Is this reasonable or am I being a newbie?

Specialties Geriatric

Published

Hi-

I am a new grad RN working on a subacute/rehab unit at a LTC facility. Received 2 weeks worth of orientation and have some questions.

I average 18 pts. on the 7-3 shift. I was surprised that the CNA doesn't do vital signs in the am, was told that they are not "certified" (huh?) so it's my responsibility as the RN to get vs. Now, we all know that the majority of the senior population is on some type of cardiac or antihypertensive med, so that means I have to stop at each pts. door, wheel in the machine and take their complete vs, then give meds. First med pass is 8am and the seniors take a lot of meds! This process takes up a chunk of the morning. Oh yes, it's also the RN's responsibility to do blood glucose checks. Between the 8am, 9am, 11am, 12pm and 2pm med passes, I also have wound treatments, charting, follow-ups, etc. to do. At my clinical rotations in the hospital, the CNA or PCA always did vs and bg's. Is this job reasonable or am I just being a newbie? Don't know if I should start looking around for another job after getting some experience. Even my preceptor told me that she's lucky if she takes 10 minutes for lunch and gets to go the bathroom once a day. Thanks for your input!

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From what I hear this is not unusual on LTC. However that does not change the fact that it sucks.

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No, it isn't reasonable! You are getting dumped on. I think it is time to start looking for a new job.

I have the utmost respect for LTC nurses. I just don't know how you guys and gals do it! :heartbeat

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I am a CNA in Indiana, and we do not take vs or glucose...the RN's at our LTC do all of the things you say you are doing and I know on our hall they each have 23 pts. I would say it's probably just a matter of you getting into your routine. We have 2 RNs during the day and either 3 or 4 CNA's and we work our tails off and still don't have any extra time to do some necessities...not that it is your fault, but as a CNA, if you added those 2 things to MY day, I'm leaving!!!...and not because I mind the extra work, but because I am one of those people that don't half-azz anything, and asking us to do more than we already have time to do is absurd. Hire more people!!!! Ok, I'm done hee hee:p

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Hi,

I also just graduated as an RN, and work in a LTC sub acute unit. Basically everything you said about pt load & CNA responsibilities is right on w/ my job, only we do have a wound tx nurse (when he/she is off, then we do the wound care). Also I had about 2 months of orientation.... other than that, it sounds just like your exprience is similar to mine.

Thank you for posting your experience, I was beginning to wonder if other LTC facilities ran differently. As for me, I plan to learn from this experience, "pay my dues", and then specialize in another area.

Good luck!

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Specializes in CNA - starting LPN school January 2009!!.

I'm a CNA in FL. We do VS, but we are not legally allowed to do BG. That falls under a nurses scope of care.

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Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

As a former LTC nurse, I had all of the CNAs get my VS. It was part of their job description. They didn't get BGs though. I fail to understand how they are not "certified" to do that. The main problem is that you are overworked and the CNAs are overworked. I honestly do not understand how LTC staff can get it all done. There is just so much work. I really feel for you.

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If they are true CNA's, they "should" be properly trained in taking VS. I haven't worked in a facility that didn't have the CNA's doing the VS while I did meds., treatments, Accu checks, ect...

I was under the impression that the "C" in CNA, stood for certified. :confused:

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Specializes in no specialty! (have to graduate first!).

At the LTC center in my town, the CNA's do all vital signs. They can do blood glucose tests as long as they have been certified as a phelbotomist. And of course they get paid more because of the two certifications.

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Specializes in progressive care telemetry.

In Ohio the STNA training doesn't include vitals or blood sugar testing and STNA's are what they staff nursing homes with. I took an additional week of what they call PCA training (patient care assistant) (which included vitals and blood sugars) and that is what my hospital required to work on acute care floors.

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Specializes in med/surg/tele/neuro/rehab/corrections.

I was a CNA in long term acute care and our main job (other than cleaning up) was to get VS for the nurses.

Other long term acute care places that I have been in also have a wound care nurse.

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Specializes in LTC.

My nursing assistant staff does my VS unless they're uncertified - it's out of their scope. CNAs don't do BG in LTC, either, at least not in MO.

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