Published Oct 11, 2006
luvmy2angels
755 Posts
Our facility is currently short of CNAs (i am an LPN in LTC). Much to my surprise when I went to work over the weekend I find that I have been pulled to work as an aide. Needless to say I didn't want to, and it isn't because I don't like that type of work! I worked as a CNA for 18 years before I went to nursing school. I went to nursing school because my body just couldn't take the physical demand of aide work anymore. I am still young (in my mid 30s) so people find it hard to believe that my body can't do it. Besides my back killing me my one leg is held together by plates and screws, anchors...you name it, it is there holding my ankle and leg in place due to injuries i got in a car accident. I don't want my employer to think I am not physically able to do my work as a nurse. Yes, I am on my feet alot but I don't have the lifting and bending that the aides do, plus I have time that I have where I can sit down and do my charting etc, it is CONTSANTLY being on my feet. I also don't want to come across as not being a team player, which is a big deal where I work. I feel threatned when the RN superviser tells me I have no choice but to accept the assignment. I know she herself can't fire me, but can the DON fire me because I feel that I can't work as an aide?? After all I was hired as a LPN, so can they legally fire me for not accepting an aide assigment?? There are other LPNs that were hired the same time I was that have never been put on an aide assignment, I was told they like to use me because of my experience as compaired to the other LPN that never worked as an aide. ANY advice?? Thanks for reading and lettting me vent!!
kranken_schwester
25 Posts
They hired you as an LPN and that is the only capacity in which they can expect you to work. Factor in your injuries, and they don't have a leg to stand on, so to speak...
Cherish
876 Posts
Kranken is right you were hired as a LPN. With those injuries it would be unsafe for you to do certain things especially without an assistance. Yes you could hurt yourself but you could also hurt a patient if anything has happened. Maybe the LPN with the so called 'no experience' could help out sometime.
llg, PhD, RN
13,469 Posts
I'm not trying to be difficult ... or to hi-jack your thread or anything ... but ... how would you feel about an RN who refused to do LPN work? How would you feel about an RN who said, "I was hired as an RN, not an LPN, and I shouldn't have to do LPN work anymore" ? Similarly, how would you feel about a nursing supervisor/manager/etc. who said, "I shouldn't have to do any patient care, I was hired as a supervisor, not a staff nurse?"
Also, most job descriptions are written so that assorted miscellaneous duties are included without being specified one-by-one. That's particularly true in positions within a hierarchy in which one group oversees the work of another group. Those higher up are supposed to be able to actually do the work of the people they supervise in most (but not all) situations. There are exceptions, of course, but it is generally assumed within nursing that RN's are capable of doing the work of the LPN's that they supervise and that both RN's and LPN's can help out with aide work as necessary. Nurses are expected to be able to provide complete care to their patients in most cases (assuming they have been oriented to the the institutional prolicies.)
If you have phyisical limitations that prevent you from providing complete care to your patients, your employer has the right to know that -- and to take that into consideration when making decisions about hiring, assignments, etc. The Americans with Disabilities Act provides some protection for some people with some disabilities that might give you some protection in this case -- but that is a legal question that none of us nurses is qualified to answer. If your disabilities are significant enough to prevent you from giving complete nursing care to your patients -- and if that is an expectation of your employer -- then you should probably discuss it with a knowledgable attorney.
Please let us know what happens. It's an interesting situation.
Good luck,
llg
jmgrn65, RN
1,344 Posts
Ok I am an RN and I would be very Upset if I came into work and they told me I had to work as an aid. Sorry been there done that. I didn't go to school to be an aide.
I don't know why they do that to LPN's but it is done alot esp. in LTC. I don't understand why they can get away with it. Doesn't make sense to me.
I don't know whether they can fire you for that or not. I suggest maybe try talking to your DON.
mamason
555 Posts
llg,
That happened at the last facility I worked at. New nurse manager stated,"I DON'T DO PT CARE!" Staff pretty much lost all respect for her after that comment. As far as the OP's situation, we had a LPN that worked on our floor. Great nurse. One particular supervisor would always try to assign the LPN as a CNA. The LPN refused. She stated to the supervisor, "I'm a nurse and would appreciate being treated as such." The supervisor eventually got the hint. And the LPN was never fired over it. I guess it depends on the facility.
I'm not trying to be difficult ... or to hi-jack your thread or anything ... but ... how would you feel about an RN who refused to do LPN work? How would you feel about an RN who said, "I was hired as an RN, not an LPN, and I shouldn't have to do LPN work anymore" ? Similarly, how would you feel about a nursing supervisor/manager/etc. who said, "I shouldn't have to do any patient care, I was hired as a supervisor, not a staff nurse?"Also, most job descriptions are written so that assorted miscellaneous duties are included without being specified one-by-one. That's particularly true in positions within a hierarchy in which one group oversees the work of another group. Those higher up are supposed to be able to actually do the work of the people they supervise in most (but not all) situations. There are exceptions, of course, but it is generally assumed within nursing that RN's are capable of doing the work of the LPN's that they supervise and that both RN's and LPN's can help out with aide work as necessary. Nurses are expected to be able to provide complete care to their patients in most cases (assuming they have been oriented to the the institutional prolicies.)If you have phyisical limitations that prevent you from providing complete care to your patients, your employer has the right to know that -- and to take that into consideration when making decisions about hiring, assignments, etc. The Americans with Disabilities Act provides some protection for some people with some disabilities that might give you some protection in this case -- but that is a legal question that none of us nurses is qualified to answer. If your disabilities are significant enough to prevent you from giving complete nursing care to your patients -- and if that is an expectation of your employer -- then you should probably discuss it with a knowledgable attorney.Please let us know what happens. It's an interesting situation.Good luck,llg
This is the kind of attitude or "perspective" I don't want to get from my DON. I am in NO way saying that I am disabled. I always help out my aides when I can, when my work is done I almost always put a couple of residents to bed or take them to the toilet (something that none of the other LPNs do). I am saying that I can't take on the load of a full assignment. I know very well how to do aid work. A lot of people change jobs or positions as they get older due to the physical demands on thier bodies. Many nurses I know used to be aides but are now LPNs or RNs because the job just became do physically demanding.
When applying for the job, I was applying as an LPN and when asked are there any physical limitations you have that would prevent you from doing your job?? I answered NO, because i can perform the duties of an LPN. They didn't ask me if there were any limitations I had as far as working as an aide because I wasn't being hired as an aide, had they asked me of course I would have said yes.
Thank you for your opinion, I appreciate your honest view of my situation.
TazziRN, RN
6,487 Posts
And this is exactly what you should say to the DON. Be calm, be professional, but be firm.
I agree with you: I used to be a CNA and have the utmost respect for them....without mine I could not do my job well. I also help them out whenever I can, but if I were to go to work one day and find out that I was being assigned as an aide for the shift, I would have protested. After so many years as an RN, I would not be able to do a CNA's job for a shift, not because it's too hard for me but because it's been so long since I had to get 8-12 pts bathed, dressed and fed through the day. At my hands those poor pts would still be unshaved, jammied, and probably still in bed at the end of my shift except for the lucky two or three that got lucky when I showed up.
Antikigirl, ASN, RN
2,595 Posts
Okay...here is the trick. Did you have these injuries and limitations when you signed on with this facility? If you did...did you list these limitations upon employement? Hopefully you did, but most people don't for the very same reasons...you don't want to NOT get hired because of them so you don't list them. That can be your employers way out and let you go.
But I do look at things this way...I only have ONE body, I have to live with that body for the rest of my life no matter what. I will not destroy my own body by work or play because then what will I get...besides being a pt, never working as a nurse again...and paying medical bills with no job! I don't know, I see risking looking for a new job is a better option than being a pt with no income and a damaged body?!?!
It is also unsafe for your pts to do lifting or transfers you can't physically do with safety. I would use this as a highlight if you have to talk to any management.
When you talk to management...use a proactive stance as much as posible. Bring up that you wish to be a team member, wish for continuity of care (use you key words, or even quote their mission statement!), but that you and management should realize that through time, the physical toll does ring in, and that changes should be made to accomidate for loyalty for the company. List all the positives on a can do basis...limit what you say about the can'ts.
If they fire you...they don't care a bit about your health or your loyalty! And that tells me....time to move along! I don't want a job where I am not appreciated!
BTW...that would chap my hide if someone hired me as an RN, and then switched my job title/details without asking me and giving me the option! Nope, I go by what I signed up for on employee admission...anything beyond is up to me to agree in writing to!
peds4now, RN
219 Posts
It seems completely inappropriate for you to be reassigned to a CNA position, regardless or you physical situation. You were not hired for that job.
That said, as an LPN or RN, everything the CNA does is actually your responsibility legally. You delegate those tasks to them. So, if your CNA doesn't get around to hygiene or turning or whatever and it causes a problem, you will be sued. All those tasks, which you are saying are too demanding for you physically, are actually already part of your professional responsibility. Obviously, the reality is that a CNA has to do those tasks for double the patients-which makes it more demanding. But as an RN/LPN, you have to be ready to do all a CNA's tasks for your patients. For that reason, I would be very careful using the "my body can't handle it" argument with your employer. They may use it to say you are not fit to work as an LPN either.
I would stick to it being inappropriate to float you as a CNA when you are a nurse.
jojotoo, RN
494 Posts
This is the kind of attitude or "perspective" I don't want to get from my DON. I am in NO way saying that I am disabled. I always help out my aides when I can, when my work is done I almost always put a couple of residents to bed or take them to the toilet (something that none of the other LPNs do). I am saying that I can't take on the load of a full assignment. I know very well how to do aid work. A lot of people change jobs or positions as they get older due to the physical demands on thier bodies. Many nurses I know used to be aides but are now LPNs or RNs because the job just became do physically demanding. When applying for the job, I was applying as an LPN and when asked are there any physical limitations you have that would prevent you from doing your job?? I answered NO, because i can perform the duties of an LPN. They didn't ask me if there were any limitations I had as far as working as an aide because I wasn't being hired as an aide, had they asked me of course I would have said yes.A couple of things that need clarification. As an LPN, doesn't your scope of practice encompass all duties that a CNA would be responsible for? Just as my scope of practice as an RN would cover all tasks that an LPN or a CNA would perform? What would you do if you came to work and there weren't any CNAs for that shift? You'd have to suck it up and do your job AND the CNA's - right? And I know how hard that is because we all very much depend on the CNAs/ Techs. I know that I do! In fact, I'M going to have to suck it tonight because we don't have a Tech scheduled.Now, having said that, the question is - SHOULD you have to suck it up? I bet if you looked up your job description for your facility it would have your LPN duties all spelled out nice and neat: then at the very bottom of the page (and probably in very small letters), it would say: "And other specified duties". As long as those "other duties" are within your scope of practice I think that your employer can require you to perform them.If your management had any sense, they wouldn't risk losing or alienating a licensed person by making them work in what is essentially a non-licensed capacity. But since when did anything that management does make good sense?One last thing, if you accept an assignment in a CNA capacity, you will still be held to the higher standard of your LPN license/ scope of practice.
A couple of things that need clarification. As an LPN, doesn't your scope of practice encompass all duties that a CNA would be responsible for? Just as my scope of practice as an RN would cover all tasks that an LPN or a CNA would perform? What would you do if you came to work and there weren't any CNAs for that shift? You'd have to suck it up and do your job AND the CNA's - right? And I know how hard that is because we all very much depend on the CNAs/ Techs. I know that I do! In fact, I'M going to have to suck it tonight because we don't have a Tech scheduled.
Now, having said that, the question is - SHOULD you have to suck it up? I bet if you looked up your job description for your facility it would have your LPN duties all spelled out nice and neat: then at the very bottom of the page (and probably in very small letters), it would say: "And other specified
duties". As long as those "other duties" are within your scope of practice I think that your employer can require you to perform them.
If your management had any sense, they wouldn't risk losing or alienating a licensed person by making them work in what is essentially a non-licensed capacity. But since when did anything that management does make good sense?
One last thing, if you accept an assignment in a CNA capacity, you will still be held to the higher standard of your LPN license/ scope of practice.
jojoto, you are sooooooo right about that tiny clause at the bottom of your duty list that says 'and other tasks'. It is a companies way of making you flexible to whatever they want you to do!
The trick is, I learned that early in life...and now I will not take on a job where that isn't defined and written specifically! If they want me, they will detail their needs for two reasons...one, they need to know what I will and will not do as a professional nurse and any limitations I have physically...and two, I need to know what they expect of me in full!
I have put in my contracts "can not do repetitive lifting over 50 lbs or more in an 8 hour period without assistance from another staff member or use of specialized equipment" this makes my definition clear to the point where I can't do something, yet offers a solution that the company can do so that I can!
In the case, and believe me it has happened lots...where they expect me to do CNA work for a shift...I have listed "will fill in as a CNA at the RN rate of pay in emergency situations only, if not an emergency I will serve as a medication administration aide, and assist CNA's in tasks needed for patient care also at the pay rate of RN" That way it is clear that I will not take on a full load unless it is an absolute emergency (because my role as a nurse comes first, they never let those duties lay idle!!! And I wind up responsible for those duties if they are done or not...so I had to be clear!), and if I am needed in a non emergency situation (which I did declair staffing failing to fullfill their duties to staff accurately as a non emergency situation!), I will ASSIST CNA's...so I would be more like a float.
I hope that is helpful to some people looking for jobs...they sure have helped me!