Nurses forced to work as aides

Nurses Professionalism

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I am frustrated with my hospital. We have a shortage of aides, and no wonder because they have a hard, backbreaking job for measly pay. As a result, sometimes when we nurses show up to work, we're made to work as aides. No notice, just here: you're an aide today.

This seems really unprofessional to me. I signed up to be a nurse. I never worked as an aide because I know how difficult that job is, and I don't want it. It's confusing to the patients to have two RN's running around. Thankfully, the other nurses haven't asked me to medicate a patient, because I'd have to say no since I didn't get a nursing report, nor did I look up the patients to a sufficient level to be able to take full-on nursing care for them nor did I assess them, but I can see how this could set up a problem in the future for a med error.

It just seems wrong on several levels. I guess this is what happens when you work in a hospital with no union. At least I still get my nursing pay, but I still feel that this is inappropriate.

Thoughts? Have you ever heard of this before?

And what is so awful about being a sitter? I have many years of experience as a psych nurse and psych CNS, and I have done my share of "sitting." Are you too good to be a sitter? Too important?

Again, I would rather be a "sitter" for a shift than get called off or sent home without pay.

There is absolutely nothing wrong with being a sitter. I have sat with patients during many of my shifts while others take their breaks, etc. I simply am not going to sit in a room for 12 hours. If you want to do it, more power to ya. I'd rather go home.

I guess I always looked at my unit as a team. Short? Hard to picture yourself (on your way in) working "as a Nurse." Then doing an about face, into another position when you get there. I was Unit Manager. When short; pushed through wearing all types of hats. We were in a blizzard once, where nothing or no one could get in. 3 days, we did just about every job there was, including maintenance. In the end, we felt like a real team...respected each other for doing what it took to get the job done. THAT'S NURSING!

My first psych nursing job, as a new grad, was on a psych unit in a small community hospital in a rural community. We were not part of the overall hospital; we were the inpatient unit for the county mental health center and leasing space from the hospital, so we weren't part of the hospital staff and there was no floating back and forth between our unit and other units of the hospital. Our staff was our staff, and that was it, no other help. There were a few times when multiple people called off, we were really short of staff and no one else was available to come in, and the psychiatrist who was the unit medical director came in and worked as a tech on night shift. Really worked as a tech -- did the q 30" rounds, helped people to the bathroom, checked vitals in the AM, everything the regular techs would do on the shift ... I learned a valuable lesson about teamwork early in my career, that I've never forgotten.

1 Votes
Specializes in Family Practice, Mental Health.

To the OP:

I work in California, the land of ratios. In the ICU, in the land of ratios, there is no CNA (not in my hospital system). I am a one person team, and provide total care.

How sweet it must be for you to be able to come to work and even have the prospect of looking forward to having a second set of hands to care for your patients.

I cannot help but get the impression that you must LOVE the thought of potentially being able to pass off as many unpleasant tasks onto the CNA as possible. No Wonder you are so disappointed, and have such despair when you are then placed under the same set of circumstances.

Let me try and enlighten you, and hope that others can assist me in this teachable moment as well: You have been educated as a Nurse. You are, for the entire time that you legally use the title of RN”, accountable to the ANA Code of Ethics, for better or for worse. No matter how much education you have as a nurse, or how much you change your job description as a nurse, you will ALWAYS have ‘unpleasant tasks' to attend to. If you want to be in an industry which does not require human contact and unpleasantries, I suggest being a bank teller, or perhaps an accountant.

Specializes in LTC Rehab Med/Surg.

I never mind being the CNA, but as one who sometimes gets floated to an area I don't like, I understand the "I didn't sign up for this" thinking.

I don't like the idea that we can be plugged into any position management deems necessary. Like pegs in a board with no regard to our personal strengths and weaknesses. I don't like showing up and find I have to spend the next 12 hours doing something I don't want to do.

Simply looking at it that way I can sympathize with the OP.

Of course, whenever a LPN or an RN is assigned this, they aren't really working as a CNA. They are working as a LPN or an RN. Toileting patients and checking vitals are just as much nursing tasks as medicating or performing a treatment. The former two are just tasks that happen to overlap with what CNAs are permitted to do.

You can't really say this isn't what you signed up for. I'm sure somewhere in your job description there's a sentence that reads something like "other nursing duties as required".

If this happens regularly, your unit should consider having a rotation list for nurses to take turns. Same as a Pull-to-other-floors list.

Yes, actually, it is what you signed up for. The minute you accepted a nursing license. Many units don't have CNAs or enough of them. Incontinent care, peri care, skin care, toileting needs, these are all nursing responsibilities and your license can be disciplined for not fulfilling them. "The CNA was supposed to," will not save you because while you can delegate tasks, it's on your license to make sure they actually happen.

I will say this too, though, that it seems odd that they don't just give each nurse a smaller assignment so she can do total care on all her patients. If you're paying nursing wages, why not get nurse-level work for them? That's a head scratcher.

No, it really isn't what we signed up for, and you may understand this better when you're actually a nurse.

Specializes in hospice.
No, it really isn't what we signed up for, and you may understand this better when you're actually a nurse.

I'll still be doing plenty of personal care after I graduate, because our units are often run without aides.

Do you deny that the tasks I listed are nursing tasks? Or that they are your responsibility?

Seems like some of you forgot what it really means to be a nurse . Caring for our patients are priority even if it means doing aide duties

Specializes in Psych, Addictions, SOL (Student of Life).
I'll still be doing plenty of personal care after I graduate, because our units are often run without aides.

Do you deny that the tasks I listed are nursing tasks? Or that they are your responsibility?

Red has it dead on. When I was in nursing school oh so many years ago I remember a student was asked to change a bed and she replied "Isn't that what the CNAs are for?" The instructor came down on her like a ton of bricks. Stating there is no patient care task that is beneath an RN to do. In my years as an RN I have mopped floors, unplugged toilets and down every dirty code brown type job there is. Consequently I have a good relationship with the CNA's on my unit. They know I have their back and they have mine. Plus when I am doing hands on total care I learn things about my patient's condition that I would never learn from a chart or report. I really hate nurses who shove all the dirty work onto the CNA's as if it's beneath them. If I'm getting paid my full wages they can make me an aid if they want.

I am still held to the scope of practice of an RN and will do RN work if asked or if I see a patient need that I can address.

Hppy

Specializes in Psych, Addictions, SOL (Student of Life).

I also really hate that mindset of you couldn't possibly know what real nursing is like because your just a student. Tha'st how old nurses get the reputation of eating their young. We need to show the up and coming generation of nurses that nursing is about care and compassion both to students who are learning, to our co-workers (that includes CNAs) and our patients.

When you go to work you suit up and show up and do all aspects of the job. I take sitting with a patient any day - I could use the rest.

Hppy

Specializes in Hospice.

I don't mind filling aide positions. When I worked LTC, it was actually fun (but really physically demanding work for the now out of shape RN). It was those shifts I knew I actually might get out on time:) It was nice to spend a little quality time with my residents. And I got to see some of the issues the aides faced. Not to mention I earned the respect of an aide or two.

I work hospice now. Giving someone a bath is a great way to identify any skin issues. If I notice a patient needs cleaned up, I just do it. I wouldn't want them to wait for aide to arrive. This also can be a great way to educate family members, some of these tasks are very new and uncomfortable for them.

I gave a patient a sink bath the other day while the DME company was setting up his hospital bed for a formerly independent gentleman who had a significant decline in condition. After I applied lotion and helped him in to clean pajamas and tucked him in to bed and helped position him, I can't tell you how comfortable he looked. These tasks were part of nursing care that I provided that day. I wasn't forced to do them, I chose to do them because it was what my patient needed to be more comfortable.

Specializes in ninja nursing.

The other night I came into work and surprisingly they had one two many nurses (a rarity for our floor) and only two techs (supposed to have three for our census). What did I do? I volunteered to do tech/CNA work AND do the admission paperwork for new admits. My coworkers loved it and my supervisor was impressed by my desire to volunteer and help the floor out. I labeled myself a "super tech" because I did tech and RN duties like start fluids for nurses who were busy, start IVs, and stop fluids, unhook their IVs so they could bathe, etc (techs have to call an RN to do that for them). I enjoyed helping out my unit in that capacity. I know some of my coworkers hate working as a tech but I find it fulfilling and a nice mental break.

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