Nurses pulled as CNAS??

[peridot2467]

I am an LPN. I work in a large suburban skilled nursing facility. The company has started pulling nurses RNs and LPNs to be aides. We are never asked sometimes we are scheduled on the deployment sheet to be an aide and sometimes it happens last minute. I am just wondering if this is legal?? i was a CNA for over 18 years. I have sore knees that cannot take that physical work anymore. That was one of the reasons that i went to LPN school in the first place. I would like any input any one can give me. We were not asked if we could/would be aides, we were not told upon hire that we may be pulled to be aides. This is not because of emergency weather conditions it is standard business practice at this nursing home. PLEASE HELP!

[Asherah, BSN, RN]

An an RN or LPN, you are responsible for all of the duties inclusive of the CNA/Aide role, so I'm not sure if you just think that you shouldn't be doing the physical labor that a CNA does? LPNs and RNs should work as a team with support staff to boost and ambulate patients (albeit, safely). After only working in a support role for two years prior to becoming an RN I'm still very aware that I'm still responsible for being an active participant in the patient care team, no matter what is necessary whether it be doing something physical like assistance with bathing or cleaning up a patient who has soiled themselves (which can also be labor intensive activities).

It sounds like the primary issue is the fact that your workplace is understaffed in regards to support associates like CNAs. Perhaps that is what should be addressed with management and administration.

[peridot2467]

My objection has nothing to do with not wanting to do the physical labor. I was an CNA for over 18 years. I don't think any nurse should be scheduled to be a CNA with a full assignment unless they have been asked or informed of this upon hire. I always help my aides when i am on a unit, i answer call light and change people and help them to the bathroom, pass food trays etc. I think you misunderstood the question. can a nurse be scheduled to be a CNA with a full assignment and what are the legal ramifications of a facility doing this all the time. according to the state of course we have plenty of staff but some nurses have never even changed a patient's brief and shouldn't be out there toileting people and transferring resident's without some training first.

[turnforthenurse, MSN, NP]

At my facility, sometimes an RN or LPN will be on the schedule as "PRN." They don't have any assigned patients, they just go around helping other staff (including NA's/NT's) with whatever needs to be done. Of course the RN's scope is broader (because they can administer medications to a patient if another nurse is tied up) but they will go around and help with vitals and other "aide duties" since they do not have assigned patients.

So yes, it happens. But they retain their scope of practice as an RN/LPN and aren't "demoted" to a CNA because they still do meds/IVs/dressing changes/etc etc etc.

[Pipsqueak, ADN]

some nurses have never even changed a patient's brief and shouldn't be out there toileting people and transferring resident's without some training first.

I respectfully disagree. Every nurse has recieved "training" in basic care. That is included in the classwork and clinicals no matter if you are an LPN or an RN.

That said, I personally would not be comfortable or happy if I was pulled to fulfill a CNA assignment. I often participate in these tasks, but I've never been responsible for having to complete all ADL's for a full patient assignment. I would never be as proficient at completing all the responsibilites in a timely manner like a CNA who does this every day would be.

[CoffeeRTC, BSN, RN]

Yes...this is totally legal.

Aside from not being able to do this due to physical limitations...all nurses should know how do do this at least at the very basic level. It isn't rocket sciece providing basic care. How do the CNAs learn this....from other CNAs and from the nurses. Just becasue you have never done this before, doesn't mean that you shouldn't do it. All nuses learned this in nusing school. Just as we've learned other skills that we might not have practiced in XYZ years would you refuse to to those skills (IM injections, tube feedings, certain types of wound care)

There are many a post on the LTC fourm about this very subject and you wil find opinons all over the place.

On a rare occasion that I do have to do this, I just let everyone know that I'm out of practice and will need help from the other CNAs. It is a wonderful opportunity to get to know your resident better and see how things are really running from another point of view. The CNAs might just see you in a different light too (as long as you aren't moaning and complaining the whole time and are looking at them as a team member)