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 Med-Surg, NICU.

I can't believe you are shocked that aides can take vitals, blood sugars or remove foley catheters. These are basic things that shouldn't require a license at all. If aides couldn't do these things, then what use would we be? I work at one facility that allows aides to do straight caths and foley insertions (I was shocked by this) and I work at another that allows blood draws.

The only thing that shocks me is IV removals. I disagree with that completely. And prepping for surgery...how? And what are they talking about in terms of communicating with doctors?

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Specializes in Med-Surg, NICU.

Also, I can see why LPNs are being removed from the nursing model. I would hate to work on a floor as aid working with both LPNs and RNs. I would get too confused as to who I should answer to and would probably go the RN at all times. LPNs are, more or less, the "middle men" in the nursing model. I know I am going to get flamed for this, but it is true. Business-wise, it is smarter to pay the CNAs a few dollars more and delegate slightly more responsibility or hire an RN who can fulfill all nursing responsibilities than to pay LPNs 18 or more bucks who can only do so much.

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I can't believe you are shocked that aides can take vitals, blood sugars or remove foley catheters. These are basic things that shouldn't require a license at all. If aides couldn't do these things, then what use would we be? I work at one facility that allows aides to do straight caths and foley insertions (I was shocked by this) and I work at another that allows blood draws.

The only thing that shocks me is IV removals. I disagree with that completely. And prepping for surgery...how? And what are they talking about in terms of communicating with doctors?

They could attend to the hands on care and ADLs that get so sorely overlooked in the hospital. Aides in the hospital are so focused on checking vitals and glucoscans, they have little time for traditional CNA duties. So many of my LTC residents return from the hospital deconditioned and with pressure ulcers because no one got them out of bed. Yes, yes, I know you turned him q 2 hours. But turning only does so much. People need to get out of bed! Even if a hoyer is required! And plopping a tray in front of a 90 year old NH resident and walking away is a joke.

There should be a class of workers in acute care who are solely dedicated to bedside, CNAish care. Throwing all these other duties on them and calling them "techs" is ridiculous.

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Also, I can see why LPNs are being removed from the nursing model. I would hate to work on a floor as aid working with both LPNs and RNs. I would get too confused as to who I should answer to and would probably go the RN at all times. LPNs are, more or less, the "middle men" in the nursing model. I know I am going to get flamed for this, but it is true. Business-wise, it is smarter to pay the CNAs a few dollars more and delegate slightly more responsibility or hire an RN who can fulfill all nursing responsibilities than to pay LPNs 18 or more bucks who can only do so much.

Oh come on.

If LPNs were to be utilized to their full extent, you could run a med surg floor with mostly LPNs and a few RNs to supervise. In many states LPNs push IV meds. Virtually all the tasks of a med surg floor can be safely and legally performed by a LPN. If a RN was freed of all the "tasky" stuff and was able to focus solely on assessments and care management, he could take a much larger pt load.

I see a lot of RNs talk about their professional role and how they want to be seen as professionals. But when the conversation turns to the possibility that they might have to be responsible for care given by LPNs they squawk like a bunch of hens.

Newsflash: accepting responsibility for the work of those under you is a huge part of being a professional.

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Specializes in Med-Surg, NICU.
They could attend to the hands on care and ADLs that get so sorely overlooked in the hospital. Aides in the hospital are so focused on checking vitals and glucoscans, they have little time for traditional CNA duties. So many of my LTC residents return from the hospital deconditioned and with pressure ulcers because no one got them out of bed. Yes, yes, I know you turned him q 2 hours. But turning only does so much. People need to get out of bed! Even if a hoyer is required! And plopping a tray in front of a 90 year old NH resident and walking away is a joke.

There should be a class of workers in acute care who are solely dedicated to bedside, CNAish care. Throwing all these other duties on them and calling them "techs" is ridiculous.

I get what you are saying, but you have to look at healthcare for it is: a business (sadly). Cost-wise, it is much more effective to hire more unlicensed workers and a few RNs than to hire LPNs who can't fulfill all the duties that an RN does. Also, as an aide, I would hate to have to answer to two bosses instead of one and would end up going straight to the RN. I've worked at multiple facilities and find that the system is much smoother with less players, for lack of better word.

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Specializes in Med-Surg, NICU.
Oh come on.

If LPNs were to be utilized to their full extent, you could run a med surg floor with mostly LPNs and a few RNs to supervise. In many states LPNs push IV meds. Virtually all the tasks of a med surg floor can be safely and legally performed by a LPN. If a RN was freed of all the "tasky" stuff and was able to focus solely on assessments and care management, he could take a much larger pt load.

I see a lot of RNs talk about their professional role and how they want to be seen as professionals. But when the conversation turns to the possibility that they might have to be responsible for care given by LPNs they squawk like a bunch of hens.

Newsflash: accepting responsibility for the work of those under you is a huge part of being a professional.

I believe this post:

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.

...answers yours eloquently. I'm sorry. I have nothing against LPNs, but there is a reason that fewer and fewer places are hiring them.

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Specializes in Emergency.
I can't believe you are shocked that aides can take vitals blood sugars or remove foley catheters. These are basic things that shouldn't require a license at all. If aides couldn't do these things, then what use would we be? [/quote']

The NAs where I work do none of these things, and I don't know what we would do without them! Basic patient care, restocking, ambulating and toileting patients, monitoring ins and outs, chest compressions during codes and basically supporting RNs in everything we do, they are invaluable and some of the busiest people on the unit without having to do my straight caths and chemstrips.

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It's all about the Dough Re Mi!

As others have stated, make the CNA do the ''unskilled labor'' Make the RN do the rest. LPN will cost more without the full capabilities of the RN. You could kick CNA's out of the equation but this brings me back to the Dough Re Mi!

Less hands in the medication drawers is probably a good thing too...

Im a CNA, I talked to a Doctor once....

I even shook a Doctors hand once, didn't wash my hand for a month

:specs:

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Specializes in Pedi.
This is probably a massive overgeneralization, but it seems like the west is very BSN-exclusive, while the eastern states tend to be more accepting of ADNs.

What eastern states are these? I live in the Northeast and it is very BSN-centric up here.

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Midwest seems to have a lot of ADNs. Even so most hospital are pushing for their RNs to get their BSNs or look for other employment.

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I see a lot of posts regarding efficiency and money, but I always thought it had to do with magnet status. That is that 80% of nurses would need to have a BSN or higher. So then 20% would be LPN/LVN or ADN level nurses. I know the hospital which I am a tech for currently, will hire ADN nurses but they must sign a contract to obtain their BSN within a set amount of time. They have NO LPN's or LVN's on staff.

In my facility you can be a nursing student who has completed fundamentals or a CNA. I am a nursing student and a PCT (I also have my CNA), and the way hospitals use CNA's is training them as a PCT, the PCT does not transfer, but is facility specific. So they have more leeway in that regard.

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I believe this post:

...answers yours eloquently. I'm sorry. I have nothing against LPNs, but there is a reason that fewer and fewer places are hiring them.

That's okay. I understand your point. To incorporate LPNs into the current acute care model would be.... unwidely at best.

But I still think a return to a "team nursing" model would have it's virtues. I think the main reason RNs don't support the idea of team nursing is due to the thought of having to take a larger pt load in a supervisory capacity. That's understandable.

But this insistence of the RN in staying primarily in a floor nurse role must play a large role in keeping the "prestige" and pay well below that of "true professionals. Physical therapists and pharmacists abandoned the bulk of the routine "tasky" work to licensed paraprofessionals long ago. This delegation has directly contributed to their rise in education, prestige and pay. RNs have a pool of licensed paraprofessionals in the form of LPNs. But they seem reluctant to use them.

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