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.
From what I've seen in a UK hospital, at least medical and surgical wards have CNAs, but the RN will often assist with AM care for her own assigned patient cohort, giving bed baths, changing linens, and helping with meals. Trolleys, waste disposal bins with wheels, hoists, helpful colleagues, and many circulating physiotherapists help to make the physical workload lighter. There is a national initiative to reduce incidences of pressure ulcers and there are fairly well-developed physical rehabilitation programs. The time spent washing, chatting, tidying the patient and surrounding space is a great opportunity for a comprehensive psychosocial and pain assessment; an easy way to evaluate tissue viability, integumentary system; and a time to get to know the patient better as well as offer encouragement and reinforcement of what the occupational and physical therapists have taught.
As a CNA I'm a little annoyed by this post, since you as RN are totally responsible for your patient's care - that's why you have a license. We're here to help, not do whatever you've decided is beneath you because you had the money for more school. What kind of NP will you be, if you think you should move on before you get experience because you don't like changing diapers?
But realistically, you're lucky you have a job at all. Here in Hawai'i, the hospitals don't hire new grads, period, and they're all working as CNAs -- for CNA pay. Many new grad RNs cannot find jobs anywhere. Consider yourself lucky and quit griping that you have to provide patient care. That's what nursing is.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I wonder if everybody bashing the OP would be just as okay with a NICU nurse being floated to psych, or a stepdown nurse floated to LTC and taking twelve patients instead of three. Would those people get bashed for being uncomfortable? If you are a nurse used to four or five patients suddenly doing personal care for ten or fifteen or more, that is an unfamiliar role. I very seriously doubt this hospital has nurses shadow CNAs when they are first hired, so these nurses are just having to wing it. Being a CNA for fifteen people is a lot different than assessing/medicating/etc five or six. The workflow and how your organize your shift are different. Are you all okay with a L&D nurse who has never worked anywhere else being floated into adult ICU?
Who cares that the ratios are different and the type of care you are providing is different? It's all nursing tasks, right?
NICU nurses do things psych nurses don't do, and vice versa. CNAs do not do anything a nurse doesn't do. Unless the nurse routinely dumps on the CNA.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
Wow, I laughed out loud a little when reading the OP.
I was just talking to a fellow nurse last night about how nurses that think any job is below them are usually crappy nurses. I don't know you and so I'm not saying that is true, but the nurses I have worked with over the years who whine about having to do jobs "below their pay grade" or skill level are usually crappy, lazy nurses and the whole floor knows it.
Aide responsibilities are the foundation of nursing. As a nurse your job is to take care of your patients, not to just do a neat little list of "RN only" tasks and dump all the dirty work on your aides.
I usually try to be a little more polite and diplomatic........but get over it. Do your job, which involves aide work when necessary. Take care of your patients and quit worrying about your make believe pedestal.
I think some folks are being a little hard on the OP. I don't see where she said that CNA work is beneath her. I have worked as a CNA and as an RN, and while it's true that as an RN you will still be responsible for things that are included in the CNA's job description and thus there is some overlap, the roles are completely different. I wouldn't want to work as a CNA either, not because I'm too good for it, but because I like the RN role better.
While it's true that what we consider "CNA work" is basic nursing care, if I worked in an environment that employed CNAs with their own job description and list of responsibilities that they are accountable for, and yet was required to work in that role, I would be unhappy too.
A better solution, in my mind, would be to decrease the RN patient load so the RNs can do more total care.
Specializes in Mental Health, Gerontology, Palliative.
Dont know what its like in the US but in NZ, we can work as a nurse aid we can only do nurse aid duties however we are held to the standard of an RN
I've heard if you work as a CNA but are a licensed RN, you are still held to the standards of an RN. Does anyone know if this is true? example : if you check a blood pressure and it is very low and report it to that patient's RN and he or she does not follow up, you could be responsible because you are a licensed RN especially if you usually work at this facility as an RN. If this is true it would be better like others have said to just have more RNs take assignments.
Specializes in Mental Health, Gerontology, Palliative.
Yes, actually, it is what you signed up for. The minute you accepted a nursing license.
Actually no it isnt.
I have an outstanding team of CNAs. Dont know how I would run my shift without them.
That said, if I had of wanted to do the work of a CNA, I would not have done my nursing training. I enjoyed my time as a CNA, I got to work in many different areas. Had some interesting situations where I was doing watches. I think its helped make me a better nurse
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 take the ADL care for the unwell palliative patients on my unit. The aides take the ADL cares for the rest of the residents. I will help them where I can. That said they know I do the meds for my residents breakfast and lunch. I have multiple gravity peg feeds, 2-6 wound dressings a shift, pain management of palliative patients. I also have care plans to update, interrai to do. One interrai can take upwards of five hours. Which is fun when the shift is only 8 hours long. Today have also had to deal with essential pain meds not being charted by a patients GP. Its the weekend which means the GP is not contactable until tomorrow. I ended up having to go through urgent care, which involved waiting to hear back from the doctor. Then collecting the paper work that needed to be faxed through and then the waiting to get the fax back. Mean while patient is going without essential pain relief. Last shift one person fell with multiple fractures. A resident in mainly independent living (we still have to attend if emergency bell is rung) fell over and ripped a 20cm tear in the skin that went down to the bone. Sure, I could have sent them into the emergency department however they would have been unable suture the wound. Took me an hour to bring the edges together to steristrip. Closely followed up by a really really bad code brown requiring a full change of clothes. Sure, i could have delegated however my arms werent painted on
I can do the work of a nurse aid. There is very little of my job that the aid can do.
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.
Its my first job working for a for profit organisation. And while I whinge and moan about 'the bottom line" compromising patient care, I know there is no show in hell I will have to work as an aide because they are not going to pay me a nursing wage for doing the job of an aide and I wont be working for less than my hourly wage
Specializes in Mental Health, Gerontology, Palliative.
I also really hate that mindset of you couldn't possibly know what real nursing is like because your just a student......snip......
Hppy
Speaking as a fairly new nurse (of two 1/2 years), the reality of nursing as a student, and actually being a nurse was very different.
As a student I had a great time learning procedures and the like. Sure I wrote the patient notes however much of the other documentation and the behind the scenes was still being done by the rostered nurse.
All of a sudden not only did I have to admit the patient which involved nursing assessment, braden pressure assessment, gait, falls risk, nutritional, cultural, wound care, cognitive assessments, assessment of mobility, temporary careplan and full careplan (about 10 pages long) and interrai (apparently they are only supposed to take two hours once we are trained). And thats all for one patient.
As a student you always have the back up of your clinical tutor or your nurse preceptor. I recall two months out from graduation having to tell a doctor what we needed them to chart for a syringe driver. I was fortunate because we had the back up of a brilliant palliative care team however thats not always the case.
I just think a lot of you are missing the point, and are focusing on what your job title is and not what your patients need. If your patent needs their bed made or their toilet unclogged, why not just do it if the appropriate personnel isn't available? Why worry about who's job it is or what scope it falls under, provided you're qualified?
Working 12 hours in a CNA capacity is back breaking and many nurses can't physically do it more than once in awhile, I will absolutely give you that.
The alternative to taking a shift as a CNA would be for two nurses to take less patients and have no CNA, so maybe next time thats what OP could do.
I swear some of you should just be doctors, and thats not a compliment. ;-)
I swear some of you should just be doctors, and thats not a compliment. ;-)
I consider being a physician (I assume that's the kind of doctor you're referring to?)
a respectable way to make a living. It's a hard and demanding job in its own right
and I would have been proud to do it, should I've desired to pursue that career.
I just think a lot of you are missing the point, and are focusing on what your job title is and not what your patients need. If your patent needs their bed made or their toilet unclogged, why not just do it if the appropriate personnel isn't available? Why worry about who's job it is or what scope it falls under, provided you're qualified?
I think that it might be you who's missing the point. If no one was available to make my patient's bed and it needed doing, of course I'd do it. I won't let my patients suffer due to inadequate staffing. The point I'm making is that I wouldn't remain in a job where this was regularly occurring.
Working 12 hours in a CNA capacity is back breaking and many nurses can't physically do it more than once in awhile, I will absolutely give you that.
As a 6'1'' 152 lbs gymrat with very little body fat I'm likely highly physically suited to lift, clean and make beds all day long. It's just that I don't want it to be the main feature of my work day. If I did I would have chosen my career accordingly. Contrary to what you and others might believe, this hasn't been a problem for me. It hasn't gotten me in trouble with the people I work with, including CNA's. The floors I've worked were adequately staffed and as I said previously the CNA's would have more frequent and longer breaks throughout the day than I would. There was plenty to keep me busy. If this rubs someone the wrong way, so be it.
While this may not be true for OP, luckily enough for me my employer is the author of "the little list", not me. I haven't worked med-surg for years but when I did there was an official job description posted for RNs and CNAs. The RN list was quite a bit longer than the CNA list but ADL's was only listed on the CNA list. That didn't mean that a nurse wouldn't help out if the CNAs were swamped but that seldom happened. It was usually the RNs who'd have to try to squeeze in a half hour meal break whereas the CNA's would take a morning coffee break, lunch and an afternoon break.
Checking vitals and diagnosing is well within a physician's scope of practice. Does anyone think that a good way to utilize a cardiologist's competence would be to have him or her take all routine blood pressures and routine assessments on the floors? Or are we okay with having that responsibility carried out by nurses without pointing fingers at physicians for dumping their dirty (menial?) tasks on us?
My point was not that RN's should be doing the CNA's job, but that when the situation calls for it (i.e. being short on CNA staffing) then the RN should accept it without whining about it. If there are plenty of RN and CNA to sufficiently staff, then of course the RN should not be running around trying to do CNA tasks as well as their own.
Green_Grass
18 Posts
From what I've seen in a UK hospital, at least medical and surgical wards have CNAs, but the RN will often assist with AM care for her own assigned patient cohort, giving bed baths, changing linens, and helping with meals. Trolleys, waste disposal bins with wheels, hoists, helpful colleagues, and many circulating physiotherapists help to make the physical workload lighter. There is a national initiative to reduce incidences of pressure ulcers and there are fairly well-developed physical rehabilitation programs. The time spent washing, chatting, tidying the patient and surrounding space is a great opportunity for a comprehensive psychosocial and pain assessment; an easy way to evaluate tissue viability, integumentary system; and a time to get to know the patient better as well as offer encouragement and reinforcement of what the occupational and physical therapists have taught.