Nurses Losing Nursing

Agnus · Mar 31, 2004

So why are you rolling the patient out the door while a UAP is doing the cath? You are still the RN. You are still in charge of what gets delegated. If you choose to delegate the wrong things who is to blame?

Don't mean to sound like I am pointing fingers as I understand what you are saying. Like you I just think it is something we all need to keep in mind.

We create our own job descriptions by the tasks we actually do. We can choose which ones to keep.

flowerchild · Mar 31, 2004

So why are you rolling the patient out the door while a UAP is doing the cath? You are still the RN. You are still in charge of what gets delegated. If you choose to delegate the wrong things who is to blame?
Don't mean to sound like I am pointing fingers as I understand what you are saying. Like you I just think it is something we all need to keep in mind.
We create our own job descriptions by the tasks we actually do. We can choose which ones to keep.

Not to worry, I won't take it personally. This isn't about me. I'm trying to bring this to nurses attention.

But since you did take it as being about me I will share my own experiences that relate to this issue.

The last hospital I worked at had team nursing. We had CNA's doing the caths, vitals, and other monitoring. That was the CNA's job description and part of the routine for the CNA. I personally did not like that and did my own VS, caths, and scans, but others had the asst doing it. In fact I was the odd one by doing my own. It's not easy being the odd guy out in a team but I stood up for what i knew was the right thing to do. What ever the RN was doing while the CNA's did thier routine is hard to pinpoint b/c the RN could have been doing any number of things at the time, including stocking, taking a patient to another unit, and the like. So my point is that the CNA could very well be doing the cath while the nurse is rolling a patient around in a W/C. The point I'm making is that the for profits are mandating the CNA's job description. Obviously, somewhere down the line a nurse was involved in creating the job description, team concepts, etc and OK'd the CNA to do certain procedures. Which I'm sure are usually safe and within the relm of a CNA doing after proper training. The delegation was not done by the RN. It was done by job description.

I currently work in a situation where a CNA gives meds and does procedures. She has her job to do, it is her job, on her schedule. This is what she was hired to do. I can only imagine what would happen if I told her that she can not give meds or do caths and that I will do them instead. I'd probably be fired irreguardless of the fact that she is working under my license. She has been trained by an RN and is competent to do what she does safely. But while she is giving a med, I might be ordering supplies, stocking shelves, or some other managerial task that really could be done by someone else. It just doesn't make since to me. I'm hearing and seeing more and more tasks deligated to non nurses. It is the system or hospital that says "this person is to do this and you are to do that". All part of the team where each has a function. BTW, I'm leaving this job next month but another RN will take my job and have the exact same situation and be able to do NOTHING about it.

RN's are taking out the trash while CNA's are doing VS. THIS IS HAPPENING in our profession. It's not always up to the RN as to who does what. We as nurses have been pressured into allowing this b/c there is just too much work for us to do now that we don't have orderlies, housekeeping, and other services that allowed us to have the time to do our nursing.

I really do wonder if hospitals and the like are implementing these things in order to save money by diluting the nurses duties. Where does it stop? How long before the UAP's are passing the meds (which is already occuring in some settings), the CNA's are doing the tasks that the RN used to do (already happening), and the RN is left to only manage it all? All in the name of a shortage of nurses and the bleak outlook for the future.

The hospitals have a plan to deal with this shortage as the boomers become our elderly. As we know, there is currently no shortage of nurses, just a shortage of nurses who are willing to work at the bedside. This shortage was created b/c of the hospitals attitudes and goals. Stretching us to our breaking point. Using the shortage as a guise to meet their profit margines.

The government is backing the hospitals plans as a way to deal with the future crisis. They have to start implementing a plan now in order to be ready for the future. I have heard that RN's will become managers. It will be our main function. We will oversee everything but there will be no way we can do everything.

I believe that the money mongrels are behind the shortage, causing this, on purpose, to fulfill their wishes of bigger profits and that they will continue to dilute nurses until nothing is left of our profession except management.

This problem is bigger than any one nurse. Bigger than me. All of us need to be aware that this IS HAPPENING. We will never be able to stop it unless we at least know what is really going on and about the threats to our profession.

Brownms46 · Apr 1, 2004

I understand your rant:), but I also see another side to this, and it's not the big, bad PTB, who is causing the situation. There are waaaaay too many nurses, who would rather be doing ANYTHING else but hands on pt. care.

I read on nursing sites, how dangerous it is for a LPN/CNA/MA...etc..etc, to be doing this or that. But you know what? You and others who take your responsibilities seriously are not the majority, I am afraid. As you said yourself, you are the minority on your unit, and do your own care, while others delegate theirs.

As Angus stated...you as the RN are responsible for what you delegate. I don't care who says someone can do this or that. And I would care less if someone got ticked, or I got fired for not delegating something I didn't feel comfortable in delegating. The pts are assigned to you, not the CNA.

However, I do understand your concern.