No More Fingersticks for Techs!!

Nurses General Nursing

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Is this happening where you all are? I live/work in New York City and work in a city hospital, and in the past few months, the BON sent a mandate stating that techs, CNAs, PCAs, etc...can no longer do fingersticks...this is designated only to licensed personnel; LPNs and RNs. Now, I am hearing from other RNs working in private industry that they are still allowing their techs to do this. Last year, they just upgraded many of our CNAs to Patient Care Associates, which was supposed to include this skill, but, now, they are not allowed to.

In addition, it causes more stress to the nurses, especially in our prenatal diabetic clinic, diabetes, endocrine and medical clinics because there are more PCAs than there are nurses. Now, I can be backed up with 8 charts, trying to push them out, and then, here comes the page: "Fingerstick in room 10" and this can go on for awhile! I emailed the BON and straight from the horse's mouth, it was told that we can no longer allow them to do so. I suspect that a mistake was made, or something was probably not reported to the nurses which had determental affects on the continuity of care. I was just curious to know if any of you are confronted with this as well.

Wow.. What is the rationale for this? We don't have a tech so the nurses LPN and RN must do. The CNA are not permitted to do this .

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my hospital sucks. RNs have to do a lot.. enemas, fingersticks, foleys, etc. The hospital next door makes their CNAs do all of that

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If you like , you may go work for the hospital next door. :specs:

my hospital sucks. RNs have to do a lot.. enemas, fingersticks, foleys, etc. The hospital next door makes their CNAs do all of that
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Specializes in Community Health, Med-Surg, Home Health.
Yeah. Those puny LPNs can do the grunt work. They aren't as good as RNs now, are they? You need to get your head out of the clouds. One day your LPN or CNA is going to catch something you missed and you're going to be be embarassed.

I am an LPN. Never tried to disrespect any title. In terms of teamwork, have always done that. CNAs have looked out for me, I have looked out for them and RNs. Maybe you didn't read my logo or all of my posts.

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Specializes in Community Health, Med-Surg, Home Health.
Seriously, you're being a little sensitive here, IMO. I don't think anyone is putting LPN's or CNA's down (not in the post you're referring to, at any rate, I haven't read them ALL in detail). The OP's point is that the RN has responsibilities that the LPN and CNA cannot do, so why give them TASKS that the LPN and CNA's CAN do, skill-wise? It is NOT a difficult skill, I'm sorry, it's not. It's not like they need to interpret the results, if they put the drop of blood on the strip on the machine and then the machine says "100," that's what it says. It's the RN (or LPN) that then executes what needs to be done with that reading (give insulin or not).

On a sidenote, I don't agree with the RN resticking them, either......I honestly don't believe, with the machines we have nowadays, that a result that's that far out of normal parameters is generally the result of user error. The machines tend to prevent that. If not enough blood is used, for example, it won't give a reading (whereas older machines might read low if the sample was too small). As I posted earlier, our CNA's go through a competency, and get checked off on the skill just the same as RN's and LPN's do. It is a TASK and can be delegated; the RN/LPN takes the appropriate action with the result.

BTW, unless something changed (and if it did, pagandeva, my apologies).......Steve, you just made your post TO an LPN. That's why I think you're being too sensitive and reading in to the post too much.

I had to laugh, because yes, I AM an LPN...one that is a team player. I feel the same as you, it is nothing wrong with assigning LPNs and CNAs to do the more mundane skills so that the RN can pay attention to the more skilled responsibilities and assessments. We can work like a well oiled machine if allowed. For sure, this person has misread my entire point. Thanks for the support...:D

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Specializes in Community Health, Med-Surg, Home Health.
OK, after I hit post, I had to go check the profile just to make sure. I wasn't trying to be mean or start a fight, hope it didn't sound that way. But yet, pagan is an LPN (and a DANG good one, from reading her posts here, if I may say so). So Steve, your anger is misdirected.

:twocents:

Your compliment is greatly appreciated...believe me! :D

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I live in Georgia and work as a tech at a hospital. We (CNAs) still do fingersticks where I work.

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Specializes in Cardiac.

Our multicare techs do fingerstick accuchecks. They scan the armband and scan their namebadge. The results are immediately downloaded into the computer when the machine is placed in the holder. We do have a board that the techs write the accucheck on, but I always check the computer. Fortunately we do have good techs who relate any abnormals to us. I did not realize other places do not allow it. Our techs also draw blood and do EKG's. The EKG's do concern me sometimes depending on who does it, but I have seen nurses not place the stickers in the proper place also. I am not sure what the right answer is, but I do know that I am responsible for the patient, bottom line. Long ago we had lab techs who drew all blood, then it was designated to the nurses and then we had MCT's. RN's must draw all type and screens for blood. If the blood is drawn from a line, than of course, the nurse must do it. If the tech has gone through competency training, I do not see why they cannot do fingersticks or POC heme testing of stool. I just have to be looking for the results.

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Specializes in Cardiac/Med Surg.

PCA or RN where I work, you have to scan the pt. barcode before you do the accuchek and a low result is always rechecked by RN. RN documents any action..RN responsibility to get result and recheck if it seems correct to do so, some RN's do do there own accuchecks though

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Specializes in Community Health, Med-Surg, Home Health.

I really think that giving RNs EVERYTHING to do reduces the quality of care as well as the self esteem of the other staff from what I am gathering from here. Just by virtue of being the RN does not have to translate to the word "dump' everything on them. I would probably go crazy if I had to chase every fingerstick, change every wound, do every med pass, etc... even as organized as I am. It fosters better teamwork if everyone feels that they can make a positive contribution to patient care. The techs I work with in my clinic are awesome and they feel belittled that fingersticks were taken away from them. Now, they have received extra money and extra training that they looked forward to performing to be told that now, they can't.

Now, what I feel should happen is that each discipline take total responsibility for their tasks; that it should not have to immediately fall on a nurse. This may actually lead to pride in their positions.

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I just want to say something to both sides of the coin here. As a current CNA and nursing student I definitely see the pros and cons of both sides of the issues. As a CNA/PCT, I am trained and have taken the competency validation course once a year for 19 years to do FSBG's. I am well trained and do it repetitively. Part of our training is that if we get a too low or too high reading we are to restick and reread the patient results before reporting to the RN in case of a mistake. Wether it is the fault of the aide, or the equipment. So that we do not incorrectly chart, report, or cause harm to the patient. From the aide point of view, it feels like the nurses are saying aides are stupid, uneducated, and have no business doing anything other than wiping dirty bottoms and running errands. I am not saying that is how you feel, but it is how you make us feel. As a nursing student, I can see how a nurse with a license has to protect her licensure by making sure that all things are done accurately and unless you are doing it yourself you have no way of knowing this. I know as an aide that all aides are NOT responsible, or competent. Most are wonderful and I will always be sure to make sure that I treat them with the utmost respect. As they are my eyes and ears when I have other things that I have to do and cannot spend the time I want to with my patients. But I also feel as a student nurse, that there will be times when I may not have that trust in my aide and will want to do things for myself wether I really have the time or not. Because my license is at stake in the aides mistakes. The aide is literally working under my licensure and I have worked way to hard and gone through way to much to gain it. I think the aides, if they really understood this aspect would be able to get over feeling undermined, and realize that in nearly all cases, they aren't being disrespected at all, but that the nurse has to protect herself, and in protecting herself she is protecting you too. So just think about this the next time you have a nurse/aide conflict. A lot of times, it is trully a misunderstanding of what really is hanging in the balance. It isn't about power, it's about what is best for the patients outcome.

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Specializes in Community Health, Med-Surg, Home Health.
I just want to say something to both sides of the coin here. As a current CNA and nursing student I definitely see the pros and cons of both sides of the issues. As a CNA/PCT, I am trained and have taken the competency validation course once a year for 19 years to do FSBG's. I am well trained and do it repetitively. Part of our training is that if we get a too low or too high reading we are to restick and reread the patient results before reporting to the RN in case of a mistake. Wether it is the fault of the aide, or the equipment. So that we do not incorrectly chart, report, or cause harm to the patient. From the aide point of view, it feels like the nurses are saying aides are stupid, uneducated, and have no business doing anything other than wiping dirty bottoms and running errands. I am not saying that is how you feel, but it is how you make us feel. As a nursing student, I can see how a nurse with a license has to protect her licensure by making sure that all things are done accurately and unless you are doing it yourself you have no way of knowing this. I know as an aide that all aides are NOT responsible, or competent. Most are wonderful and I will always be sure to make sure that I treat them with the utmost respect. As they are my eyes and ears when I have other things that I have to do and cannot spend the time I want to with my patients. But I also feel as a student nurse, that there will be times when I may not have that trust in my aide and will want to do things for myself wether I really have the time or not. Because my license is at stake in the aides mistakes. The aide is literally working under my licensure and I have worked way to hard and gone through way to much to gain it. I think the aides, if they really understood this aspect would be able to get over feeling undermined, and realize that in nearly all cases, they aren't being disrespected at all, but that the nurse has to protect herself, and in protecting herself she is protecting you too. So just think about this the next time you have a nurse/aide conflict. A lot of times, it is trully a misunderstanding of what really is hanging in the balance. It isn't about power, it's about what is best for the patients outcome.

Very well put! And, I want to add that many times, LPNs feel the same way...when times are desperate, we become the flavor of the month, but then, when the tides turn, we also interpet our treatment as being underminded, uneducated imbeciles, even though we have gone to nursing school, learned about the risks of not following through and are licensed as well. I don't take it all personal, because like you, I can see both sides of the coin as evenly as I can. However, I can also identify with those LPNs who do feel slighted on a daily basis.

The bottom line is that all of these titles exist and it will not change overnight (if ever). I keep seeing here that these decisions made by the BON is not always for the best interest of the patients, ultimately and does not always foster positive working relationships between the different disciplines within the nursing spectrum. And, obviously, their stance is neither considered or even respected if you have a state ruling (which, to me, means that everyone should comply), but you also have entire facilities who are basically saying "Screw you, catch us if you can". It makes the efforts from both sides fruitless, really, hence, bad feelings.

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