the nurse still needs to spend time to adequately assess their patients on a regular basis in addition to documenting, prepping, ordering, reviewing, contacting MDs, etc.
Better staffing still seems to me to be best way to provide the best patient care but that means increased costs (at least on paper - I mean it's always hard to account for costs of AVOIDED problems) and organizations will continue to try to tweak the system to lower costs.
I, too, think that families will begin to provide more care to inpatients. Or start hiring their own private assistant to take care of basic needs of inpatients. Not because it's better than a nurse or CNA doing it or because they want to, but because there simply won't be enough staff available to adequately take care of such needs. In too many places, staff is already stretched beyond the ability to provide truly quality care.
I do wonder how the roles of nurses and assistive personnel will continue to develop.
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lee1
754 Posts
Have you really seen a family pitch in and help out?? We do not encourage that as a society of nurses, at least not the experience that I have had, possibly because I worked in an ICU setting and therefore physical care of the patient was at all times an ongoing assessment of skin, secretions, etc.
I have had only a few families help out and then of course YOU as the nurse need to know what they did and what they found also so you are all on the same page.
In Europe I know that families help out much more. I am not seeing that trend here in the USA