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New grad, need advice! CNA performing RN tasks

Nurses   (948 Views 11 Comments)
by The Lady Kate The Lady Kate (Member)

5,000 Visitors; 44 Posts

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Hi all! I am a new grad at a large community hospital on a busy med-surg/tele unit with a great manager and mostly great staff. Everything has been going well so far except that a CNA on our floor who also happens to be in nursing school has been performing nursing tasks such as picking up meds for other RNs from the tube stations, taking out foleys, and hanging fluids for nurses. My preceptor has taken it up with her and when the tasks continued, took it up with her manager, who did nothing about it. Other nurses seem to tolerate it, but it makes me uncomfortable. Yesterday I went in to hang a new bag of fluids for my patient only to find that it was already done by this same CNA! I know it seems like a menial task, but it's something that she and I can get in trouble for. I don't want to seem like a snitch for saying something to the manager, any advice? I thought about writing an unusual occurrence report which turns over to risk management, but I'm conflicted about it. Thoughts appreciated!

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CelticGoddess has 6 years experience.

20 Likes; 1 Follower; 11,076 Visitors; 879 Posts

Do you have the option to MIDAS? I have had to midas a CNA for doing nursing tasks (starting IV's, inserting foleys, etc) Even though Midas isn't anonymous, the only people who should know you made the report will be the manager, risk, and possibly your managers boss. IMHO, you need to report this. If your manager won't do anything to stop it, you might need to report up.

If you do have the option to midas (or whatever reporting system you use at your facility) I would do it.

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5,000 Visitors; 44 Posts

I don't think we have MIDAS at my facility, but I will look into it! And yeah, I will definitely say something to the manager at minimum, it's unfortunate nothing has been done sooner :/

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CelticGoddess has 6 years experience.

20 Likes; 1 Follower; 11,076 Visitors; 879 Posts

I don't think we have MIDAS at my facility, but I will look into it! And yeah, I will definitely say something to the manager at minimum, it's unfortunate nothing has been done sooner :/

You should have some form of reporting system. Even if it's corporate compliance. (That is anonymous at our facility, btw) I just prefer midas. It gets handled faster.

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5,000 Visitors; 44 Posts

We have what is called an unusual occurrence report, it's anonymous and goes to risk management.

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Been there,done that has 33 years experience and works as a case manager.

262 Likes; 4 Followers; 68,483 Visitors; 6,203 Posts

Hi all! I am a new grad at a large community hospital on a busy med-surg/tele unit with a great manager and mostly great staff. Everything has been going well so far except that a CNA on our floor who also happens to be in nursing school has been performing nursing tasks such as picking up meds for other RNs from the tube stations, taking out foleys, and hanging fluids for nurses. My preceptor has taken it up with her and when the tasks continued, took it up with her manager, who did nothing about it. Other nurses seem to tolerate it, but it makes me uncomfortable. Yesterday I went in to hang a new bag of fluids for my patient only to find that it was already done by this same CNA! I know it seems like a menial task, but it's something that she and I can get in trouble for. I don't want to seem like a snitch for saying something to the manager, any advice? I thought about writing an unusual occurrence report which turns over to risk management, but I'm conflicted about it. Thoughts appreciated!

Certainly this CNA is working out of her scope. If a CNA "hung a new bag of fluids" it is medication administration. I would have taken down the bag and documented a new one.

As you are still in orientation, any action is up to your preceptor and management.

Best of luck with this mess.

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CountryMomma works as a Full-time Med-Surg RN (Secret Step Down Unit!).

13,052 Visitors; 589 Posts

Be sure you clarify which "infractions" you are reporting are truly out of the CNAs scope. On my floor, some aides are able to remove Foleys and courier meds to/from pharmacy provided they are not narcotic/controlled.

You could also just flatly tell the aide that you aren't comfortable with his/her efforts and that it messes with your duties.

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4 Likes; 23,347 Visitors; 3,726 Posts

At this point I would press my preceptor to both clarify the infractions and demonstrate the process when the infractions continue unimpeded.

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AnnieOaklyRN works as a RN, Paramedic.

3 Likes; 1 Follower; 33,666 Visitors; 2,577 Posts

Personally I would take the CNA aside and ask her not to do RN tasks on your patients. Let her do what else she wants so sshe gets herself in trouble. Also mention that she is risking not being able to get an RN license in the future if she gets caught and it is reported to the BON.

If after you ask this CNA to stop doing RN tasks on your patients, and it continues, assuming your hospital must have a computerized safety reportiing system. Start writing it up in there and I bet it gets attention real fast!!

Hanging fluids may not seem like a big deal, until she accidently fluid overloads someone, hangs the wrong fluid, or her comfort level improves and she starts playing with medications. A patient at my hospital got an entire bag of Heparin in an hour because someone adjusted a beeping pump, and they had a strong suspicion that it was the CNA.

Annie

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5,000 Visitors; 44 Posts

Thanks everyone for your comments! Greatly appreciated [emoji4] just wanting to do the right thing

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crazin01 has 7 years experience and works as a RN.

5 Likes; 4,326 Visitors; 218 Posts

i agree with having a polite but very to the point conversation with this CNA. If nothing changes, then go further up the chain of command. I always respected when a person would come to me in person, versus running to 'tattle', like is so common in nursing. You certainly wouldn't be/haven't been 'tattling'. Thus, I would prefer to calmly approach the person & let them know ABC because XYZ, and that you do not want her assistance as it is completely out of her scope.

Hopefully she doesn't have a chip on her shoulder and respects your feelings/realizes she is in the wrong here. Although she is in school and everybody else lets her and it helps the nurses, still doesn't make it right. Good luck & let everyone know what happens.

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