This is in reference to a thread called "Re: Nurses - Leading your subordinates"
I just wanted to discuss the idea expressed there by several members that we should not view aides as our subordinates. Rather, we should look upon them as our coworkers and team members. Several people thought it was demeaning and disrespectful to view aides or LPN's as somehow not our equals.
I know we are all on the same team and have the same goal, at least we should.
However, someone leads a team. In Nursing, that is the RN. Legally, LPN's and aides are subordinate to the RN. The Charge RN leads staff RN's, too. And a Manager or Clinical Supervisor or House Supervisor or Shift Supervisor leads the Charge Nurses. In a very real sense, there is a definite pecking order. When my shift supervisor tells me what to do, as a Charge RN, I do it. She's my boss. So is my manager. So are the doctors, even though they're not nurses. So are administrators, directors of the service we're on, and probably other people. Some of our bosses are younger and less experienced. Doesn't matter. They are in charge and outrank us and that's how it is. They might be nice, they might less us know they value us, they might be nasty and unappreciative. Doesn't matter. If they're over us, they're over us. Yes, it would be nice if work were always pleasant but the bottom line is, it is work, our job, not the place to look for kudos and confirmation of our worth. Yes, I want that as much as anyone else but I've learned to confirm my own worth or get it from family and friends. At work, I do my work.
We need, IMO, to realize that we nurses are in charge. By virtue of our responsibility, by virtue of being licensed and the laws governing that licensure, by virtue of our great liability for the acts of our team members, we are in charge. Like it or not. And lots of us do not like it. Lots of us would prefer to just do our own work and give total care, not need aides to help us or LPN's to do whatever for our patients. But it doesn't work that way.
I am not saying to be ugly or imperious or rude, arrogant, or otherwise lord it over anyone. But we need, I think, to accept that we are truly in charge and that some staff members are truly subordinate to us. I think a lack of this acceptance is largely responsible for the troubles in our profession.
Other lines of work have bosses. Grocery stores, car repair shops, schools, you name it, their are bosses and subordinates everywhere. In families, this is true. When we forget it, there is trouble.
Yes, every member of a team in any line of work is important and should be treated with dignity. But, bottom line, somebody calls the shots.
Valid points posted on this thread, about team work etc, also about the ranking of the team, and where the buck is going to land..(firmly on the licensed nurses backside)
However, subordinates is not a word I would like to use, I can see how it would get peoples backs all fired up, valuable team members, all of us.
It still remains the fact though, that whatever we call each other, someone has to be the charge for that shift, ultimately the person who the poop hits when the fan is off!
With utmost respect to all the team, it's still the licensed RN who has that responsibility.
Superior is no a word I like to use either.. and would never...I'm not in anyway superior to any human being, just sometimes , if I'm charge, I have to take the flack for their mistakes.......
JBudd I understand that it is the "correct" word to be used but it is condescending especially when an RN goes up to you and asks you if you are her aide and then you over hear call you her subordinate. It has happened to me and it literally made me feel like crap.
So I am part of the nursing team and I am a co-worker... on my hospital ID it says Nursing Services just as it says on the RN and LPN Badge.
It is not my intention to make you feel like crap. It should never be any professional's intention to make you feel that way. That isn't what leadership is about. My point is, you are in a subordinate position. Doesn't mean stupid, incompetent or any other derogatory thing. Your badge says which department you are part of, it does not say you are a nurse. I have worked as an aide in a LTC, I know the heavy work load, but I would never have dreamed of calling myself "equal" to the nurse's role. As a human being, yes; in the work setting, no.
As for banding together, you are absolutely right. We have recently gotten our aides and support personnel into the union, that before was only nurses. We all together are standing up and demanding adequate staffing, and compensation for working shortstaffed. Some battles we win, sometimes we only gain a little ground. You sound like someone I would like to work with.
The next time the choice is helping with the wound care or doing the BGL, point blank ask the nurse what her priority is: which do you want done first? Since its ultimately her (his) responsilbility, let her make the choice. It is also a way of letting her know you were in the midst of something else. Personally, I ask my techs if they are in the middle of something or if they have time to help. I get honest answers, "I'm doing this, then I can" or "yeah, I can do this later".
The only decent nurse that treated my FIL was an LPN! She was worth more than the others wrapped in gold!
Subordinate, lower down the ranks, whatever.....we all work together, but the severity of punishment changes depending on who you are if a patient is harmed.
The hardest thing about these levels, is that when we TEAM, TEAM, TEAM all of the time....some of us forget what our jobs are. Everyone has an important part of patient care. If someone doesn't like their specific role or level...IT IS THEIR JOB TO CHANGE IT! So while I agree that subordinate sounds like a "bad" term, it is the proper term according to the BON, and in hospital regulations.
Maisy
PS. I don't think any physician is my boss, unless it is my director of the ER! I am a co-worker, and collaborator in patient care. The day that ends is the day I quit! Nurses should all feel that way.
Seriously, a physician may write an order for medication...I am responsible for the conditions it is given under. I make lots of suggestions to our doctors based on my observations of the patient and the patient's history.
It may be a little different because I am in ER, but after recent experiences with FIL and his PMD, I am more sure than ever we need to be on the same team!
Everyone seems to think that an aide does not have anything to lose. Not only do they lose their job they can have a report filed with the BON. If that happens and they have a demerit of some sort, not only can they be held legally responsible, they cannot attend nursing school or qualify for an rn or lpn license.
Sailordave, I think you and I are on the same page when it comes to styles and types of leadership. I still don't have a problem with the word subordinate, but if using "rank" suits you better, so be it. :cheers:
Specializes in Cardiothoracic Transplant Telemetry.
everyone seems to think that an aide does not have anything to lose. not only do they lose their job they can have a report filed with the bon. if that happens and they have a demerit of some sort, not only can they be held legally responsible, they cannot attend nursing school or qualify for an rn or lpn license.
that may be correct, but if the nurse makes a mistake, you will not be liable and possibly lose your license or face criminal charges for not adequately supervisingthose that are providing care on your patients.the relationship between rn and lpn is a little more complex than the relationship between rn and cna because both are nurses, but when patient assignments overlap the rn has the ultimate responsibility when it comes to assessing change in patient condition.
Specializes in Cardiothoracic Transplant Telemetry.
In some cases the only thing that truly separates a nuses assistant from an LPN or RN is money to attain the degree. My ex-wife attended college to become an RN and was working as a CNA. She had to drop out of college to take care of her newborne son and her mother suffering from cancer. You can learn something from even the dumbest person no matter how smart you are. Just because you're paid more than others doesn't mean you are a better person than they are. Every job in a hospital is important
I don't believe that anything was said in the original post about anyone being smarter or better than anyone else, and the distinction of who was subordinate to whom was not placed on whose salary was higher. I believe that the original post was actually well stated and respectful, except for the buzz-word of subordinant. You are correct, every job in a hospital is important and I cannot count the times when information provided to me by a CNA led me to be able to take swift action to help a patient. But the fact remains that every job has someone who is ultimately responsible, irregardless of how well the 'team' works together.
I must also disagree with your statement that the only thing that separates a CNA from a LPN or RN is the money to attain the degree. That statement discounts all of the hard work and sacrifice that it takes to earn that degree. If you don't believe that, take a look at the student threads on this board. I am not saying that CNA's do not have the capacity to become RN's, they do. The fact is that there is a vast difference in knowledge base between someone who has completed nursing school and successfully sat for NCLEX, and someone who has not. Many of the nurses on this board are previous CNA's, including myself. I would not have dreamt of considering myself as the professional equal of the RN's that I worked with until I passed boards. I know how hard CNA's work, and I appreciate the work that they do, but as long as I am responsible for the work that they do and have a legal responsibility to supervise them, I will.
Now flame me if you must, but no disrespect was meant. Semantics aside, we all do work together.
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danissa, LPN, LVN
896 Posts
Valid points posted on this thread, about team work etc, also about the ranking of the team, and where the buck is going to land..(firmly on the licensed nurses backside)
However, subordinates is not a word I would like to use, I can see how it would get peoples backs all fired up, valuable team members, all of us.
It still remains the fact though, that whatever we call each other, someone has to be the charge for that shift, ultimately the person who the poop hits when the fan is off!
With utmost respect to all the team, it's still the licensed RN who has that responsibility.
Superior is no a word I like to use either.. and would never...I'm not in anyway superior to any human being, just sometimes , if I'm charge, I have to take the flack for their mistakes.......