I was suprised...

slinkeecat · Sep 7, 2006

It depends on the hospital. There is a trend to use "tech's" who education-wise are trained at the minimum as a CNA ( certified nursing assistant) and then are trained to various levels by the hospital. and yes they can do per their facility/hospital policy some invasive procedures that were formally only to be done by an LPN or RN. ( like insert foley's into the the bladder ). I think this was hospital/ management/ beancounters way of trying to phase out LPN's at one point. They wanted to put more on the tech's and still pay them the same low wage. They wanted to eliminate the LPN. Which is stoopid!!! I thank my lucky stars that i have LPN's and techs since my world as an RN has become more of a paperwork /computer job and I miss "traditional nursing". I like talking to my patients, caring for them. I am too busy now w/ casemanagement, d/c planning and Assessment and that is time consuming.

AuntieRN · Sep 7, 2006

At my hospital we use techs for a lot of things. Techs have to be at least in their second semester of a nursing program though or trained (like a monitor tech). The techs in the ER do f/c, blood draws, EKGs, D/c IVs, start IVs...etc...but they have to be trained and competent and like I said they have to be nursing students in at least their second semester and each semester they finish they move up the ladder, like me I just graduated but have not taken my boards yet...I am now a tech IV, get pd a dollar less then I will once I get my license and do just about any skill under the direct supervision of an RN.

Gompers, BSN, RN · Sep 7, 2006

Hi all,
So unfortunately, my mother has had some problems and had to be in the hospital for the last six days, and while I was there I noticed how a lot of tasks that I thought the nurse would do was done by other various "techs". For instance, when she had to have an EKG, the EKG tech would give her the test. When she had to go to XRAY a transpoter came and got her. When she needed a blood draw and an IV, or a cath inserted, a "nurse associate" did that for her. I am not trying to say anything negative about the nurses in that hospital, I was just surprised at how much other people did for my mom besides the nurse. So, my question is is it like that now in a lot of places. Do nurses mainly do assesments and meds and paperwork? How much patient contact do nurses really have nowdays?

Sounds pretty normal, yeah.

From what I can see, as a nurse and a patient myself, is that it really depends on both the hospital and the floor/unit. In areas where there is a high nurse to patient ratio, there are more people to help the nurse out. In places like ICUs, though, where the nurse only has 1-2 patients, there is much more patient care and interaction by the nurse.

babynurselsa, RN · Sep 7, 2006

Most facilities that I have worked at things like EKG, lab draws and transportingpatients off the floor (unless an ICU patient) are always done by ancillary staff.

IVs and catheterization are performed by nursing staff.

With nursing ratios being what they are in most places there would not be enough time in a 12 hour shift to every single task for 6-8 patients.

If nursing did things like transports who would be caring for this nurse other patients while she was off the floor? I would venture to guess that your mom's nurse was more involved in her care than you may have realized.

llg, PhD, RN · Sep 7, 2006

Great question. It really does depend on the specific work environment -- even within the same hospital. At my hospital, the NICU has an all RN staff, with a few nursing assistants to help with equipment set-up, supplies, etc. The RN does almost all of the direct hands-on care. However, on our most general med/surg unit, the nursing assistants do a lot more of the hands-on care, such as starting IV's, getting vital signs, hygiene, etc.

This is one aspect to consider when you are choosing a job. As you interview for jobs, be sure to ask about the specific tasks that the nurses do themselves most of the time and what tasks are usually done by assistants.

llg

catlady, BSN, RN · Sep 7, 2006

We have plenty of patient contact. You are seeing that nursing is not just a collection of technical skills, because clearly it doesn't take an RN license to transport a patient or do an EKG (although I've done both). When I have to transport a patient (which seems to be often, despite having CNAs and transport personnel), that's less time I have to do assessments, patient teaching, or planning of care. We are also still passing meds, doing treatments, checking blood sugars and covering them, talking to the doctors, reviewing orders, documenting care, etc. If some of our responsibilities aren't delegated to someone else, then we either have to take a lower patient load (like that's gonna happen) or some things are going to fall through the cracks. Even with help, I still run, run, run all day long.

dreamingofbeing · Sep 7, 2006

I have, at a previous job, been trained to do catheters. The job I am at now I don't do any invasive procedures. My friend works in the same hospital system but at another facility and she does almost everything including IVs and blood draws. She had to have a special class but she can do it. Being almost ready to graduate I would love to have the experience she has had. I have yet to start an IV and she has started hundreds. I guess it all boils down to the facility and how much they want their techs/aides to be responsible for.

vamedic4, EMT-P · Sep 7, 2006

Hi jenni...

First off, let's hope your mom gets out of the hospital and gets well really soon!!!

As a "tech" myself, I pride myself in being able to do the things that a nurse could certainly do if given the time and the right training. We help nurses so they don't have to spend their valuable time on procedures when they could be giving meds or doing assessments.

You will find that the work that can be done by a tech varies by facility, but many can do IVs, blood draws, other labs (urine/poop collection), EKGs, foleys, NG tubes, I/O catheterizations...et cetera. All of these activities free up the nurse to catch up on whatever it is she needs to do. It's usually a big help, especially when working on a busy floor.

Hope your mom gets better soon!!!

vamedic4

Antikigirl, ASN, RN · Sep 7, 2006

We have lots of techs that do various things by training. It is also a way for the hospital to cover liablity by having departments that do certain tasks instead of nurses doing it all. All diagnostic testing/blood draws are done by techs at our facility (we nurses will get urine, bm, and certain culture samples like wound and throat and such). We also have a Nursing team that handles difficult wounds, catheters, ostomies and IV/Picc/Central lines so that continuity and specific implementations/charting are done to the maximum.

But when I hear...does a nurse just do paperwork, meds, and assessments...when you have 5-8 pts...that is NO EASY task in itself!!! Nope, I have to tend or oversee all ADL's, help with PT/OT (lots of follow up work to be done), meals ordering/feeding/education, deal with families, communicate and assist doctors and follow their orders for treatments or stat orders, document like crazy on several different areas of a chart, assessments both general and specific, tube feedings, ostomy care, bathroom issues, double checking and really watching orders so they are written and implemenated within protocols and rules, communicating with MD's when issues arise or there is a change in condition, watch pts who are fall risks or demented/agressive/confused/scared, tend skin issues, dressings, pull out certain tubes, insert certain tubes (like NG, or changing out traches), helping with spiritual and emotional needs, stat meds, routine meds, IV's, as needed meds, coordenating with lab for tests and meds/tx that need to be done before and after, surgery prep and consents/education, Post surgery care, discharges and admissions, coordenating in facility care and out of facility care and communicating with disiplines that assist in that, and anything else that pops up...and believe me, things POP up all the time and need stat care...there is where I come in fast!

So really, a nurse does so much that adding on more is not only not very feasable...but can be dangerous if the nurse is doing too much and say...forgets something or something gets missed. That is why these teams were made, so the nurses could focus on more immediate needs of their patients and supervise the other disiplines and communicate to all healthcare staff. I see it as I am the assumed main gal, and the middle gal, and the end gal in all the care of my patients...and trying to balance that is sometimes like rolling a boulder uphill with all the rules/regulations!

( funny side note: I tell my patients about the paperwork end of the deal, because it is a large part..."if I knew I would be writing so much, I would have taken my chances on being an Author! LOL!". That always gets a giggle, but it is ironic that it is sooooo true. But I will tell you, my paperwork comes last to me if given a patient needs me in that room (I can always stay a little extra to complete my paperwork).

justjenny · Sep 7, 2006

How much patient contact do nurses really have nowdays?

Don't you know? We sit around and eat bon-bons all day :rolleyes:

To echo the above posters...it depends on the unit and the RN to patient ratio. I have been on units where the RN has 7 patients, is hanging blood, giving chemo, and doing all meds, assessments, paperwork, teaching patients and families, more paperwork and is supposed to be able to have time to eat and use the bathroom every now and again...

Perhaps your Moms RN had "sicker" patients on her assignments and your Mom was stable enough to not require quite as much of the RNs time as other patients....?

Jenny

ckben · Sep 7, 2006

I worked until recently on a unit where, despite taking around 5 renal patients, we were lucky to have either an aide or a tech helping us. Some nights we were scrambling just to do the bare minimum, sometimes not passing 9 o'clock meds until 11 or 12. Is this safe nursing? Absolutely not. Were we satisfied having a patient in respiratory distress that we were lucky to check on ever hour because we had other patients who were pulling out dialysis catheters and others who were bedbound with diarrhea stools every 30 minutes?

I say, if the unit your mom was on was lucky enough to have that ancillary staff, then your mom was getting much better care than many other places. It probably meant that the primary nurse was able to check her medications and orders and to care for her patients properly.