No Nursing Care?

Virgo_RN, BSN, RN · Jan 9, 2009

I don't miss being a CNA at all. As a nurse, I still do a lot of hands on care, because my CNAs don't all work equally hard, have equal organizational skills, or take the same amount of initiative. For example, I had a patient the other night who had been admitted for over 24 hours and still had no water pitcher (I noticed and brought him one). So for me, just because I have "RN" behind my name in no way, shape, or form means that I am not doing those little things for my patients that mean so much to them. In addition to those little things, I'm also assessing, teaching, administering medications, checking charts, charting, monitoring telemetry, communicating with physical therapists, occupational therapists, respiratory therapists, transport techs, fellow nurses, and doctors, to coordinate the patient's care. Just catching and correcting oversights and errors could be a full time job in and of itself sometimes! This is what stresses me out at times, is feeling like I am doing the job of two people; the job of the CNA as well as the RN level tasks that I cannot delegate. Still, I would not go back to being a CNA. As an RN, I have a lot more freedom to develop my own practice and to perform higher level skills. I can do patient teaching and solve patient problems, and believe me, those things matter to the patients as much as a warm blanket or some jello.

CT Pixie, BSN, RN · Jan 9, 2009

I am an LPN in a LTC. I was a CNA for eons. (my first job as a baby faced 16 yr old was CNA and I did that job from 16 to my early 30's..by choice.)

I didn't realize how much I missed the patient one on one contact until I helped out with a CNA assignment when we were short a CNA (but by some miracle we had TWO extra nurses on the floor). I, then, realized how much I missed it. I was actually able to have time with the resident, to joke, laugh and talk. But at the end of the night I remembered why I wanted out of being a CNA...my body just can't take it anymore...all the lifting, positioning, bending, stooping etc...this ol' body ain't what it use to be.

I have mixed emotions on being a nurse. In the position I have now, as the OP stated, there is little time left to just talk with the resident. But I do know that there are a lot of areas of nursing where there is constant nursing/patient care.

I loved being a CNA and I love being a nurse. There are pro's and con's to both positions.

racing-mom4, BSN, RN · Jan 9, 2009

I am a nurse in an ICU where I do complete pt care. I give my pts thier warm blankets, I also give them thier cardizem. I have an influence with the Drs and can really be a good patient advocate. I feel I am a better pt advocate as my pts nurse than I was as my pts CNA.

Please do not take this as CNA bashing in any way shape or form---All I am saying is if you want to be a nurse, then keep studying and become one. You will be very happy you did.

classicdame, MSN, EdD · Jan 9, 2009

many times the nurse is only able to exhibit caring by doing what is needed in a professional manner. As for the personal touch, wish we had time! Another reason CNA's are priceless.

jjjoy, LPN · Jan 9, 2009

To me, this raises the question of "what is nursing"?

Direct patient care most would consider to fall under the auspices of nursing. Communicating with the physicians would as well. Being aware of all new orders. But what about actually making contact with the physician? Having to physically make the call and wait for a call back? Making sure that the physician has properly signed all new orders? What about taking new orders off and making sure they get faxed to the pharmacy and that the medication is received on the floor in a timely manner? These are often the responsibility of nurses, but I don't see them as specifically functions of nursing. Non-nurses could also do this. That's what many unit secretaries do.

In the long off past, nurses were responsible for preparing food for the patient. Today, no one would think of food preparation as a typical nursing responsibility. Of course, nurses need to make sure that the food is appropriate for the patient. Overall, we still ask the average staff nurse to be responsible for a wide variety of things.

Maybe asking the average staff nurse to wear so many different hats is part of the cause of the nursing shortage. We need lots of nurses. Can we really expect so many people to be good at so many different skills and tasks? Comforting patients. Dealing with anxious family. Coordinating care. Clinical assessment. Pharmacological knowledge. Technical skills. Chasing down other harried providers. Being assertive with difficult colleagues. Entering orders in computer systems. Checking on others' work (is the aide giving thorough baths? did the physician write their order correctly?) and more!

Some people like nursing specifically for the diversity in roles. It keeps them busy and never bored. But how many people can keep it up day in and day out for years on end? Isn't that what leads to burn out? Are we running good, talented people out of nursing because they don't happen to have ALL of the skills and talents required of the average staff nurse these days? For example, they may be great caregivers, know a ton about pathophys, etc, but aren't good at dealing with pushy physicians or keeping on top of NAs. So they avoid being a staff nurse. Or they are good at dealing with pushy physicians and unreasonable families, are great patient advocates, but hate having to regularly juggle toileting a patient, taking a phone call, getting meds out on time, etc and so they avoid being a staff nurse.

Just thoughts!