LPN working as CNA

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Can an on-call nurse be forced to work as a CNA? My administrator is demanding that the on-call staff (I am part of the on call rotation) fill in as CNA's. This is not about me thinking I'm better than the CNA's, but the fact is, I'm not a CNA and have never worked as a CNA. I don't believe I can physically do the work at least not without a proper orientation period, which isn't being offered. In addition, when I was in nursing school we were discouraged from ever working in an unlicensed capacity once we were licensed.

Has anyone else had to deal with this, and if so, how did you handle it?

Specializes in ICU/ER.

Another thought I have is, if I heard through the grape vine that one my nursing supervisors refused to work as a CNA, my respect for her would plummet. My 1st thought would be "oh is she too good to do CNA work?"

That is just my :twocents:

I really hope you reconsider.

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Specializes in LTC, Medicare visits.

It has happened a few times over 23 years, but I volunteered. One Mothers Day we were so short, I took an assignment with 10 patients and the supervisor took my medcart. We actually had a blast, all my patients got showers that day and the supervisor ( she was 70 and hadnt passed meds in a longtime) said she hadnt had such a good time in a while, by the afternoon the remaining aides split my patients and I did the treatments. We got it all done and it was fun that day.

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As an RN, I've done it on an 11-7 shift. I would love to be able to do it more often, just for the change of pace and hands on care. You see and learn so much more about your residents, families and cna team.

I think I see your point about the safety part of it. CNA work in LTC is back breaking. If you haven't done it in a while..you are out of shape. Honestly...I help out all the time, but doing it for a complete shift....wow. CNAs are just about the strongest bunch of workers I know. Also...Some nurses don't know how to properly lift and transfer residents. Yes....they should know this, but you watch some of them and no wonder they get hurt.

As far as other nurses supervising you in when you work as a CNA...you are still a licensed nurse, so if you mess up...yes, you would be under your LPN or RN licenses. AS a CNA..you would still need to take direction from the supervising nurse. If they tell you so and so needs changed or please do XYZ...yeah..they are the boss that day.

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I agree, I don't see what the confusion is all about. i have worked as an NA on my unit basically because we had the staffing just no CNA. That means I am responsible for the duties of a CNA. As far as acting as an RN- I don't do anything for any patient without the permission of the RN with the assignment.

I say this for a few reasons. You can place both you (NA) and the RN in a compromising situation.

If a patient needs medication I need to inform that patient's nurse. They received report, they know how to care for their patient. I would ask 'do you want me to see if the patient has something ordered? Would you like me to give it?" If so, I do and document it as an RN

It really isn't that big of a deal. Some nurses don't feel comfortable doing that and that's ok too. then just stick with patient care, vital signs etc, all things we were taught in nursing school.

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Specializes in ICU, Psych.
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.

Same here, I really love it when I do more real hands on work and less paper work.

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yes, been there I refused. once u do it, they expect u to do it more often, It's not a good idea,one reason, the cnas eventually demean your authority, when u are working as an lpn. also, if they can get lpns to do it, they won't they very hard to hire more needed cnas. It's not that your better than the cna, but hey,you got your lpn to be an lpn. my don tried the guilt trip w/ me, didn't work. all we lpns met w/ don re this, & no one has been told their working as an cna since!!!!!!!!!

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yes, been there I refused. once u do it, they expect u to do it more often, It's not a good idea,one reason, the cnas eventually demean your authority, when u are working as an lpn. also, if they can get lpns to do it, they won't they very hard to hire more needed cnas. It's not that your better than the cna, but hey,you got your lpn to be an lpn. my don tried the guilt trip w/ me, didn't work. all we lpns met w/ don re this, & no one has been told their working as an cna since!!!!!!!!!

I don't understand why they would want the nurses to take the full NA role for a full shift more often. It costs them more to have the nurse do that than for the NA so they'd be wasting money to put off hiring a NA because the nurses are filling in.

In regard to NAs "demeaning your authority", that's not necessarily the case. In fact, they may be more respectful because they know that you understand just how heavy their workload is.

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Ok, I did it. I worked as a CNA last evening/night with a resident load of 17 due to another unexpected CNA call out. I was also the supervisor on duty. I was able to get everyone changed, toileted and put to bed without any injuries to myself or the residents. I was NOT able to adhere to the turn schedule, and the residents did not get changed q2h. Nor was I able to spend enough time with the residents who required feeding to get them to eat more than a bite or two. The LPN was busy passing her medication and dealing with the behaviors. She simply didn't have time to assist me so we could have "fun" making sure the residents were properly cared for. Add to this the fact that I was still the supervisor on duty and had all those fires to put out too. Most notably, trying to find staff to cover the call outs for the overnight shift, however I was unsuccessful, so I had to stay until 4 a.m. As soon as I got home and got to sleep, I get a call....someone has called out for 7AM, they were already short, I need to come back in. This time to cover for a nurse who called out. Are you kidding me? Can one on call person be expected to cover for the entire facility?

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

Turn off your phone before you go to bed when you really want some sleep.

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Specializes in ICU/ER.

LPN111 it sounds like some staffing changes need to be made your your facility, now that you have 1st hand knowledge of how hard it is to adhere to turn schedules, feeding and toileting, you would be the ideal person to start the ball rolling on those changes...

Gee I wonder why people are calling in???

LTC is hard back breaking work, hats off to you and all who do it!!!!

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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.

That is not quite true.

As long as you hold a license in that state for the RN or the LPN/LVN, you can still work on occasion in the role of the CNA, and yet be able to give meds as you would normally. It is just that the meds are not your primary concern on this date and you have many more patients under your care.

It is only an issue when the person does not hold a valid license in that state and then oversteps what they can do and cannot do. That is another issue all together.

Same way that it is hard for the RN to get hired for an LPN position, and the LPN for the CNA position. Since they are licensed, they are always held to the title that they have earned and are expected to perform under those standards of care of the patient.

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Specializes in LTC, Nursing Management, WCC.
That is not quite true.

As long as you hold a license in that state for the RN or the LPN/LVN, you can still work on occasion in the role of the CNA, and yet be able to give meds as you would normally. It is just that the meds are not your primary concern on this date and you have many more patients under your care.

It is only an issue when the person does not hold a valid license in that state and then oversteps what they can do and cannot do. That is another issue all together.

Same way that it is hard for the RN to get hired for an LPN position, and the LPN for the CNA position. Since they are licensed, they are always held to the title that they have earned and are expected to perform under those standards of care of the patient.

The WI BON has written a statement regarding working at a level below your license. If you are acting as a CNA, than you should stay within the job description. http://drl.wi.gov/boards/nur/pap/pap07.pdf

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