RN"s and LPN's mandated to work as CNA's

Nurses General Nursing


I am a nursing assistant and at the nursing home where I work nurses are being mandated to work as cna's for RN pay. This has caused all heck to break loose. Many nurses are leaving because "I did not go to school to do aid work" This whole mess started after are building decided to go agency free. What are your thoughts on this;what are some answers. Why do nurses take offense to working as aids. Some nurses have been great about it and others are repulsed by the idea. WHY?


Nursing assistant


59 Posts

It depends. Are they also doing their RN and LPN duties? Or, are they being brought in for extra shifts to work as the aide without the added responsibilities? If the latter is the case, then it should be their choice to do that. If your facility is short staffed and they are required to do their normal routine AND the CNAs duties, then I'd be upset as well. No one can do it all. As far as some leaving because they say they didn't go to school to do aide work, well that shows their level of compassion I guess. If doing 'aide work' repulses them, then they are in the wrong field.


OC_An Khe

1,018 Posts

Specializes in Critical Care,Recovery, ED.

I would be upset also and wouldn't accept being mandated to come in extra to do aides work. I would also fight mandation if I were being mandated for RN work also. My response has nothing to do with compassion, but misdirected compassion can be very dangerous. Look at the messages that are being sent. The LTC facility wil pay an RN to do the CNA's work, but doesn't value the CNAs enough to pay them enough to either retain current staff or recruit into vacancies. At the same time the facility is telling the RNs, we don't respect you as professionals.

Just curious, how many administrators are working extra shifts as aids?


68 Posts

We have alot of Snowbirds here in the winter and work our behinds off in season, but in the summer get called off. Instead of getting called off in the off season, licensed staff will fill in in other areas left understaffed due to vacations as ability permits in our hospital. I've worked as a unit clerk as well as a CNA. Let me tell you, CNAs work hard, but a day without the usual responsibilities is like a breath of fresh air. As an RN, not a day goes by at work that I don't wipe butts & slosh pee in addition to my other, non-CNA duties anyway. Spending a day in their shoes helps increase your respect and appreciation for your hard-working CNAs. But, sorry, there's no way I would come in and work for less than my regular pay: guess I'm just a material girl after all.


29 Posts

I just came out of a situation just like that.

I refused to be assigned CNA duty.


Because I did not go to school to become a CNA. I respect CNA's and have nothing bad to say about them or their work. However, I have spent years as a CNA and I was anxiously looking forward to the day that I graduated from LVN school so I would not have to break my back for the low pay that a CNA was making. My last CNA job in 1997 paid a whopping $5.66/Hr. And let me tell you, I was gratefull to graduate LVN school for the boost in pay but also to save my back!

I can understand why nurses at your facility are pissed. Prior to becoming a LVN or RN they had probably been a CNA; therfore, being asked to do something that you worked so hard to get away from is more or less a slap in the face.

Here is an anology: Does a bank president go back to teller duties if there is a shortage of bank tellers?

Not no, but HELL no! He instructs his bank to get on the phone and call up Snelling & Snelling or some other temp service to fill the need of the bank teller.

Do doctors become nurses when there is a nursing shortage? Hell no!

And for those nurses who do accept the mandate: you are the ones who do nursing a diservice.


You accept the unacceptable w/o complaint. Therefore you send a message that is loud and clear to those who are in authority: that you will continue to accept being unduly overburdened.

And when you do this you more or less set the standard for which all nurses are viewed: that you will accept b.s. assignments and keep on like there is nothing wrong. But knowing damn good in well that you hate doing it, but out of fear of termination you continue to accept dangerous assignments.

Its like I told my employer: Am I worth more to you as a nurse or a CNA?

CNA's frequenlty have constant back problems. And as a nurse, I have taken care of retired CNA's who slaved for facilities for years, and the majority of them end up at my facility w/ spinal fusions. Chronic LBP, herniated discs, etc.

Just the everday stress of getting people in and out of W/C's and bed and doing dressing changes--wears my back out.

But you Florence Nightengale types are gonna keep up w/ your persistant a$$ kissing and you'll end up being in the nursing bussiness by yourself.

Like I said in my previous posts: If the assignment is not acceptable~~~~~~don't accept it.

There are TOO many jobs in this world, and only so many nurses.


91 Posts

The administration at this place is very hands off. He likes to throw around words such as abandonment and neglect when the nurses refuse to work as cena's. The full and partime cena's are all required to pick up several shifts. If they do not they are assigned shifts. Some are mandated to come in at three am in the morning. Many of my co-workers do not own cars and must take the buss to work. These buses do not run after mid-night. Several of them are having trouble finding someone to watch their children for eight more hours than they had originally thought. We have asked the administrator to provide a make shift day care in our chapel. He can come in with his wife and baby-sit. Not gonna happen.


1,301 Posts

Hi chili2641. I guess one question is whether your administrator and others who use staff in a multipurpose way are doing so within that person's scope of practice and job description? If it's understood that nurses, for instance, can be utilized as nurses and etc., then I guess the administrator would feel that it was within his/her right to push the envelope in that direction.

Chili, just out of curiousity, did nursing assistants repeatedly approach administration about how overwhelming the work was for them and include comments that nurses can frequently be found sitting in rooms or at the nurse's station not offering to help? I write this because I can't tell you the number of times I have heard complaints from aides who use to work in LTC complain about nurses who did not lift a finger to help them. These complaints may or may not have had a bearing on the administrator's decision. I wonder if some of the nurses will choose to report their concerns to the various state licensing boards. That would be interesting.

I'm aware that LTC is underfunded. I also feel that, after talking with others who have worked in LTC, the quality of management in many of these places leave alot to be desired. The nurses as well as CNAs need to take a stand for best use of resources for patient care or look elsewhere for employment as some of the other posters have suggested. Best wishes to both the nurses and nursing assistants.


499 Posts

I do CNA chores every day, but I would not work where it was mandated. I enjoy the mental challenges of RN work. I do the other because it goes with the job, but I couldn't do it full time. It is disrespectful - what's new. I would be more willing to comply if management were in the trenches too.


91 Posts

In the last couple moths we had around ten cna's quit. Are administration refuses to cover shifts with the help of agency staff. The nurse aids were quitting because they were being mandated to work so much over time. Nurses were mandated to work as a last resort. Mijourney I have never heard any nurse aids say that their nurses were lazy. Nurse aids do feel that the nurses think they are to good and to educated to lower themselves to do aid work. I do not know why but they say it all the time. The nurses where I work are mad and they talk bad about the cnas because they are mad. Some are being to blunt and cnas are taking offense. Team work is in the toilet.


Nursing assistant


8 Posts

has anyone considered that for census-legally they are not supposed to list rns as cenas. in michigan last time i knew if an rn in the building-despite working as a cena they must be listed for state numbers as rns, or lpns depending on licensure. this i believe changes with type of facility. is it medicare approved, not for profit, ect. each facility type has different regs. as a long term care nurse. i routinely assist my cenas on the floor- yes i get my hands dirty, but that is my choice not the companys. i became a nurse after 5 yrs as a cena. i hurt my back as a cena. i am very careful of it now.cenas are underpaid , underrecognized, and underappreciated by other staff, often by nurses who "supervise" them. a kind word or a helping hand goes a long way to improve working environment. i do not believe in general mandates when it comes to cenas, but we work in a 24hr facility that if the weather is bad-everyone is mandated. not all administrators are bad my last one did help on the floor, it is the don who did not help.(nurses or cenas) the cenas work hard as do the nurses, but at least we get paid semidecent for the crap we take and we are more able to afford insurence for are health, often because of low wages, cenas can not. it will only change with specific legislation regarding changing from census to acuity level to base staffing on. and it should also make specific provisions for cena wages and legalities.cenas do not know their rights that if someone gives them a directive to say lift a 2 person transfer by themself they have the right to refuse..for their and pt safety. the system will only change if enough people stand up and demand changes

i appreciate and respect my staff. they are my eyes and ears and i would not trade them for anything..



91 Posts

I understand how the nurses feel. Its interesting that a nurse admitted that nurse aid work was direspectful. One other nurse said she was past it. Nurse aids are the back bone of nursing in ltc. The nursing home would not run with out them. Nurses are responsible for all the patient care if there are no cnas around. Mabe I do not understand what a nurse is. Nursing is dirty work and it is bedside pt care am I wrong? How can a nurse be past it. Why would you work in a field where you feel disrespected? Why do you feel that working as an assistant is disrespectful? I I am starting to see where my co-workers are coming from.


Nursing assistant

ktwlpn, LPN

3,844 Posts

Specializes in LTC,Hospice/palliative care,acute care.
Originally posted by chili2641:

I understand how the nurses feel. Its interesting that a nurse admitted that nurse aid work was direspectful. One other nurse said she was past it. Nurse aids are the back bone of nursing in ltc. The nursing home would not run with out them. Nurses are responsible for all the patient care if there are no cnas around. Mabe I do not understand what a nurse is. Nursing is dirty work and it is bedside pt care am I wrong? How can a nurse be past it. Why would you work in a field where you feel disrespected? Why do you feel that working as an assistant is disrespectful? I I am starting to see where my co-workers are coming from.

You said it well Chili-can't run a LTC facility without CNA's...I too have worked shifts as a cna-but after speaking with the DON I made it clear that when I am working as a CNA that is exactly what I am doing-not treatments and tube feedings while the nurses snack at the desk.After I saw our DON and ADON come in several evenings last summer to help do evening care I gained a whole new respect for the administration-ours really does care.I will say though that I physically can not do it day after day-luckily I was able to go to school years ago...nothing ruins your body faster I think.But I will pitch in along with most of the other LPN's and RN's I work with now...but still we have afew that say"it is beneath them" Hold that opinion privately I think-don't spout it at the Nurses station.But as someone else said-when I am the charge nurse the only break I take is a short lunch-and I am always 10 or 15 mins over shift tying up loose ends...no one can pitch in and help me get my meds and tx done or my MDS....but let me ask for someone to be taken to the bathromm at breaktime for the floor staff...It is not going to happen without alot of gryping and complaining.
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