Where I work sometimes if there are not enough CNAs or float pool coverage available they will assign the RNs to work as aides. I have written my concerns about this to the nurse manager. They say we do the job of an aide but you "work to your license" which means I have as much responsibility legally to the patients in my care as their assigned nurse does yet I get an aide's report which usually does not even tell me why the patient is there, only the chores that need to be done!
Granted this doesn't happen all that often but I resent my license being put in potential jeopardy because of the hospital's lack of planning. This is what staffing agencies exist for! The last time this happened I told the person who made the assignments out that I didn't want to do the assignment, but I didn't refuse to do it, she just changed the assignment without any hassle.
This practice is illegal in some states but the state I live in (AR) is not one of them.
What are your experiences or thoughts on this issue?
Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.
Why not just staff you as an extra nurse?
The reason I ask, is because our staffing grid calls for, say, 2 RNs and 2 NAs at night with X amount of patients. But what if one NA calls out with no replacement? Our floor would just call in for 3 RNs and 1 NA, with the thought process being (and bearing in mind that this is night shift) that the RNs can help with patient care stuff like taking people to the bathroom, etc.
That strategy doesn't make sense fiscally to me - like, why would you want to pay an RN twice as much rather than call in an extra aide - but oh well. I don't mind taking my patients to the bathroom and getting sets of vitals and stuff like that, plus it makes the patient load lighter for nurses.
I have had to serve as a mental health tech a few times due to staffing issues. I was a RN whose assignment happened to be tasking for the unit.
I didn't mind as long as I got my RN pay :) And some days, it was a nice change of pace to be closer to the front lines.
This is far more fun, to me, than being stuck behind a desk. I relish these days when I get RN pay for teching (though we like to call it being the "milieu nurse").
We just accept it for what it is, I guess, because of the nature of the job. It's damnably dangerous to leave the floor unmanned... so we take who we can get and do what we can!
When I worked in the hospital, if a CNA called out we'd just work without one. That doesn't mean an RN would get pulled to be the floor's CNA, it just meant that all RNs had their full assignments and did EVERYTHING for their patients. Truthfully, it wasn't that different than when we did have CNAs.
Not every hospital has agency staff available at the drop of a hat either. At my old hospital if we were overstaffed with RNs and short on aides, they would ask if the RN wanted to stay and work as a CNA and solely as a CNA, but at RN pay rate. Of course we always said yes because when they asked, it means we were desperate and we had a good bond between our staff. Is it bad staffing, oh probably.
Personally, I dont care. I could be told to do whatever I am legally allowed to do an be ok with it. Granted I wouldnt make the best CNA because the ones we had were awesome and had the timing down for everything.
I am a current full-time CNA, and a BSN student. I have thought about this myself in the past, and do find it wasteful to pay an RN to do a CNA's job. HOWEVER, I do think that a lot of the nursing staff in this hospital truly don't understand what the CNA is asked to do. There are some that don't come to me unless they absolutely can't avoid it, and others who don't want to step in the room unless the patient specifically asks for them. I work nights and on nights we only ever qualify for just one aide, even if the floor is full. We burn through so many aides here, and a lot of the nurses wonder why. I think the primary reason is the fact that the nurses don't see everything the aide is doing, and often just take into consideration what they are asking of the aide instead of what ALL the nurses are asking for. I do understand that sometimes you just CAN'T do everything as a nurse, and that is what an aide is there for. I do believe though that RNs working as CNAs once in a while is a good refresher, just so they see what it's like on the other end of things. If everyone knows what responsibilities each team member has, everything becomes more efficient, balanced, and friendly. It's easy to get annoyed with someone, when you think they aren't actually doing anything. This goes both ways, and applies to all staff.
Not necessarily. I worked through an agency (not nursing) several years ago so I have an idea of how the costs work.
Agencies charge higher rates because they can offer staff on short-notice or to suit the facility's particular needs. So they may charge the facility $30/hour for the CNA they send over, that your facility would pay $15/hour if she were an employee. Of course, the agency CNA isn't getting $30 an hour; she probably gets $20 or so and the agency pockets the rest...that's how they make money.
But if the agency charges the facility $30/hr for the agency CNA, while a RN on your facility's payroll makes $25/hr, its actually cheaper to use the employee RN.
Yep I willingly work as a cna , for rn pay. I do help give meds but I report everything to the rn assigned. I only cost a few more dollars an hour than the agency cna , so they will se an rn if they are willing.....most are not. I like to do it .....about twice a year....just to remind me all they do
I can't imagine how awesome it'd be if every time we're short a tech we're given an extra nurse. That would be a dream come true. Any time we're short a tech we get nothing, we're on our own.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Where I work sometimes if there are not enough CNAs or float pool coverage available they will assign the RNs to work as aides. I have written my concerns about this to the nurse manager. They say we do the job of an aide but you "work to your license" which means I have as much responsibility legally to the patients in my care as their assigned nurse does yet I get an aide's report which usually does not even tell me why the patient is there, only the chores that need to be done!
Granted this doesn't happen all that often but I resent my license being put in potential jeopardy because of the hospital's lack of planning. This is what staffing agencies exist for! The last time this happened I told the person who made the assignments out that I didn't want to do the assignment, but I didn't refuse to do it, she just changed the assignment without any hassle.
This practice is illegal in some states but the state I live in (AR) is not one of them.
What are your experiences or thoughts on this issue?
While it is not the most prudent financial decision.....it is not illegal unless they try to dock your pay. Of course you work to your license. If you are a RN working as an aide and fail to act to an emergent situation you know how to deal with, you will be held accountable. Thank doesn't mean that while you are doing "CNA" work that you need to perform a full head to toe assessment on every patient in your care.
While it is an expensive alternative, it is an alternative. I wouldn't call an agency as agency aides are more expensive than some nursing staff so then that makes the nursing staff the cheaper option. I some Union facilities when there is Low Census I can not cancel the RN staff which means I have to cancel the CNA"s, Techs, and secretaries.....then reassign the RN staff. In the long run with a RN still in the facility, if admission begin to slam the floors I can assign the RN to take admits to maintain safe nurse patient ratios.
I am unfamiliar with any legal documentation of this being an illegal practice...do you have any references? Your license isn't being put at risk.....they are not asking you to act outside your practice/scope/expereince nor are they asking to perform duties that you aren't qualified to perform.
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Morainey, BSN, RN
831 Posts
Why not just staff you as an extra nurse?
The reason I ask, is because our staffing grid calls for, say, 2 RNs and 2 NAs at night with X amount of patients. But what if one NA calls out with no replacement? Our floor would just call in for 3 RNs and 1 NA, with the thought process being (and bearing in mind that this is night shift) that the RNs can help with patient care stuff like taking people to the bathroom, etc.
That strategy doesn't make sense fiscally to me - like, why would you want to pay an RN twice as much rather than call in an extra aide - but oh well. I don't mind taking my patients to the bathroom and getting sets of vitals and stuff like that, plus it makes the patient load lighter for nurses.