Just wondering if other hospitals are doing this....

[AMD88]

Starting next month in my hospitals we are changing the roles of the RN and UAP. The RN will have 5-6 patients (not uncommon) and will be responsible for all their normal nursing duties of assessing, medicating, and implementing orders but will now be responsible for taking all of their patients vital signs Q4 hours and blood sugars as ordered. The UAP's used to be responsible for the vitals and blood sugars. The UAPs only duties are to provide ADLs, turn patients, and stock the unit. Many of the nurses including myself feel we are already stretched very thin with our normal nursing responsibilities and that taking our own vitals and blood sugars will only stretch us thinner. My question is, are other hospitals adopting this role change and has this worked well or not?

[Esme12, ASN, BSN, RN]

My thoughts exactly...

I'm surprised so many are under the opinion that taking vital signs is considered "assessment". I mean really is taking a blood pressure and a temp accurately rocket science?? You need little more than maybe an hours worth of education on the proper positioning of pt, cuff, etc for accurate blood pressures, thermometer placement, etc. By this logic, why are you ok with downloading vitals that the machine did automatically.....you think the machine "assessed" anything? It's up to the nurse to look at how the vitals trend and determine if the readings make sense clinically. If there is ever a suspicion that something is not accurate, I will recheck it myself. Unless every nurse has access to a dynamap or there is a monitor in the room, it's not a very efficient use of time for the nurses to be waiting on equipment when an aid can get most of the vitals done while the nurses are finishing up report and getting organized for the shift.

Even with automatic assistance in vitals...I always checked a manual B/P on all my patients even in ICU with arterial line to ensure accuracy. I think the UAP can take B/Ps, resps, and temps just fine but the responsibility for them remains squarely on the nurse. If you are making treatment decision based on these number you need to be sure they are accurate.

[Anna Flaxis, BSN, RN]

Even with automatic assistance in vitals...I always checked a manual B/P on all my patients even in ICU with arterial line to ensure accuracy. I think the UAP can take B/Ps, resps, and temps just fine but the responsibility for them remains squarely on the nurse. If you are making treatment decision based on these number you need to be sure they are accurate.

I can see your point of view and mean no disrespect, however I want to point out that physicians make treatment decisions all the time based on vitals that they did not take.

[Despareux]

The UAP's on first and second shift are completely worthless on my floor. I'd rather do it all myself anyway. The only problem we have is not enough equipment to go around; we're always searching for tubing, cuffs, glucometers so we can do our own manual BP and our own glucs. Generally, the only things we need help with is turning, bathing, and oral care as most of our patients are total care.

[CrazierThanYou]

At my hospital, NAs do CBGs and vitals but on certain units, they sent out an email that basically says "We now have more CNAs so we're going to reduce what they do."

Totally makes sense. Or not. So on some floors, we do our own vitals, which I hate only because I keep forgetting them since I'm not used to doing them. On some, the nurses do their own CBGs.

Frankly, there have been many times when the nurses are slammed trying to get everything done while the CNAs are sitting around chatting. I think if its in their scope, they should do it. They can always ask for help. I, in turn, can't ask their help in giving meds, tube feeds, hanging IV bags, packing wounds, etc.

[Rnis, BSN, DNP, APRN, NP]

Our hospital switched to it in november..............and has already switched back. (they also increased patient and CNA loads which hasn't switched back.....) There are a lot of hard feelings all around..... I actually didn't mind the switch all that much but with the additional patients we are all stretched thin....not a very happy place to be.

[VANurse2010]

We have no aids at all. As an RN, I have between 4-6 patients on days/evenings and I do every single thing for them on my shift. Vitals, glucs, meds, washing, turning, feeding, assessments, admissions and discharges, calling docs, calling pharmacy, arranging inter-facility transfers, etc. I also happen to work on a cardiac unit where we monitor our own telemetry, so while I'm doing all those things, I have a pager in my pocket going off q2m on a bad day... And of course the alarms are usually nothing more than artifact, but I dread the day an ignored alarm turns out to be a fatal arrhythmia. We're really between a rock and a hard place here in trying to protect our licenses.

This is so, so, so dangerous. I can't even imagine. I'd be out of there in a nanosecond.