Too good to aide?

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Question....do any of you by chance think because ur an RN you can't play the CNA for a shift?

Specializes in ICU, CCU, Trauma, neuro, Geriatrics.

The ICU I worked in was a primary care unit. The RN did everything for their patients, bath, feed, clean up poo, empty the trash, change the suction canisters, take them to Radiology, GI Lab, OR, and all the other nursing things too.

I work in LTC now and there are nurse aides to do their part of the team nursing. I help lift, I put patients on and off the bedpans, I toilet and feed, I even will do an AM or PM complete care if the aids are not fully staffed because of calloffs or "got sick at work and went home early" events. We don't have RNs or LPNs do an aide assignment, we just split what needs to be done a little differently than usual. With one less aide we will have the nurses answer the call lights during meals so the aids can feed the patients that need that and we will do the complete care on a patient on our team or walk the patient or two that needs that on their restorative care plan. With one less nurse the aids will just buckle down and not ask for our assistance because they know we don't have the time, plus they seem to answer the phone a bit more and they don't interupt us with input, they leave notes about patient needs or requests that are not life threatening or urgent on the top of the med cart with initials and smiley faces. With regular staff and team oriented nursing we know how to shift the work load so the work gets done and no one is overwhelmed.

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Let me see if I'm reading this right (it may just be a little too early in the morning). The regular CNA is called off for a low census day and the nurses are expected to work as a CNA in order to compensate for management's penny pinching. First of all, that is absurd - which costs more, a nurse or a CNA? Second, under no circumstances would I work as a CNA if this were the case - it only encourages management to continue the practice. It seems from the original post that this is not a rare occurrence, but a fairly regular one. That is just poor management of resources and I would not encourage it.

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Although I certainly don't mind in the least helping out when I am needed and where I am needed, which includes doing some patient care, I agree that I went to school to be a nurse.

I was a CNA, and if I wanted to remain a CNA, I wouldn't have went to nursing school.

A whole shift? I don't think so. But if the Aides are busy elsewhere and a patient needs to relieve themselves (or perchance, already has and is distressed about it) I'm certainly not above helping a person in need.

I totally agree, Julie.

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I have always held the opinion that just because I have a certain set of initials after my name does not make me immune to the duties that accompany the initials that others have. At each step of the educational and/or clinical ladder responsibilities are merely added.I am responsiblefor my patient's care. If that means that I have to function as an aide for a while (if our aides are busy and not available -- or if I am merely more readily available to meet the need )- I am responsible to do so!!

I am not real keen on having an RN routinely remove herself from the RN role and work as an aide -- you are going to be held accountable for your level of licensure regardless of the role you are playing for the day -- But then I would call someone out for feeling that they were "above" doing the patient care tasks that an aide routinely does. We should be willing to tackle all the tasks, skills, thought processes inherent to our licensure in addition to all the tasks etc that we worked our way through to get where we are!!! If that's what is best for the patients -- that's what I need to do!

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wouldn't it make more sense for the low census days to have different sign up sheets for nurses and cnas. Say on monday we can let go one nurse but we have to keep our aides, and maybe on tuesday two aids can get called off?

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

You can have all the lists possible, but there's always the days where someone doesn't add correctly and winds up calling off one (or more) too many people.

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right but, if I am understanding correctly this is not where people are calling off, it's where management is saying we are not busy enough x# of people can go home.

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Specializes in Happily semi-retired; excited for the whole whammy.

I don't understand if you're asking me, would I "aid" when needed, or will I agree to forgo my own duties and be an aide for a shift? I will always help out where needed, and I frequently end up staying far past the end of the day to get my own work done because I assisted our line staff during my regular work hours and still have all my own admin stuff left to tend to. What I won't do is assume responsibility as the primary line staff for a shift. Its not what I do, its not what I want to do, and its not what I'm paid to do.

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Ok, guess i should clarify the LCD thing. We have a sheet you can sign up for a low census day. To get one, it's based on when u had one last. So if we're full(37 pts) we require 11 employees. if it's less, we require x amt of employees. So yes, the CNA's sometimes get off. but we just dont say "ok. all cna's off today". it's based on if their signed up. Nurses sign up too, but if the aides beat out the nurses last lcd...we dont need 8 nurses on the floor. so 2 will aide. cna's dont take priority over the nurses. it's just how the lcd system works. wouldn't be fair to only let the nurses get low census. hope that clarifies why cna's get the night off.

Sara

It still sounds like a crappy deal to me. Staffing should be according to skill mix.

In other words - For X number of patients, we need this many nurses and this many CNAs. Then, low-census people accordingly. If you need 6 nurses, not 8 - 2 nurses get called-off. If you need 8 CNAs and there are 8 on the schedule - no CNA's get called off. Calling off 2 CNAs and having all nurses working (though 2 are working as aides) is still, IMO, poor management. Some may not mind, but I am a nurse, I was hired as a nurse and I will work as a nurse. I don't mind helping out, but I would not take over someone else's job so they can have the day off - Let them take turns amongst themselves, just like the nurses do.

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Specializes in Case Manager, LTC,Staff Dev/NAT Instr.
The reason we nurses are not taking patients, and working as the aide on a hall, is d/t if our CNA's get low census(we sign up for LCD's). In general, most of the ppl on our floor do not mind doing the vitals, getting the pts up, answering call lights, etc. But what's happened is, all of a sudden, that RN, who would aide occasionally prior as an LPN, seems to think she shouldn't have to now because she's an RN and that RN's shouldn't have to at all. And so the argument on our surgical care floor is, what, as an LPN, we should have to aide all thetime when needed? We're nurses too

When I say the same 6 nurses aide...it seems the days we need a nurse to aide, it's me, allison(we're both lpn's), my best friend(who's an RN) and 4 other RN's. (guess that's 7 come to think about it). LIke i said before..I have no problem aiding...but i think when need be, everyone needs their fair share of it. And our nurse manager agrees, and of course when that RN was confronted by our NM, she denied everything.

I may be wrong but it appears you have a nitch with this RN, and as you stated above you all (7 nurses) are doing this by choice, by signing up so...if she don't participate by signing up isn't that her right? I mean by you signing up to do the work aren't you getting LPN pay? What's the big issue? I'm not trying to be sassy, it's just she have a choice, you and your co-workers also have a choice so that doesn't make her too good or you all any less because she don't sign up.:rolleyes:
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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
It still sounds like a crappy deal to me. Staffing should be according to skill mix.

In other words - For X number of patients, we need this many nurses and this many CNAs. Then, low-census people accordingly. If you need 6 nurses, not 8 - 2 nurses get called-off. If you need 8 CNAs and there are 8 on the schedule - no CNA's get called off. Calling off 2 CNAs and having all nurses working (though 2 are working as aides) is still, IMO, poor management. Some may not mind, but I am a nurse, I was hired as a nurse and I will work as a nurse. I don't mind helping out, but I would not take over someone else's job so they can have the day off - Let them take turns amongst themselves, just like the nurses do.

In a dream world, staffing would always be in accordance to skill.

Taking turns amonst "themselves" isn't necessarily realistic either, since i remember several days, evenings and nights of doing the 16 hours shifts (i needed the money, the pay sucked 8 years ago) and then asked to double-back on my day off, because there wasn't enough people on the payroll to start with, and then corporate *****ed about overtime (of course). You have to make sure there's even enough staff to take turns in the first place, not to mention there's a few that are already stretched thin in the stress dept.

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