Nurses who Nurse Patients

RNGrammie · Jan 22, 2012

i never understood that mentality either. when i was an lpn i had no problem helping my cna turn a patients or give a bath, it's a really good time to do that complete head to toe skin assessment. when i finally get to work as an rn it will be the same thing. you can't do an assessment without actually touching the patient or talking to them for that matter, ok you can without the talking.

i mean did your co-workers completely miss that class in school?

lpn's do not "assess"....they "gather data".

Sparrowhawk · Jan 22, 2012

Oh well scuse her then..she meant "Skin Data Gathering time"

LiveIrishRN · Jan 22, 2012

I am a new grad working as a cna untill the end of the month. I was under the impression that a RN was responsible for all patients and was still responsible even if the task was deligated. The ICU unit that I work at, all of the Rns are very dependent on the cna's. I was really surprised because in nursing school, I didn't see that much. Not to mention that my clinical instructors beat in to our heads assessment all the time. These nurses are always sitting and hardly look at the vitals. To me this is actually kind of disturbing. I really don't want to be the nurse that doesn't know what's going on with my patients. But the question is, How to fix that? I know that I have to worry about myself, and make sure that I don't fall in to the "hole" that they have. It is really frustrating.

WildcatFanRN, BSN, RN · Jan 22, 2012

lpn's do not "assess"....they "gather data".

hmmm, from my schooling lpn's do assess. they just don't do the initial assessment. so, i guess i "gathered data" on my patients and made judgements on that data to determine the course of the priorities of my shift.

anyway, the fact of the matter is that all nurses must "gather data" or "assess" their own patients and that requires actually going in and seeing said patient.

Guttercat, ASN, RN · Jan 22, 2012

I've seen nurses "assess" breath sounds from the doorway, on a cardio pulmonary floor, no less. Absolutely unconscionable.

And I've seen MD's chart that the pt. denied c/o, HRR, abd soft/nontender, and lungs clear all from walking up to the foot of a bed and saying hello to a (sleeping) patient and walking back out the door.

Astonishing assessment skills right there.

QI/QM · Jan 24, 2012

Loved hearing this. It actually makes me feel better to see some "real" nurses out there-and by that I mean LPNs & RNs alike. I did notice the "assessment" vs. "gathering data" conversation and wanted to let any LPNs from Mississippi out there know that there are changes in the Scope of Practice coming (or may already be in place) stating that LPNs can assess. Of course you still have to have the inital comprehensive assessment completed by an RN. So it doesn't really change things except they are giving you credit for being able to "Assess"

LaterAlligator · Jan 24, 2012

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If you want a nursing assistant to be at your beck and call, just help with a bath, or incontinent care, walk a patient to the toilet.
QUOTE]
I second this. I'm a CNA and I love love love working with the nurses who will do these things. So often I'm running from room to room trying to keep all my patients turned/walked/toileted/bathed/fed on top of doing their vitals and blood sugars, that if I find someone has already been "done" I will immediately go see what that nurse's other patients might need as a thank you.

suga_junkie, BSN, RN · Jan 24, 2012

In Australia, we don't have CNA's. RNs do vitals, bathing, toileting etc as well as everything else. We don't have Respiratory techs either so do breathing treatments, vents etc as well. I have to say I prefer it this way. I enjoy doing all the patient's care :)

gwyneffar · Jan 25, 2012

I work in Rehab, too, and I know exactly what you're talking about!

But then again I'm the nurse with no time management (per my boss) because I:

1) help my CNA's do everything because we're a team. If I can help with any ADLs, especially with mobility, I may pick up on things .. those little things.. see #2..

2) assess my patients and see things other nurses don't

3) and really talk to the patients because, hey, they know their bodies and they forget to ask the doctors.

Some of the nurses I work with always get out on time because they cut corners and do some of those things mentioned before. But you can't.. you just can't. That's not real nursing.

cdsga · Jan 25, 2012

I really don't know how you can be a nurse and not expect to do hands on care? I work in surgery where the nurse, believe it or not, is held responsible for just about everything that goes on related to patient care. The nurse has to be the watch dog, nagger, reminder, trouble-shooter, hall monitor, guard over the sterile field-room traffic, maintain order, cleanliness, procedure and protocols. There is only one nurse in the room, and believe me they are questioned when something does not go according to the protocol. Everything is monitored. And even if the nurse didn't do something wrong and something happened that was not the fault of the nurse, the nurse is held accountable. I know that personally. It is a very daunting task to be the patient advocate. While everyone else wants to loosen the rules up and relax it's the nurse that has to play the part of the "old stick in the mud". Some nurses cave in because it is quite a battle at times, but the nurses that do keep everything in check are appreciated in the long run. You save not only the patient but the other members on the team from some bad outcomes. You have to go back to why you wanted to be a nurse to begin with. If you are not a people person, if you are afraid of germs or diseases, if you don't keep up with the latest medical information, if you can't do math, if you can't prioritize, then maybe finding a job with a better fit with your attributes in mind would be beneficial. Nursing is not for everyone. And I know there are some nurses out there who mad a bad selection in jobs. I also think that in any SERVICE industry, and nursing certainly is one of those, you must SERVE. That is a verb people.

hidesertdi · Jan 25, 2012

Unfortunately I see a LOT of this at the government facility I work in. There was usually always one or two nurses in the places I worked, but where I am at now, it is the majority and many of the nurses have worked there a looooooooooong time so this behavior is tolerated. At first I didn't know if the nurses were ignorant or just didn't care. They don't care! They are apathetic and self-centered . It is all about them.

I look at my job as a challenge in caring. It is challenging to care in an environment where many don't, but it is what I do best and what is truly needed. Furthermore, I also look at it as a time to develop my self personally and professionally. I do not engage with them socially. I engage with them only in a way that is needed to do the work. I maintain my work ethic and personal boundaries. They hate it when I'm in charge because things gets done even though a lot of the passive aggressive behavior ensues. Even though I try my best (and notice the operative word is try) to not judge them, I still find that I sometimes I have to think of them as 12 year olds (and emotionally, despite their physical age, that is how they are acting). You can't make them change, they have to do it themselves either through peer pressure (remember the 12 yr old mentality) or maybe they'll eventually grow up, doubtful sometimes though. Everything is always temporary and especially this job. I'll take this learning lesson with me as it is making me more powerful, compassionate and understanding, and take the next job that shows up that offers me more reciprocity in my work environment. Have the courage to keep doing what is right despite the action of others. Our profession, communities, and the world desperately needs it. Things will either change that we'll move on to better places or the others will move on to places where they belong.

CrunchRN, ADN, RN · Jan 25, 2012

So, what are they doing? :smokin: