New piloting of RNs&LPNs roles with CNA's less work

[CynicallyVexed]

I've been in the nursing field for a long time, 5 years as a CNA in a hospital where primary care was the thing RN did meds, assessments, NO LPN's, and CNA's did everything the RN wouldn't do that the RN could delegate, VS, I&O's, BATHES, ect... you get my drift, and now I'm in a different hospital cause ofcourse the last hospital I was at didn't take LPN's in their hospitals and I had to quit. I mean I literally got hired on two months ago, and the first week, I went to my first staff meeting where all the LPNS are mad.... RN's Upset.... CNA's happy....

Here are their Rolls:::

There is going to be more RN's and LPN's on the floor (but we don't have enough computers to cover them) and only 2 CNA's when they usually had 3-4. These rolls described from my nurse manager (which when I was hired on, I was told I would be a med nurse, I would have a CNA doing care of ADL's and an RN I would work with that did assessments and my IVP's and cardiac drips)

CNA's to do walking rounds every 1 hour and do basically candy striper duties and maybe assist them to the bathroom, pass trays, feed if anybody needs help ect. 2 Cna's to 30 patients

LPN's if you had a computer you could do your medication administration if your RN wanted you to. other than that you did wound care, vs, I&O's, bathes, turns, ect. there would be 3-4 LPNS to 30 patients

RN's also to do bathes, vs, I&O's if your LPN couldn't get them, but to do assessments, IVP, cardiac drips. There was 5-6 RN's to 30 patients

TWO Lpn's have quit their job since I started. CNA's think they are too good to take someone to the bathroom, RN's want to sit behind the desk and delegate everything and drink their coffee so who is left with all the work.. LPN.....

When I was a CNA I had 15 patients sometimes 30 on a medsurg floor that was just as critical as this one that VS were done q4hr, q2hr turn and tolieting with skin care, I&O's, bathes, trays, ect.....

I don't understand these changes, but the way I feel about them is that they are trying to **** off all the LPn's into leaving so they don't have to fire them all cause they are fixing to phase out LPN's, although I'm not sure if that's true that they are trying to phase out LPN's but that's how I feel..

I'm glad I'm going back to RN school, but I'm very afraid to work there as a RN now of these things... It's not that I'm not above and beyond to do ADL's and I&O's, but I went to school and there is things I went to school and was trained to do that I want to do and I feel those things are being taken away from me and I'm being told that my cna is better than me that after q1hr rounds she can't come and help me bath somebody or help record a simple PO I&O...

what is nursing coming too.. Sorry this is just a rant... but I want to know if other places are doing this..

BTW this new piloting of their new role descriptions is not working out. Bathes are not being done, I&O's incomplete, more med errors, more patients crashing, more falls, and not to mention we are switching Emar programs and fixing to start computer charting...

[classicdame, MSN, EdD]

seems like patient satsifaction surveys will indicate it is not working.

[heathert_kc]

Sorry to here it isn't working, and that you aren't getting to use all of the skills you learned in school. Honestly I don't hate this idea, I think that nurses ought to be more involved with 'basic' patient care more often. Due to nurse/patient ratios that isn't always possible but it gives an opportunity to be more familiar with the patient's capabilities, establish a better nursing-client relationship, and better assess things like skin. I can certianly imagine the LPNs not liking it and the RN pushing off all of the less desirable tasks.

[Up2nogood RN, RN]

Sounds very confusing! In many facilities RN's are providing most of the patient care. Please don't think just because you'll be an RN that you won't be having to toilet and do vs on your patients. I thought when I was a CNA that the RN's had it pretty good. Haha the joke's on me, I think the CNA's got it REALLY good AND they get to leave on time!

We only get one CNA at night for 24 pts so all that really is done by the CNA for my pts are vs, cbg's, and maybe an occ I & 0 for 1 out of my 5 pts.

On days they only get 2 CNA's and pts rarely get bathed anymore and don't get up and walking like they should at all for post op pts. We have one MD who actually will enter an order to get his pts OOB TID. Duh that should be a given for our post ops. It WASN'T getting done though.

[somedaypeds]

I think what they are trying to do here is to replace the CNA with LPN's in order to put a more skilled person at the bedside. I like this idea, but it sounds like your facility has to work out the kinks in their plan.