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.
Apple's and oranges. The scope of practice for a cna is drastically lower than an rn, so the change in focus of tasks (not change in tasks because we do cna work anyways) Will not have much of an impact on patient safety. However a nurse floating to another unit is a complete different story. There is an issue with unfamiliar tasks, procedures, medications, parameters. This can cause issues in patient safety, which is why when someone is floated, they should be getting the lower case load or lower acuity and stable patients.
And once again, cna work and competency is something all rn should have and is a part of the job you signed up for. Where as say giving chemo is not part of my job description if I'm a L&D nurse. Also, icu is like one of those places that you won't get a float in unless they've had some sort of experience.
I do think it's apples and apples to float an acute floor nurse to LTC (same employer, same procedures) to pass meds on 50 patients. Same tasks any bedside nurse should be competent in, just more patients, right?
I don't have any problems with cleaning up a patient out of necessity but my lower back wouldn't tolerate it all day long when I'm not physically acclimated to physical work of that duration. But if it were there are days I would willingly trade to skip a day of paperwork and higher responsibility. It's not beneath me but it would kick my butt.
The RN acting as a CNA would not have the responsibility to make sure the RN overseeing the cases follows up. The RN acting as a CNA who sees abnormals needs to report it to the RN and then document that she reported it.
See how far that argument gets you with your boss if a client has a bad outcome related to something you knew about while acting as a CNA, reported to the RN, but didn't pursue any further. Our RN licenses are 24/7. We can't "turn them off" just because we're working as a CNA for a shift, which is why working "below" one's level of licensure is somewhat tricky, professionally and legally. Regardless of the title or job description of the job you're in, you are legally bound by the standards of your highest level of education and licensure. If something goes wrong and you didn't respond appropriately as an RN, you're responsible for that.
Specializes in Management, Med/Surg, Clinical Trainer.
The hospital that I work in has a policy that when a nurse floats to a different floor, they go only as support staff. A nurse from NICU is not expected to go to Med surg and handle a vastly different population type and load. That is just not safe.
When the policy above was implemented all of the sudden the NMs were willing to hire more nurses for their floors...surprise, surprise...as Gomer would say.
My boss asked one of our employees on a Monday afternoon (I'm in the OR) to go help the NAs clean the OR and turn it over. His response was, "That's not my job. That's what the nursing assistances are for."
Yes, I think anytime you are brave enough or foolish enough to say, "that's not my job" (out loud) in this job climate (unless they are asking you to break the law or put yourself at physical risk), you may find yourself:
a) working in that capacity that you felt so indignant about (i.e.: nurse working as CNA)
b) looking for another job
c) snubbed by your co-workers who heard your snarky remark
d) combo of above
The most disliked, least respected worker on the unit: the one who refuses to pitch in because it's "not their job."
I dislike assisting with ADLs. Fortunately, it is only a small part of my normal daily work flow. However, if I were to show up for work and be expected to only assist with ADLs for my entire 12 hour shift and perform no higher level skills, I would not be happy about that, and if this were a regular occurrence, I would probably be looking for work elsewhere.
I'm sorry, but I would quit. If I wanted to be a CNA, I would have became a CNA. I don't care if the work only contains patient care, I became a nurse for a reason and expect to function as a nurse in my workplace. Yes, CNA duties are embedded in the role of the nurse, but I like practicing to the full scope of my abilities.
It is common practice around here. You aren't being asked to change light bulbs, you're being asked to care for patients in a capacity that you are qualified. The only problem I would see with it would be if you were getting paid the same as a CNA.
My tongue is bleeding now.
It's not about pay. Yes, you're qualified but the moment something goes wrong, I bet you're going to say, "Welp, I was only an aide today, not a RN." You'll be thrown right under the bus..
See how far that argument gets you with your boss if a client has a bad outcome related to something you knew about while acting as a CNA, reported to the RN, but didn't pursue any further. Our RN licenses are 24/7. We can't "turn them off" just because we're working as a CNA for a shift, which is why working "below" one's level of licensure is somewhat tricky, professionally and legally. Regardless of the title or job description of the job you're in, you are legally bound by the standards of your highest level of education and licensure. If something goes wrong and you didn't respond appropriately as an RN, you're responsible for that.
Okay, so I have a question. In my state, hospitals have stopped hiring LPNs to work as nurses but they will hire them to be techs, especially those going back to school to pursue their RN...could they really be held responsible for not making sure the nurse does their job? I'm not trying to be argumentative, I'm honestly wondering what the legal implications are in this situation.
Sometimes I've even had a easy night, just sitting while a patient slept instead of running around stressed out juggling a full assignment!
Don't you help with turning or boosting patients where you work? Is it such a big deal? I doubt it would be a daily thing anyway since they usually rotate nurses.
I really didn't know this was going on so I apologize if I come off as this guy who's just hearing that the light bulb was invented.
Why exactly are you a nurse if you prefer to do the work of an unlicensed professional? Let's call it what it is. If you weren't making your regular pay for doing less work, you'd be shouting exploitation and complaining that the hospital is taking advantage of you. The problem with nursing is that sometimes nurses don't even know when they're being taking advantage of. And I can't stand when nurses only take a stance on issues when it's convenient for them smh.
Okay, so I have a question. In my state, hospitals have stopped hiring LPNs to work as nurses but they will hire them to be techs, especially those going back to school to pursue their RN...could they really be held responsible for not making sure the nurse does their job? I'm not trying to be argumentative, I'm honestly wondering what the legal implications are in this situation.
The courts have repeatedly found (there's no question about this) that licensed professionals are obligated to function at their highest level of education and licensure, regardless of what your job title or job description from your employer might be. That doesn't mean that you have to also give meds while you're toileting people and changing beds because you're working as a CNA on a particular shift, but it does mean that, if you observe something that you know is dangerous and that you, within your scope of practice as an RN or LPN, would ordinarily be expected to address, you are obligated to respond as any other safe, prudent person with your same level of education and licensure would. You don't get to say it's not your responsibility because you're working as a CNA that day. So, basically, employers that hire individuals to work "below" their level of licensure (permanently, I mean; I'm not talking about occasionally filling in because of staffing needs) are intentionally exploiting those people; the employers realize that they're basically getting an LPN for a tech's salary because, whatever title they give the LPNs, they can't stop being LPNs.
You make it sound like working as as "aide" is beneath you. That's not they type of attitude to have as a nurse especially since you get to be more up close and personal with your patients. I'm not going to write a long paragraph, but let me share something with you quick. I was at work yesterday and just so happen to be taking care of two retired RN's from the days where they wore all white everything! And guess what she told me? "Back then we DIDN'T have nurses aides, we did EVERYTHING, WE WERE NURSES".
Well this isn't "back then" - we have nurses aides in 2015. And working STRICTLY as an aide would be beneath me, because that's not what I went to school for. There's a difference between being a RN and being an aide. And when I had to do patient care, I never thought of it as stepping into the aides' role (most nurses have that mindset). That's because I knew it was expected of me in MY role as the RN.
The courts have repeatedly found (there's no question about this) that licensed professionals are obligated to function at their highest level of education and licensure, regardless of what your job title or job description from your employer might be. That doesn't mean that you have to also give meds while you're toileting people and changing beds because you're working as a CNA on a particular shift, but it does mean that, if you observe something that you know is dangerous and that you, within your scope of practice as an RN or LPN, would ordinarily be expected to address, you are obligated to respond as any other safe, prudent person with your same level of education and licensure would. You don't get to say it's not your responsibility because you're working as a CNA that day. So, basically, employers that hire individuals to work "below" their level of licensure (permanently, I mean; I'm not talking about occasionally filling in because of staffing needs) are intentionally exploiting those people; the employers realize that they're basically getting an LPN for a tech's salary because, whatever title they give the LPNs, they can't stop being LPNs.
Thank you for your response. I'm glad that I kept my LPN position without benefits and am paying my own tuition to finish my degree now than staying with the hospital and working as a tech getting tuition reimbursement. The way that the facilities have it set up they won't allow us to do anything besides tech work, but then we're being put in a bad situation legally. Either way, we would either A-get fired for working as a nurse and outside of the tech scope which we were hired for or B-potential lose our license/face legal problems for not going over our employer's head. Gotta love my state.
Libby1987
3,726 Posts
I do think it's apples and apples to float an acute floor nurse to LTC (same employer, same procedures) to pass meds on 50 patients. Same tasks any bedside nurse should be competent in, just more patients, right?
I don't have any problems with cleaning up a patient out of necessity but my lower back wouldn't tolerate it all day long when I'm not physically acclimated to physical work of that duration. But if it were there are days I would willingly trade to skip a day of paperwork and higher responsibility. It's not beneath me but it would kick my butt.