LPN working as CNA

S.N. Visit, BSN, RN · Mar 15, 2008

I am an RN and I fill in on call for CNA's when needed. CNA duties are ultimately the nurses resposibility, so yes we do have this situation as well. I don't mind, I get paid the same RN wages.

racing-mom4, BSN, RN · Mar 15, 2008

I am an RN and have picked up CNA hours our on the Med Surge floor, as well as ward clerk hours, sometimes by my choice and sometimes because a CNA called in and the only staff we could get to pick up the phone was a nurse.

I dont mind doing CNA hours, in fact it is actually kind of a nice break. "Your hurting and need pain medicine--let me get your nurse for you" I still get paid nursing pay and I have minimal to zero charting!!!! I can spend time with the patients and make their stay more comfortable and the nurse assigned to them knows their patients are really getting pampered which makes a happier patient, so her day is easier too.

At least a few times a week there is an RN doing CNA hours.

As far as properly being trained, I think your RN training qualifies you for CNA duties.

Flames9_RN, BSN, RN, EMT-B · Mar 15, 2008

So if ur doing CNA duties, one can only do up to the level of a CNA, correct? Even though your a RN? Thus no dispensing of meds or other RN duties?? Yes, Im a RN student,lol

S.N. Visit, BSN, RN · Mar 15, 2008

So if ur doing CNA duties, one can only do up to the level of a CNA, correct? Even though your a RN? Thus no dispensing of meds or other RN duties?? Yes, Im a RN student,lol

When I'm filling in for a CNA, I can and do provide my RN duties and dispense PRN meds. It lessens the workload for the nurses and the patients don't have to wait for nsg cares .

catlynLPN · Mar 15, 2008

I've filled in once as a CNA. The RN's have filled in alot, in my LTC.

They don't usually pass meds or anything of that nature, but I love having them on the floor when I'm working, cause I know the people are well turned and the lights are answered immediately, and they are observant in any issues with the patient, such as skin, etc, and report anything they find, so we can get right on it.

Things just go different when a nurse, RN or LPN has to fill in.

caliotter3 · Mar 15, 2008

If you are working in a CNA capacity, then you should only be doing CNA duties. But you are held to the professional standards of your higher license. That means that when you observe something that should be reported to the nurse for intervention, that you just can't ignore it without jeopardizing your license. That is why people are discouraged from this practice in nursing school. A CNA who was dispensing meds at the direction of her charge nurse who was a "nurse" in her native country was immediately fired when a family member complained when they saw her doing this. The nurse who asked her to do this was also fired. The CNA had not passed licensing boards in the US and thus, not able to practice as a nurse. No nursing student should be doing RN duties unless they are in a student clinical situation and under the supervision of their clinical instructor. This is not to say that in many such situations, the nurse who is working as a CNA is not also doing other duties as well. Facility mgmt will look in the other direction as long as the work gets done and there are no complaints. In the facility where the CNA got caught passing meds, it had been a well known fact for years, that this was going on. She only got fired because a family member complained. I've worked as a CNA, while licensed. I only did CNA work (there was plenty enough of that) and provided input to the nurses. They didn't ask me to do nurse's work since I wasn't being paid as a nurse. Once I started getting paid as a nurse at this facility, I took on the duties of a nurse. I wouldn't do this again.

PsychNurseWannaBe, BSN, RN · Mar 15, 2008

If you are working in a CNA capacity, then you should only be doing CNA duties. But you are held to the professional standards of your higher license.

Yep...that is why I won't do it. Too many legal and ethical implications. While acting as a CNA you have to stay within the job duties of the CNA put still perform at a higher standard. I would be too confused.

TheCommuter, BSN, RN · Mar 15, 2008

I'm not a CNA and have never worked as a CNA.

This might be true, but all licensed nurses are expected to be able to do the tasks that a CNA can do. It's called the basics of nursing care. Therefore, the on-call nurse should be able to fill in and work as a CNA during times of short-staffing.

The DON (director of nurses) and ADON (assistant director of nurses) at my former workplace had to come in on their days off and work as CNAs last weekend, because two of our CNAs simply walked off the job without notice. These nurse managers had never worked as aides, but they were able to accomplish the tasks in a somewhat satisfactory manner.

racing-mom4, BSN, RN · Mar 15, 2008

So if ur doing CNA duties, one can only do up to the level of a CNA, correct? Even though your a RN? Thus no dispensing of meds or other RN duties?? Yes, Im a RN student,lol

I can and will pass meds if I have time and the assigned nurse is busy in another room. On the med surge floor the nurses hold the key to the med room, so if I have time and want to get the patient in 412 a Tylenol, I have to go to the assisgned nurse to get the key so I let her know that I am giving it, then I do mark it off on the MARS.

I dont see the confusion others are having with the duties assigned to the CNA not being in the scope of nursing. I am an RN, who happens that day to be helping out as a CNA. I am held to my nursing standards. As an RN I am able to also give the meds, and that includes properly charting that I gave the meds and for what reason. There is nothing a CNA does that an RN is not allowed to do.When I am working that day as a CNA I still sign RN behind my name on the kardex as that what my license says I am. :nurse:

Personally I LOVE having an RN work as a CNA with me, and I am sure the other RNs love me working as their CNA that day too. It really is more like team nursing. As long as the assisgned nurse is clear that I am taking on the CNA role that day and not to think I am just going to take over half her load, all is well.

LPN01112005 · Mar 15, 2008

To be clear, I have worked in the hospital med surg unit. We were "total care", there were no CNA's, so the nurses did work as a team to provide all the care necessary to care for the patients. However, what I'm referring to here is a LTC setting where there are two LPN's and 5 CNA's assigned to 66 residents, 90% if whom are totally dependent with ADL's. The LPN's pass meds and assess the residents. The CNA's do all the ADL's, turning, toileting, incontinent care, feeding. So, although I have the skills necessary to "know how" to do the job, that doesn't necessarily mean that I can be effective or safe in a job I've never done before. To be clear, this is not about me not wanting to change incontinent briefs. I help out with that on a near daily basis even though I am in an administrative position. My concern comes with the transferring, bathing, etc. of immobile residents. I don't feel comfortable being thrown into a situation that has the potential to be harmful to me and to the resident. Ultimately, I am responsible for any assignment I accept, so I'm probably not going to be accepting this "assignment" out of fear that I'll jeopardize the resident and in turn, my license.

Another thing, what about being forced into a subordinate position to those nurses that I supervise on a daily basis? Exactly who is the supervisior? Are they without one? How do I take on the role of nursing assistant to a nurse that I am actually supervisor to?

racing-mom4, BSN, RN · Mar 15, 2008

To be clear, I have worked in the hospital med surg unit. We were "total care", there were no CNA's, so the nurses did work as a team to provide all the care necessary to care for the patients. However, what I'm referring to here is a LTC setting where there are two LPN's and 5 CNA's assigned to 66 residents, 90% if whom are totally dependent with ADL's. The LPN's pass meds and assess the residents. The CNA's do all the ADL's, turning, toileting, incontinent care, feeding. So, although I have the skills necessary to "know how" to do the job, that doesn't necessarily mean that I can be effective or safe in a job I've never done before. To be clear, this is not about me not wanting to change incontinent briefs. I help out with that on a near daily basis even though I am in an administrative position. My concern comes with the transferring, bathing, etc. of immobile residents. I don't feel comfortable being thrown into a situation that has the potential to be harmful to me and to the resident. Ultimately, I am responsible for any assignment I accept, so I'm probably not going to be accepting this "assignment" out of fear that I'll jeopardize the resident and in turn, my license.
Another thing, what about being forced into a subordinate position to those nurses that I supervise on a daily basis? Exactly who is the supervisior? Are they without one? How do I take on the role of nursing assistant to a nurse that I am actually supervisor to?

I guess I just dont get it, do you not think you can transfer a patient safely to the bathroom? Safe transferring is part of basic nursing skills, bathing is also part of basic nursing care, so you must be skilled in this area, so you would be fine working in that role.

As far as supervising, if you were there working as a CNA, you would not be the supervisor per say. Iam assuming someone else would be taking on the role of "supervisor" during that shift. Or their would be no supervisor that shift, many times our "supervisor" is not on the unit, but we have a house supervisor that we can utilize. FYI our nursing mgr many of times has taken on the CNA role if a CNA called in.

In my opinion it sounds to me like you dont want to be one of 5 CNAs taking care of 66 patients. I would not either, but what a wonderful opportunity it would be for you as a supervisor to see how challenging the CNAs role is in your facility. Maybe if you take on this challenge you as a supervisor can implement some much needed changes, and you will have 1st hand experience to draw from.

Also---I cant help but think your subordinate nursing staff would have an increased respect for you to take on this challenging role.

I think it would be a wonderful opportunity for you.