I still don't understand why a hospital would hire cna's, or techs but not lpn's

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Just curious here, the last hospital I worked in was a magnet hospital and they were not hiring any lpn's even for outpatient. They fired their lpn's even the ones who had been there 20 plus years. Now I can get why a hospital would feel that more educated nurses would deliver better patient care but here's what I don't understand: THE CNA"S THERE WERE ALLOWED TO DO ALL KINDS OF THINGS i have never seen cna's do. They did all the vitals, blood sugar checks, Iv removal and catheter removal. They also prepped patients for surgery, even communicated with doctors at times.

I guess there are things about this whole system I don't understand. Who is actually deciding these things? Insurance companies? Other nurses? Doctors? Non medical board of directors? Is it really just a way to cut costs?

Specializes in Hospital Education Coordinator.

THe CNA's do not have a scope of practice in my state. Their work is delegated and supervised by a nurse. The LVN does have a scope of practice, but it does not fit the requirements for our acutely ill patients. They are not allowed to do the full assessment, define the plan of care, formulate the education plan, give blood, give some narcotics and sedatives, draw from central lines ---- Therefore, we have elected not to hire LVNs. They cannot help as much as a good CNA and cost more.

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a CNA communicating with a doctor? Discontinuing foley's and IV's? lolwut

I am a NA d/c IVs and Foleys all the time. I suppose you could argue the insertion, but what is wrong with the d/c?

I suppose it depends on state/country and hospital policy. Never really communicate with a doctor, though, unless they happen to ask something like "What is Mrs X's temperature" if they see me checking it.

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Specializes in Nursing Professional Development.
THe CNA's do not have a scope of practice in my state. Their work is delegated and supervised by a nurse. The LVN does have a scope of practice, but it does not fit the requirements for our acutely ill patients. They are not allowed to do the full assessment, define the plan of care, formulate the education plan, give blood, give some narcotics and sedatives, draw from central lines ---- Therefore, we have elected not to hire LVNs. They cannot help as much as a good CNA and cost more.

That's pretty much the case in my hospital, too. The patient acuity requires the RN to spend a considerable amount of time with each patient -- so it doesn't pay to have an LPN assigned. The RN/CNA combo covers the needs just fine and is cheaper than the RN/LPN combo. Having all 3 is just "messy."

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THe CNA's do not have a scope of practice in my state. Their work is delegated and supervised by a nurse. The LVN does have a scope of practice, but it does not fit the requirements for our acutely ill patients. They are not allowed to do the full assessment, define the plan of care, formulate the education plan, give blood, give some narcotics and sedatives, draw from central lines ---- Therefore, we have elected not to hire LVNs. They cannot help as much as a good CNA and cost more.

How could a LPN "not help as much as a good CNA"? There's nothing that a CNA or tech can do that a LPN can't.

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How could a LPN "not help as much as a good CNA"? There's nothing that a CNA or tech can do that a LPN can't.

At our hospital, they stopped hiring LPNs years ago. They have let some go and have kept a handful that have been there a decade or more and they are utilized just as CNAs. Also, the hospital has a pilot floor that has let go of all their CNAs and has moved to RN total patient care, which is rumored to be going hospital wide.

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At my facility CNA's do all vitals, fingersticks, EKG's, phlebotomy, condom caths, suction trach pts, place/disconnect/troubleshoot telemetry, prep for surgery, and more. Plus all the regular stuff like ADL's, catheter care, emptying foleys, etc. Why hire an LPN for more money? It seems more and more hospitals only want CNA's and nurses with a bachelors; nothing in between like an LPN. Sad, but it seems to be the direction it's headed.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
TheCommuter -

Yikes! New RNs only make $23/hour where you work?

Yes. All of the major hospital systems around here pay new RNs between $22.50 and $25 per hour. A new grad who wants to earn more money must start in LTC, home health or hospice because the hospitals do not pay a whole lot.

I live and work in a very large metropolitan area (Dallas/Fort Worth, Texas) with a lower-than-average cost of living. There are plenty of nursing schools in the area that overproduce more new grads than the local job market can absorb, and as a result, the nurse wages around here are depressed.

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New RNs make less than 20 where I work.

~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~

New grads start @ $30 at my hospital. I guess I just assumed it was about the same everywhere. I'm not sure what the CNAs make, but I'm sure it's not enough. I love our aids! I absolutely could not be a good nurse without them.

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"aides" = auxiliary staff

"aids" = a sexually transmitted immunological disorder

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Specializes in Hospital Education Coordinator.

How can an LVN not help as much as a good CNA? Let me expand. If I have a grid that allows for 5 FTE's I may elect to have 4 RN's and 1 CNA rather than 4 RN's and 1 LVN. I know that the 4 RN's will be able to do EVERYTHING for the patient. I will not have to buddy up with an LVN to do the assessment, hang the blood, draw from the central line, etc. If there are enough patients with a high enough acuity, I may elect to have ALL RN's as the RN can do it all. But the LVN is limited in an acute care setting and if I have an LVN I have to expect that one of the RN's will have to assist with the LVN's patients at some point. In this scenario I prefer 4 RN's and 1 good CNA who will assist me and the other nurses in the tasks that can be delegated. I will not have a break in my time management as I would if I had to help the LVN get some tasks done. Nothing personal but it just creates more work for me if the LVN is on the floor.

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"aides" = auxiliary staff

"aids" = a sexually transmitted immunological disorder

You are correct - thanks for that. :-)

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Specializes in ER, progressive care.
New grads start @ $30 at my hospital. I guess I just assumed it was about the same everywhere. I'm not sure what the CNAs make, but I'm sure it's not enough. I love our aids! I absolutely could not be a good nurse without them.

I think CNAs will NEVER make enough for the amount of work they do. They truly are the backbone of the nursing team and I agree, I, too, could not be a good nurse without them.

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