Should I ask new employer if I can work the floor with the aides before charging?

Ms.RN · Oct 22, 2008

i suggest against it. you are working as a charge nurse and you are suppose to supervise cenas like what you've learned during the leadership class of your nursing school.

PICNICRN, BSN, RN · Oct 22, 2008

We had a nurse apply to our unit ask if she could "work" a shift before accepting a position and my NM told her that she could not because she would not be "covered"- I guess kind of a CYA thing. She would not be an employee of the hospital or student so .... I guess this would pose some legality problems? Now, I have heard of shadowing during an interview process- which I guess means that you are not actually allowed to touch the pt from my understanding.

Now, I'm not sure of any of this.... could just be my NM making up stuff so as not to deal with it LOL!

cardiac~lover · Oct 22, 2008

The problem employers have with this is that you are a nurse, and working as an aide allows for too many grey areas. What you are allowed to do and not allowed to do. The scopes of practice are so different that liability would be an issue.

jjjoy, LPN · Oct 22, 2008

The problem employers have with this is that you are a nurse, and working as an aide allows for too many grey areas. What you are allowed to do and not allowed to do. The scopes of practice are so different that liability would be an issue.

Of course, if there aren't enough aides, who will pick up the slack? A nurse! The aides' work IS their job, in addition to many other responsibilities. It's not like an administrator filling in for a brain surgeon to "get a feel for the job."

If there IS a nurse assigned to a particular patient load, then THAT nurse has the primary responsibility and should be able to address any concerns that the aide or nurse-working-as-aide brings to their attention. The real risk is that most places are understaffed and thus there ARE nursing needs going unmet that the nurse-as-aide could theoretically help with, where a regular aide legally can't jump in and help. They can only tell the assigned nurse if they see a problem.

I wonder how it works for hospice nurses and CNSs and other "consultant" nurses who drop in on patients? Are they held to the same level of responsibility for the patient as the assigned floor nurse? How about physicians? Is an orthopedic surgeon responsible for the endocrinologists' mistakes since they are both MDs?

Practically, it sure makes sense for the charge nurse to have a little first hand experience in the aides' shoes to really understand their issues as aides at that particular facility. It's sad that fears of liability would prohibit this.

caliotter3 · Oct 22, 2008

I worked as a CNA at a facility until a nursing position opened. Due to jealousy, I was presented with an almost impossible task of supervising the CNAs once I began as a nurse. In my case, I had no support from my management. I was criticized for not being able to handle supervision, when all the CNAs were allowed to sleep on duty (noc shift) and do little to nothing long before I showed up. I would not recommend that you do this.

cardiac~lover · Oct 22, 2008

Of course nurses are responsible for the duties of an "aide". My reasoning comes from my current employer who, as a nursing student and 5yr CNA, will not allow me to continue in my current job description as an Lpn while I work towards my RN. I was not implying that there is any kind of separation between nurses and aides in regards to direct patient care. I was purely speaking out of personal experience as to what employers think about this kind of situation.

jjjoy, LPN · Oct 22, 2008

Of course nurses are responsible for the duties of an "aide". My reasoning comes from my current employer who, as a nursing student and 5yr CNA, will not allow me to continue in my current job description as an Lpn while I work towards my RN. I was not implying that there is any kind of separation between nurses and aides in regards to direct patient care. I was purely speaking out of personal experience as to what employers think about this kind of situation.

You're right that many employers won't allow folks to work in "lower" positions if they have higher licensure. And yet others do allow it. Personally, I don't see a problem for patient safety with someone with a higher level of training taking a lower level position. The potential problems would seem to more along the lines of employers taking advantage of someone with higher training in a lower level position by insisting that they are obligated to do more than someone in the exact same position who doesn't have the extra training. And, of course, it's not a good career move for someone with higher training to work a lower level position for any extended period. I'm sure many employment lawyers would disagree, but I personally don't see why it should be a problem for a nursing supervisor to work a few shifts of any positions they are qualified for in order to be a better manager.

southernbeegirl, BSN, RN · Oct 24, 2008

In our company, the administrators and DON go thru a process when they are training...they work a week in every single dept. I love the idea myself. If one of my new nurses wanted to work the floor for a shift as an aide and i had the staff...i'd go for it.

mondkmondk · Oct 24, 2008

I'm really confused. Today was my second day, but only on the floor half a shift, and shadowing the other RN. I watched movies all morning about how to care for dementia patients and what to do during a fire drill etc. I almost fell asleep (I'm not a morning person). Anyway, I'm confused about what station the ADON put me on. She told me one thing and everyone else is telling me another so I'm going to have to call her tomorrow and ask her. Anyway, if I end up on the easiest station where I charge plus pass my own meds and only have 1 CNA, then I will probably just go ahead and orient to charge.

Thanks for all the replies...and different perspectives!

Blessings, Michelle