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No More Fingersticks for Techs!!

Posted

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

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herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

Honestly, I think this is just another example of something that some RN's don't want to give up/are "possessive" about, in thinking that only they can do. We have seen a lot of this on the council that I'm on, as we review the LPN/CNA task lists. Several RN's have a hard time delegating ANYTHING. We have gone to using automatic blood pressure cuffs quite a bit more than we used to, and I'm OK with getting VS from my CNA's (and I would also be OK with it if they were doing them manually, I TRUST them, and it's within their scope of practice).

If you have a patient on routine blood pressure meds, do you always do your own VS? If a CNA tells you a patient's temp is elevated, do you recheck it before giving them Tylenol, or whatever? I don't, necessarily. They know how to take a temperature.

I guess you could use the argument then, that the RN should always do peri-care, too, since the CNA can't *assess* skin and therefore might miss signs of breakdown....one more thing you'd better do. Especially if they need Sensicare or some other skin barrier cream put on, right? If it has to be put on, you'd better be the one doing it, and looking at why, every time.

I agree with the comparison to lab results. I don't have to go down to the lab and run my own CBC to believe that the Hgb is low, and that those 2 units of PRBC's need to be administered.

A FSBG is not an invasive procedure.....

I work in critical care. We have one CNA/secretary for 21 patients so of course I do my own VS, baths, and cleaning. We help each other for lifting that cannot be done by one person.

Our CNAs are invaluable but no way can one person do it all.

When I float to telemetry or med/surg I don't always know the competency of the unlicensed caregivers. I do know that to be certified a CNA must have their competency for vital signs, I&O, and ADLs validated by observation.

But when we lobbied for the law the houskeepers and dietary staff were only given 16 hours of orientation, including BLS, before replacing a aid off RN. Often the same RN who 'trained" them. I think they were taking advantage of them because they had them replacing registered nurses for very low pay.

They were neither educated nor experienced for the responsibility placed on them. I know for sure that one patient died due to this.

I floated and arrived early. An aide had written over and over on the med cart, "C/O pain." The patient was having an MI. I went in and got the patient transferred to CCU but the patient coded a couple hours later on route to cath lab.

An experienced CNA would know to report chest pain STAT. This person just knew it wasn't yet time for pain medication. This was NOT a certified CNA. Not someone who had chosen patient care. just didn't want to lose a job.

Now it is not legal. But we had to make our hospital follow the law:

http://www.rn.ca.gov/pdfs/regulations/npr-b-29.pdf

We have worked to keep our LVNs and experienced CNAs. LVNs are assigned to work with the high acuity patients.

Our younger LVNs have earned their RN. Older experienced LVNs are as competent as any RN but don't have the same legal authority. SO we work as a team.

Effie, RN

Specializes in nearly all. Has 32 years experience.

...we have worked to keep our lvns and experienced cnas. lvns are assigned to work with the high acuity patients. our younger lvns have earned their rn. older experienced lvns are as competent as any rn but don't have the same legal authority. so we work as a team.

the key here is knowing the knowledge level of the practitioners and everyone working as a team! it's not supposed to be about egos or letters after your name, it's about using everything you know and everything everyone else knows to make sure the patient gets the appropriate level of care.

jackiesue94

Specializes in LTC. Has 16 years experience.

This past week at work I had a graduate nurse helping with tasks before she takes her boards. What I didn't like is my own 'disconnect' with the glucose readings she reported to me. I guess I actually do quite a bit of assessing while going through the task of checking the patients glucose. I have 28 residents to care for so I m super busy with 8 of them ac and hs checks...and yes I had more time to chart but I also learned that by doing them myself I really take better care of them.

Where I did my clinicals, CTs did the sticks but could not take pusle-ox. I was told that the rationale behind this was that O2 is considered a med....

In the 2 jobs I've had since as an RN, it was only nurses that took the sticks, but the aides did take pulse ox.

Matt

island40

Specializes in ICU, School Nurse, Med/Surg, Psych.

I've had units where the CNA did glucose monitoring and units where the LPN & RN only did them. It really depends on the staffing mix that you have which is going to work better for the client. Having a nurse so overloaded with work that the clients are at risk for hypoglycemic shock is a situation that would probably not be helped much safety-wise by having the ancillary staff do the glucose checks.

I work on a critical care step down unit and our Techs do our chemsticks. We are on a computer system so when the chemsticks are taken they go into the computer system where they pop up under lab results. If the chemstick is below 60 or greater than 150 our techs come and report the results to the nurse.

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.

um, she IS an LPN.

pagandeva2000, LPN

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

um, she IS an LPN.

I hope he caught on to that by now...:lol2:

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