Nurses Being Made to Tech?

[westieluv]

Does your clinic force nurses to work as techs when you are short staffed? I'm not talking about putting a patient on or taking one off once in a while, that's no big deal, but actually scheduling nurses for tech shifts?

I am so frustrated with this practice! Our nurses have been leaving over it, and it really doesn't seem fair to make nurses work as techs. I mean, techs can't work as nurses and fill in and do a nurse's work, and the nurses don't do it often enough to feel comfortable and/or competent, especially with patients who are very difficult to cannulate or are very picky about who puts them on.

Thoughts?

[lifelearningrn, BSN, RN]

Is there a wage difference? Most "tech" work is nursing work, so I'd say as long as you're being paid your nursing salary, it's fine.

[schnookimz]

As long as they're giving you nursing pay then isn't this a nice easy shift for you? Way less responsibility?

[akulahawkRN, ADN, RN, EMT-P]

I would say that nurses make for very expensive techs... but you should be able to do everything they do. If I'm a nurse that's working a scheduled tech shift, I expect to be paid a nurse wage, not a tech wage because those "tech duties" are also nurse duties and within the scope of practice of a nurse. If they could get away with it, they'd probably try to figure out a way to pay us for tech duties, office duties, nursing duties, and so on, just to lower the effective hourly wage (and therefore cost). If what I'm doing is within the nursing scope, I expect to be paid as a nurse for doing it, whatever it is.

Because of that, nurses make for expensive techs...

[Mr Sacdiff]

Getting paid a LOT more to do a tech job is not something I would complain about in the current economy.

[Chisca, RN]

We can't keep techs so it happens rather frequently. From a business standpoint I can't understand why retention of staff, nurses and techs, isn't a higher priority. Very expensive to keep training staff that leaves.

[ChristineN, BSN, RN]

I used to be a float pool nurse and on rare occasions I had to be a tech. I loved those shifts. I still got the same salary as if I was the primary RN, but I didn't have to worry about meds, and was able to make sure my pts were bathed and comfortable. It was a nice change of pace.

[kdunurse]

We currently have only one tech for our 19 chair unit, so, yes, our nurses do tech shifts. It's a bit weird, actually, because the nurses have pods assigned to them, while the tech doesn't; he floats during turnover, mixes baths, and does a lot of the cleaning and stocking on the unit. The nurses are very good at cannulating and stringing machines...

[Guttercat, ASN, RN]

Back in the day, it was only nurses that did "tech" work, plus managing the overall care.

Not long after that, it was a nurse and a tech that teamed up to oversee four to six patients for each shift. In my humble opinion, that was an optimal situation: the RN was able to field ongoing and acute medical issues while still keeping their hands-on skills, and the tech was able to fill-in-the-blanks where the RN was lacking, and vice versa.

In this age, however, where it's usually one or two RN's to every 20+ patients, I think it's a stretch to tell them to be a (Surprise!) tech, and still complete their own duties.

I'd like to see RN's routinely scheduled for a "tech shift" every four to six weeks, so that we can jump in where needed.

The downside to this solution is that techs (in my experience only) will then be more apt to call out "sick" if they think there is an able nurse available to cover them.

[westieluv]

Thanks, Guttercat, I think you get where I was coming from.

It's not that I'm complaining about making nurses' wages to tech, and I definitely don't think I'm above the duties of a tech. The problem lies in the fact that the nurses are not scheduled to do it often enough to feel confident and proficient and the patients, who you all know are usually very smart cookies and know the score, realize that the nurse is not a proficient tech and can sense his/her trepidation and, in turn, become nervous as well or just flat out say something like, "No offense, but can Susie Supertech (who is a master cannulator and cannulates an average of ten patients a day) over there put my needles in? She's sooo good at it", and then the nurse, who through no fault of her own hasn't touched an arm in 2-3 weeks, feels totally embarrassed and incompetent. Not to mention, the nurse is still expected to complete all of her extra nursing duties even while she is working as a tech, something that the techs never have to worry about.

I know nurses who have worked in dialysis for years who literally get an upset stomach at the prospect of teching for the above reasons. It has been very, very bad for employee retention, that's for sure!

[SmilingBluEyes]

I have done this many times. The only time I ever complained was when I had to make up for a shortfall of a tech who called out sick AND do my nursing duties, too. That used to happen to me a lot, but under new management, staffing has improved. I have been a replacement "tech" for sick calls and frankly love it once in a while. I spend more time with patients and chat, and have a lot less responsibility. I have always, always said, I will not ask others to do what I cannot, for how can I supervise them? For me, it's been win-win as I can cannulate most all the patient (even new fistulas at time) and can string machines almost as fast as our techs can.

[jdethman]

It is better to do that then run the unit short. it also keeps the RN's up on the basics. It is not a bad practice at all.