RN's and LPN's working as Nursing Assistants?

Nurses General Nursing

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If you came into your facility and they asked you to work as a nursing assistant for the day for your regular nursing pay, would you agree to it? Why or why not? If you would, or if someone else would, do you feel they are still accountable to their patients as a nurse?

How is your license at risk because you are working as a CNA for one shift? Yes, you are held to the standard of your license, but again, how is that dangerous for your license? CNA duties are certainly part of the RN scope. If you had no aides that day, you'd be providing that level of care for your patient as well as the advanced scope of your RN license.

It's true...if there are no aides you'd be providing that care for your 5 to 6 patients, helping other nurses if you choose...still responsible for your normal patient load. Not half the hallway, or the whole hallway, like you would if you're acting as the CNA. Are you saying things can't get crazy in one shift??? Ofcourse they can.

If you look at my post below it might explain a little more. I was talking to a very large group of nurses who felt they did not have to intervene as a nurse if that wasn't their role that day. I know it sounds crazy. But this large group of people really felt that way. I argued that you're a nurse and will be judged in that capacity regardless of what role you're in. And because that's the case. Work as a nurse.

As long as I'm getting my usual pay. CNA duties are in my job discription so why should I act like I'm above it?

I'm not talking about being above CNA duties or acting above them. Why does everyone always assume that? I'm talking about working as the nurse you were hired to be.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

If I showed up for work and was told I would be doing only CNA duties for my regular RN pay I would consider it a gift from the gods. Of course I would be held accountable as a nurse if the situation arose, but otherwise I would have no patients to be completely responsible for. I'd get to take breaks! What's not to like?

If I showed up for work and was told I would be doing only CNA duties for my regular RN pay I would consider it a gift from the gods. Of course I would be held accountable as a nurse if the situation arose, but otherwise I would have no patients to be completely responsible for. I'd get to take breaks! What's not to like?

Breaks? I remember those. Vaguely.

If I showed up for work and was told I would be doing only CNA duties for my regular RN pay I would consider it a gift from the gods. Of course I would be held accountable as a nurse if the situation arose, but otherwise I would have no patients to be completely responsible for. I'd get to take breaks! What's not to like?

..........cnas are responsible for their patients as well you know. Also, I don't know where you work but the nurses here do get breaks

Specializes in LTC, assisted living, med-surg, psych.

When I was working my first job as an RN, I had the worst of all worlds---I was the charge nurse for 28 residents, *plus* I was the CNA for a group of eight patients whom I had to get up and do their AM care, take them to breakfast, lay them down between breakfast and lunch etc. This was done to make the staffing look like it conformed to state law regarding ratios. Needless to say, it was on top of the morning med pass, treatments, doctor calls and so on. It wasn't that I minded doing CNA work, it was simply an unsustainable way to work. I left that first nursing job after three months. You couldn't have paid me enough to stay there.

When I was working my first job as an RN, I had the worst of all worlds---I was the charge nurse for 28 residents, *plus* I was the CNA for a group of eight patients whom I had to get up and do their AM care, take them to breakfast, lay them down between breakfast and lunch etc. This was done to make the staffing look like it conformed to state law regarding ratios. Needless to say, it was on top of the morning med pass, treatments, doctor calls and so on. It wasn't that I minded doing CNA work, it was simply an unsustainable way to work. I left that first nursing job after three months. You couldn't have paid me enough to stay there.

WHOA. Yea, I would've left too. Far too much. When I worked in LTC, I had 30 patients in my hall to pass meds to and do treatments. I was almost always short an aide, having only one aide for the entire hall. I'd do every round to ease the burden, and then I'm clocking out late while she or he is leaving on time. I lasted a year. It's nothing like what you had to do, as I worked midnights...but still too much!

Specializes in Emergency Nursing.

Every once in a blue moon CNA work for a shift is nice. It gives my brain a break. I always say CNA work is physically demanding and nurse work is mentally demanding. When I worked in a nursing home and would be assigned as an aide, I always felt relief when the nurses had an admission or something and I was simply toileting someone =)

It's true...if there are no aides you'd be providing that care for your 5 to 6 patients, helping other nurses if you choose...still responsible for your normal patient load. Not half the hallway, or the whole hallway, like you would if you're acting as the CNA. Are you saying things can't get crazy in one shift??? Ofcourse they can.

Did you just pull that out of a hat? Where did I say or imply that "things can't get crazy in one shift???" I made no such reference.

If you look at my post below it might explain a little more. I was talking to a very large group of nurses who felt they did not have to intervene as a nurse if that wasn't their role that day. I know it sounds crazy. But this large group of people really felt that way. I argued that you're a nurse and will be judged in that capacity regardless of what role you're in. And because that's the case. Work as a nurse.

Just because someone else "feels" something, doesn't make it true, which you have well appreciated. I still think you are overstating the potential for liability here. You, as an RN, would be doing basic care for patients normally assigned to a CNA. Those patients have an RN assigned to them. You, with your RN knowledge, would very likely recognize the signs of impending trouble, far earlier than a CNA likely would. You would inform the RN, you would work with her to handle the situation, even if it meant the relatively healthy guy in 208 didn't get his bath. The RN assigned to that patient would legally carry the bulk of the responsibility here, but yes, if you did something crazy, like walk out of a room with a patient bleeding out without informing anyone or doing anything to help, you'd be liable, just as you would be if you (working as an RN with your own patients) answered a call bell for someone else's patient in the same scenario and you did nothing. But you wouldn't do that in either case, would you? You just wouldn't do something crazy and irresponsible like that, and I don't believe your colleagues actually would either, despite what they say.

Let's put it this way: Do you, working in the capacity as an RN, refuse to answer call bells of patients assigned to other RNs because once you interface with them you are now "responsible" for anything that happens to them for the rest of the shift? I doubt it.

Being assigned 8 patients as a CNA with your RN license doesn't mean that you have total responsibility for those patients at all times when you are not dealing with them. Their RN is top dog in that scenario and if Mr. Johnson is 1st on your list for his bath and you are now working on your 8th patient in a different hallway, you are not going to be held in the same light as his primary RN if Mr. Johnson begins to bleed out and his assigned RN doesn't act in a prudent and reasonable manner. If Mr. Johnson was perfectly fine when you did his vitals and bath and you have documented that, you just won't be held liable for something that happened down the line that you would not have been witness to. The same applies if you as an RN answer a call bell for your colleague's patient and he is stable and sans complaints. If that patient later bleeds out, you are not going to be held liable for that just because you walked in hours earlier and did something for him as a favor to your colleague unless you did something imprudent and unreasonable in your scope as a registered nurse.

You, while legally held to the standard of an RN, actually have less risk on the days you are working as an adjunct with another responsible RN than you have when you are working as an RN on your own with a CNA to help you. JMO.

Specializes in Case Manager/Administrator.

I am quite perplexed that this is even a question. As a Nurse and LNHA I have worked in every capacity that is available. When I was a floor nurse at a small hospital I worked again in every capacity helping out when needed. I would never think it would NOT be my job.

I have often overhear nurses say we have to help them with their work but they cannot help with ours. I think this is a silo concept and one that smacks of hate and discontent.

Now I understand when a nurse has boundaries, can delegate tasks and follows through with those tasks. I have asked many nurses to work as CNA, all the while they are getting nurse pay. A nurses responsibility includes everything a NA-C must do, so why the feeling of it is not my job?

If a nurse commonly works as a NA-C then I would speak to management to find ways to hire the best staff for the right position. In the mean time work is work and for me I am just happy I have a job that supports the life style I want.

Specializes in mental health / psychiatic nursing.

Where I work we don't have CNAs so any CNA duties that need to be preformed are already part of my nursing scope. (I work psychiatric setting so we have mental health techs, but most are not trained as a CNAs and can't take vitals or anything like that). I don't think I'd mind working as a CNA or mental health tech for a day while receiving RN wages, it would be a completely different head space, but refreshing to be interacting with patients in a different way than I do now.

Specializes in Critical Care.

Working as a CNA doesn't bother me and working nights I'm already doing those duties as well as my nursing duties so this would be a break from the responsibility of being the nurse. In that sense it is much less stressful like an IV nurse, stat nurse or admit-discharge nurse. Sure if you noticed a problem as a nurse just let the patient's nurse know. I worked as a stat nurse on light duty and it was very refreshing, no stress, no responsibility, you always got your lunch break. I would have loved that job, but it was only given to nurses on workers comp. Once upon a time we had a few resource nurses but those jobs were eliminated to save a buck. Those were the good old days! Now they say nurses aren't supposed to work as CNA's or sitters as we cost too much, but it still happens all the time anyway.

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