LPN working as CNA

JeanineLPN1984 · Mar 17, 2008

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 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?

Wow, that's not good- if they had you do all that. Something is wrong there. It's also sad that the other nurse did'nt help you.

I was on this weekend and we did'nt have enough CNA's either. My unit has 94 residents with 3 nurses and 4 CNA's- we stopped medpass as soon as trays came and each fed a few residents each, so they would'nt eat cold food. This allowed the CNA's less stress, and able to get started with bathing and dressing. During medpass, we toileted the continent ones to prevent falls and still finished the passes. Lunch and dinner was the same but, we had some family members visiting and they helped out too. Here in the South, eating is as important as the meds.

But we all got it done and worked together as a team, and all our residents were safe, happy and no one went to the hospital, including the staff.:wink2:

LVNwannaBE2007 · Mar 18, 2008

i work in a ltc center. the ONLY RN we have is the DON.... the other day i was short staffed on a hall and my DON came in as an aide.....

**btw our management is quick to tell us what needs to be done then do it themselves..... our administrator the other day had the nerve to walk into a patients room... saw they weren't eating.... walk around the whole facility looking for the nurse **walked PAST dietary** to tell the nurse the patient needed the alternate meal**

but back to the original story my DON came in and worked my hall as an aide... she was also one of my nursing school teachers... i have only been a nurse for 5 months .... i was HER boss and it was so weird she wouldnt even sign my no lunch slip that has to be approved by your dept head. but i got to sign hers

lol

suespets · Mar 18, 2008

jjj joy, they have already paid for hiring an lpn,they wouldn't have to pay the benefit package a new hired person gets.In essence, they would be still paying into the lpn benefits as well as the newly hired cna,if they hire 1. also, I already emmensely appreciate all the cnas do, I did it prior to being an lpn(i think I'd appreciate it if I hadn't been a cna!)

Hospice Nurse LPN, BSN, RN · Mar 18, 2008

I have worked, on occasion, as a CNA and LOVED it! I was able to spend more time with the residents, was able to take my lunch break without being interrupted, got two other scheduled breaks, and got out of the facility on time. I was paid my regular hourly rate.

jjjoy, LPN · Mar 18, 2008

jjj joy, they have already paid for hiring an lpn,they wouldn't have to pay the benefit package a new hired person gets.In essence, they would be still paying into the lpn benefits as well as the newly hired cna,if they hire 1. also, I already emmensely appreciate all the cnas do, I did it prior to being an lpn(i think I'd appreciate it if I hadn't been a cna!)

I see your point. It's still penny-wise, pound foolish, though, isn't it? Every day the nurse works as an aide, they are still having to pay for a nurse and that's one less day that employee can work for the facility as a nurse. It makes sense to ask a nurse to fill in if it's just once in a while, if there's not enough demand to justify another employee.

If it is seriously just as cost effective to have the nurses work as aides as to hire new aides, then I suppose there's nothing really wrong with it... as long as they make it clear that part of the nurse's job description is to take the aide role..., oh, and allow for the fact that if you're not doing that everyday, you're not going to be as quick at it... AS IF administration ever allows for that!!!

And I do think that's a big part of the problem. Why wouldn't a nurse just enjoy getting paid the same rate for "less responsibility"? Because the aides have heavy workloads as well and the nurses don't want to do that even when they're getting paid more than the people who usually do it. In LTC, you've got to go-go-go, no time to stop and think, to just barely get everything minimally done, and changing to a new role means you'll be slower at the new role as well as lose your momentum in the other role. So it's a real pain to change roles. At least, that's why I wouldn't want to do it.

ChanceORiley27 · Mar 27, 2008

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.

I completely agree. If you are on-call you should be able to perform anything that might be necessary. I'm an LPN and several times I have done aide work when we are short. No, it's not easy as I was never an aide, but all nurses should be able to perform the jobs of those they supervise. And when I call the on-call person I expect them to come in if we are short no matter who called in.

ChanceORiley27 · Mar 27, 2008

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?

There should be a limit to how much coverage you can provide. No one can be every where at once, and other managers should be helping cover if you've already covered and haven't had hardly any sleep. But, doing aide work gives nurses and insight as to how hard it is. Once you work nights and have to get up a resident yourself you cut your aides a little slack when once in a while they can only get up five out of the six residents they're assigned to.

bcollins61 · Mar 29, 2008

I am an LPN. I graduated in 2006. Before I become an LPN I worked as a nurses aid then a CNA for 30 years and at age 46 I finaly became a nurse. I just started a new job at a LTC facility as an LPN Charge Nurse. But I am orienting as a CNA for three weeks , because for one they are short CNA's and also it will help me to get to know the residents needs and personalities. I think it is the best way to start a new job ,so when I take the cart to pass meds , I will Know who, what and how to administer meds and treatments .As far as the pay I am getting LPN wages. Where I am a new nurse my biggest prob is all the papper work, I have such a difficult time remembering how and what to write. so many forms !!!!!!! and doctors orders . and I am totally affraid to have to talk to a doctor . But I guess in time as a nurse I will get use to it . Sometimes the Doctors can be a little or a lot snappy . to end with I love working with the residents one on one . No matter whether you are an LPN ,RN, or a CNA the resident or patient care is all our jobs.

Pipsqueak, ADN · Mar 30, 2008

I have refused to do it when I was sent to a LTC facility thru my agency. Not because I didn't want to do the work and not because I "didn't know how" to. I can and often do perform duties that are regularly assigned to the CNA's. Yes I can do the job, but the bottom line is I have never worked as a CNA before and I know for a fact that I could never be as effective or manage my time in a manner to provide the appropriate care to ALL the residents in that 8 hr shift.....at least not without practice. So I politely declined as I felt the residents deserved someone more efficient.

bcollins61 · Mar 30, 2008

My post earlier today was not ment to offend anyone!!!!! but if someone took it that way i am sorry but I did go back and read my post again and I dont think it was critical at all . I was just talking about myself and my prefrence.

suespets · Mar 30, 2008

not sure why you feel offended. there is nothing snarky in your blog .sue

MentalRn · Mar 30, 2008

I have filled in as a CNA/PCT several times when they can't find someone to do the job, and I don't mind. It pays the same.