RN as CNA

This is not uncommon to be asked to do the job of CNA especially if floating to a unit that you are not cross trained in. I floated to peds and did feeds, diaper changes/ weights, answered lights, took vitals, answered phones, entered orders,  anything I could to help but no pt assignment, no meds as if an adult telemetry nurse. So this was on your own daily unit? What liability concerns did you have? You were being asked to help everyone just like CNAs do. How long have you been a nurse? And no since you were not charting on ten patients ( nurse assigned to pt would be) it wouldn’t look like you “ had 10 pts”.

If you aren't capable of being a CNA then you aren't capable of being an RN.

My current state's board of nursing would just politely remind you of this, but I have worked in states where they wouldn't hesitate to suspend your license if you self-reported that you aren't capable of practicing as a CNA.

This of course doesn't include various "tech" roles, where the expected proficiencies may not necessarily be within your established proficiencies, but for a CNA role any RN should be able to perform these duties without concern of legal liability because the duties of a CNA are not within their capabilities.

Remember it is Certified Nursing ASSISTANT. So if there is no assistant (like some places are starting to do) you alone, as a RN, have to do those task that a CNA has been certified to assist you with. It says it all in the job title. A CNA is certified by the State Board of Nursing of their perspective state to assist the Nurse (RN). All task and duties that the CNA does is solely to assist the nurse from vitals to ADL. The CNA job is dependent on the RN. The RN job IS NOT dependent on the CNA.

When a CNA is busy with a task and a RN ask them recheck a patient's VS due to very high/low reading after they give a med to remedy it. Sometimes a CNA can get do it and sometimes they can't. It never fails, there will be a RN who will literally wait until a CNA has retook a VS instead of rechecking the VS themselves.

No one wants to hear from a RN that they don't know what the new VS after a med, because the CNA did not retake the VS. First thing they will ask is, why didn't YOU retake it?

Update already: the board says “

The Board of Nursing has no regulation addressing personnel issues.

You may work in whatever capacity you are trained and licensed/certified.

In the event of an incident, you would be held to the standard of your RN license.”  But where I work I was never trained for what the CNA does. I am held liable for 10 patients with my RN license…plus there’s are two other new cnas that have not been trained yet. If a family perceives anything wasn’t done to their standard I am one who is under fire and could potentially get burned for it. We have safety issues all the time in our ICU!! and that just is not OK bc they are literally just trying to to save a buck. I am submitting my resignation today. My license is way more important than a liability.

I am not getting my point across and feel I am only getting rudish commentary. Last comment: there was not enough aids. Not enough nurses. Safe Harbor?!  Even my Nurse Lawyer agrees with me. Not worth it. I hope you all take better care of your license.

48 minutes ago, Cwschlesner said:

  But where I work I was never trained for what the CNA does.

What things do your CNAs do that you don't know how to do as a nurse? That's concerning.

39 minutes ago, Cwschlesner said:

I am not getting my point across and feel I am only getting rudish commentary. Last comment: there was not enough aids. Not enough nurses. Safe Harbor?!  Even my Nurse Lawyer agrees with me. Not worth it. I hope you all take better care of your license.

Not enough aids or nurses..were you asked solely to work as a CNA that night doing CNA duties? 

Don't confuse others not agreeing with you as being rude. Maybe you aren't getting your point across/giving enough information.. IDK.

It is Certified Nurse Aide, not Certified Patient Aide. How can an RN not do what a CNA does if the CNA is there to aide the RN? Besides if you work in a ICU unit there will not be a CNA (at least in my state). I doubt many RNs there were trained to be a CNA.  Some hospitals are moving away from having CNAs (I believe there is a thread some where around here that talks about that).

The truth is that some RNs believe it is beneath them to perform any CNA duties. After all they spent all that money and time going to school to be a RN not a CNA. I get that. It is just that many places don't even have CNAs.

Years back my hospital put up a vote seeing if the RNs wanted more pay, but they would not have any CNAs. The RNs all said "heck no!"

Patient ratios. But I’m done. I’m not getting my point across. Verbally my lawyer and BON understand and finally my job are behind me. So this is pointless. I don’t know how to delete the post.

My understanding of an RN being in a CNA role, is if the RN is not attending to something that may cause harm or be indicative of a significant change in condition, the RN in the CNA role needs to identify the problem and take it higher.  Not be the primary person responsible. I don't think it was intended that for the 10 patients you had as a CNA, that you were responsible for interpretations of labs, giving medications and evaluating the effects of those medication unless the RN was disregarding important signs....for example, BP 210/140 and no BP medications given and no contact with the MD. Another example, patient having frequent grossly bloody stools but nothing being done in terms of assessment.

Since it sounds like you worked in a unit that used CNAs how did you evaluate if they were doing their jobs correctly? Did you ever assist a new CNA with an unusual  transfer and give a helpful hint  or turn your back and head out of the room. 

OK, I really do not understand your frustration with your role assignment but I agree it was best to part ways and seek a job without any CNAs or delegation. In the 1970's I worked  primary care nursing which meant an RN had no CNAs and did all the care themselves....like running 7ups down the hall when another patient was crashing. If you want that world, it is yours for the taking.  I so appreciate the CNA role and appreciate them as essential in the whole of patient care. 

26 minutes ago, 512Runner4lf said:

Patient ratios.

Have you objected to a CNA have a 1:10 ratio?

Best wishes on your new ventures.