klmb318

I work for a small rural hospital in California. Until about 3 years ago our adc was 3, staffed with one RN and one CNA. The administrators have pushed for an increased census, now it is 6 (as high as 9 at times). Their response to the staffing for the increased workload was to add an LVN. The burdens this has placed on the RN have been overwhelming. When the state ratios are brought up by the RN, we are told that we have a "waiver" and the ratios only call for licensed nurses, not necessarily RN's. The hospital has no policy for the use of LVN's. I have reviewed the state Nurse Practice Act for the RNs and LVNs as well as title 22 and cannot find any information on the use of LVNs as primary caregivers in acute care. Does anyone have a policy for this? Or can someone point me in the right direction to write a policy? Additionally, we do not have a charge nurse or relief for breaks. Please help me!

You need to take your breaks. 10 mins away from the unit can make a world of difference in your sanity, moral, efficiency and ultimately the care you give your patients. Take a walk, put your head down, breathe, collect your thoughts and come back ready to excel!

Yep, this is acute care...thanks everyone for your input!

Our nurse manager is requiring all of our unlicensed assistive personnel to document that "nail care" was done on each pt. This includes cleaning, trimming and filing. I thought I learned a long time ago that in the state of CA, nurses are not licensed to perform manicure or cosmetology services. Thus, as the RN responsible for all tasks delegated to the nurses assistants, am I (and they) going beyond our scope of practice? I cannot find anything on the internet about this topic. Thanks- Kathy

Our nurse manager is requiring all of our unlicensed assistive personnel to document that "nail care" was done on each pt. This includes cleaning, trimming and filing. I thought I learned a long time ago that in the state of CA, nurses are not licensed to perform manicure or cosmetology services. Thus, as the RN responsible for all tasks delegated to the nurses assistants, am I (and they) going beyond our scope of practice? I cannot find anything on the internet about this topic. Thanks- Kathy