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?
Here is my thing......it seems to me that Nurses work hard to be known as a bona fide profession Nurses seem to always be craving respect.
Each one of us has our own beliefs but to me a professional nurse jumping on CNA work to get a few extra shifts sorta makes it look like they are more innterested in a few bucks than in developing Nursing into an accepted and respected profession.......
I don't see it so much as putting your license "on the line" if they're not expecting you to do any nursing duties that would require taking report. But if you notice that so-and-so is turning blue, they would expect you to use your RN-educated brain and do things that "just a tech" may not know how (or be licensed/authorized) to do. That's my understanding of the expectation of being held to the level of your license -- is it something that you, as an RN, should have known better than to do.
You're not going to be asked to pass meds or call the doctor and take verbal orders -- because those aren't "tech duties" -- but if someone codes and you're nearby, you're expected to "be an RN" (because you are one) and do whatever it takes to save that person's life (just like you'd do for any patient whether you're working as an RN or not, whether they're your patient or not -- you don't refuse to work a code because you never received report on that particular patient).
Exactly. Being held to the RN "standard" doesn't mean you're required to do the primary nurse's job for them. Just like if one of my coworkers is busy in a room and I go to check a beeping IV pump or an alarming monitor on one of their patients. I take care of the problem. If it's going to involve digging deep into their chart to determine and working with the case manager, I let the primary nurse do it.
Personally, when I worked at a place that did this, it really was easier to have a nurse work as a tech than to have one less patient and do total care on everyone. Fighting over the only blood pressure machine that works alone made it easier. And I would often be the aide. Easy shift. Everytime a patient has a problem, "I'll let your nurse know." :) I would just have to be careful, as some nurses would take advantage and want me to do all the tech duties AND try to get me to do half their nurse duties. "Nope, I can't start an IV for you, I've got vital signs to do!"
The best shifts though? A few times I got holiday time and a half RN pay to be unit secretary. Even though I was a horrible unit secretary when I was a secretary, and even worse once I was out of practice, didn't mean I'd turn down that nice of a gig.
Sometime staffing office just needs a warm body to fill a hole and the rn ends up being the warm body. I'd want an rn report and a cna report. Most shifts you would just do cna duties and go home. However you might have a patient you think is in trouble because of your higher level skills and report that to the primary nurse sooner than it might otherwise be done. Someone needs to be coded, you do it. Would want rn pay. Would not want it to happen very often. Our hospital uses their lpns like this quite a bit. Other than that you are an employee and do what needs to be done.
I have worked as a unit clerk and I have teched. The RNs like having an RN as uc, because I can answer call lights for beeping ivs or pain meds. Of course I tell the primary nurse first, so they are aware. Teching is a change of pace too. I'm usually proactive helping the techs.
So, basically as long as my check shows up with RN pay, I am willing to do whatever needs to be done for the good of the floor/patients.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
Another thing regarding the economics of paying a staff RN vs an agency CNA -- efficiency. A staff RN who knows where all the supplies are kept, who has access codes/swipe cards to get into all the necessary supply areas, who knows the way around the computer charting and has a username and password, who knows the names of the other staff members, who knows the general flow of the unit, etc., is going to be able to perform the CNA duties a lot more quickly and efficiently than a staff CNA who isn't oriented to the facility/unit.
I just wondered something: Please don't anyone take this as rude, but what is putting ur license in jeopardy? Do u have access to the charts will the nurses u work with not answer ur questions? I have worked as CNA (as an LPN). If u use safety 1st and universal prec. and the above charts w/ ur coworkers what other information do u feel ur not getting or not allowed to have cause u r working in a CNA role? FYI-here in MA. I called the board and asked if a person w/ a nursing license can take a CNA job ( for an actual job). Answer was:yes as they will only be held to that scope of pratice as that was what they were hired to do and not required to do anymore than that ( just a side note)
..... When did charge nurses stop engaging in critical thinking??? This is team leading 101 folks.
The "staffing grid" is just a reflection of the application of a particular care delivery model. In the OP's case, it appears to consist of RNs assisted by CNAs. WELL - why attempt to adhere to that particular care delivery model if all the prerequisites are not there??? Whenever this occurs, the person in charge should re-draw the map and establish a new care delivery model that incorporates the available resources. If there aren't enough CNAs, just re-distribute the RN patient assignments & establish a new 'task list' for the CNA(s) that doesn't involve continuous interaction with only one RN.
In the life of any charge nurse, there always comes a time when the standard operating procedures simply don't work due to unanticipated circumstances - simultaneous codes, sudden influx of admits, staff going home sick with food poisoning, police arresting your monitor tech (hey, it happened), internal disaster, etc. In these situations, all bets are off and you simply have to punt. The best course of action is to quickly assemble the team, explain the situation and come up with a workable plan that is agreeable to everyone. Sometimes you have to do it in mid-shift before things spin completely out of control. I call it "circling the wagons".
Honestly - effective leadership is what turn's a potentially chaotic situation into simply a "memorable shift". Interestingly enough, the simple process of making it through a challenging situation can actually be a positive team-building event. Now, promise me you'll try to stop "awful-izing" and start thinking when the next crazy shift comes along.
In the state where I live a RN working as a CNA is illegal but as a RN I not only do RN things but I also do cna things so I do not understand why it would be illegal as long as I understand as an RN I still have certain duties and accountability no matter what job I am doing
It may be a "huge waste of money" but which would the floor prefer -- no tech/aide/CNA at all, or an over-qualified one? (I also agree that it's a good idea to work "in the trenches" from time to time; teams work better when everyone understands everyone else's perspective, IME).
I don't see it so much as putting your license "on the line" if they're not expecting you to do any nursing duties that would require taking report. But if you notice that so-and-so is turning blue, they would expect you to use your RN-educated brain and do things that "just a tech" may not know how (or be licensed/authorized) to do. That's my understanding of the expectation of being held to the level of your license -- is it something that you, as an RN, should have known better than to do.
You're not going to be asked to pass meds or call the doctor and take verbal orders -- because those aren't "tech duties" -- but if someone codes and you're nearby, you're expected to "be an RN" (because you are one) and do whatever it takes to save that person's life (just like you'd do for any patient whether you're working as an RN or not, whether they're your patient or not -- you don't refuse to work a code because you never received report on that particular patient).
AMEN......hmm no aide or over qualified "body" seems to be a no brainer to me
I am an LPN and was asked to work as a CNA when someone called off. I did it once and would never do it again, ever! Why? Because that just gave the facility the right to abuse me. I got to do all the CNA work, since the RN was not going to do it ever, and I got to do all the LPN stuff I could do as well. I would never do this again. Not only was it stressful, but extremely dangerous in my honest opinion. Now I have worked in facilities that do primary care, where the RN or LPN does all the patient care without the assistance of a CNA. That is completely different.
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?
Here is my thing......it seems to me that Nurses work hard to be known as a bona fide profession Nurses seem to always be craving respect.
Each one of us has our own beliefs but to me a professional nurse jumping on CNA work to get a few extra shifts sorta makes it look like they are more innterested in a few bucks than in developing Nursing into an accepted and respected profession.......
Just my two cents....
I'm just wondering. How is doing what use to be called beside nursing not developing into a respectable profession? Don't you consider 'CNA work' not part of the profession? Then what do you consider nursing to be if it isn't some days doing bedside care. What better way of getting to know the patient then assisting him in his daily care. I don't understand what you consider nursing.
mindlor
1,341 Posts
Here is my thing......it seems to me that Nurses work hard to be known as a bona fide profession Nurses seem to always be craving respect.
Each one of us has our own beliefs but to me a professional nurse jumping on CNA work to get a few extra shifts sorta makes it look like they are more innterested in a few bucks than in developing Nursing into an accepted and respected profession.......
Just my two cents....