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?

That's an interesting system, but it seems to me that it should be two lists.. one for CNAs, and one for Nurses... because the roles aren't the same. It's not that nurses can't, won't, or are "above" that sort of work.. its just that there is work that nurses have to do that CNA's don't have to do... and that responsibility doesn't go away if a nurse decides to "play CNA" for a day. The unit should determine the number of nurses needed, and the number of CNA's needed separately, in my opinion. Otherwise, they're wasting money on nurses when they don't really need them.

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

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But there is a difference.. a legal liability one. You can't just say in court "I wasn't being a nurse that day". That's why "being the nurse" requires a license, and involves so much assessment, planning, intervention, and, unfortunately, documentation. I've felt this pressure from CNAs before - because I have stuff to do that they don't value, or don't even know about, they assume that I should be doing the stuff they're hired to do. Don't get me wrong... I'll always help a patient in need, and I'll help the CNA if I possibly can. But I think that nursing is one of the few PROFESSIONS that has a lot of trouble truly delegating tasks to others, and has trouble standing by that delegation. Goodness knows, doctors don't seem to have that problem!

I have the attitude that I can do RN, LPN, CNA job. If the bucks are the same then just do what needs to be done. Now if I am truly the CNA that means no taking orders off charts, no giving meds, no starting IV's, no calling MD, and no giving blood. Sounds cushy to me. Here if the patient needs something and the aide is busy then we get to do it. It's part of the job. I guess I have done the job for so long that I never stop and think if it's my job or the CNA's. Some of the best coversations I have with patients are when I am cleaning up messes. Nobody likes to do the dirty part of nursing, but it is part of the job.
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Another thing to think about here is how hard it is to change your role within a group of people that you have worked with for a long time. Before you get too mad at the new RN, remember that she is now moving into a different role, and a different level of legal responsiblity. In her mind, she worked hard for that degree, and now she has it, and she's ready to use it. It probably would have been easier for her if she had started working elsewhere once she got her new degree - where folks had not known her in her old role. I've been through this before myself. It's hard for people to look at you in a new role when they are used to you filling a different one. Then if you protest, people think you're being arrogant. It's not an easy thing to do. Not having all the details, I don't know if that's happening here... but I have this question: is the staff on the unit expecting certain behavior out of this new RN because she used to be an LPN on the unit, and they thought she'd "understand", or are they really expecting her to act like they expect other RNs on the unit to behave?

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We do it all the time. As a matter of fact, last spring we were short a tech and I was called in on my on call nite to fill in- I have NO problem making my night differential plus time and a half to tech. It's hard physical work, but it's nice not to be the one responsible for everything sometimes.

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Bless you. But think about this. There is NO job on the floor the RN cannot do. They can "RN", "LPN", "Tech/Aide" , Unit Secretary", "dietary aide passing trays", "sweep up" etc. .

I am not sure your point. Of course the RN can do all these. However, the RN's responsibilities and expertiese are not held by these ancellary perosonel they can not do the RN's job. That is the reason the RN is better compensated. She/he is not compensated so well because of versitility to do ancillary jobs; she/he is compensated to do what these others can not.

If I am tied up doing these lower, although essential tasks, instead of attending to the responsibilites that only an RN is qualifed to handle, then I should be compensated at the lower rate. Are you willing to accept CNA or house keeper pay? I do not slight the ancillary folks I have been a maid, CNA, and LPN. I know how hard they work etc. However, I went to school and got my RN so that I could earn a better level of income. I accept the responsibility that goes with it.

That is like saying a Physician or Lawyer can empty waste baskets and clean his office. Of course he can but his time and energy are better invested in doing those things that the housekeeper can not do.

All I am saying is if you are calling the CNA off to save money then utilize your nurses (LPNs and RNs) as NURSES. Total care of a few patients will insure all partients get good professional nursing care at a reasonable cost. I

If you are not going to reduce patient assignment,don't assign a Nurse as a CNA; use a CNA. Don't over pay for CNA services by using a Nurse.

Places I have worked, when they call off a CNA, have the nurse responsibile for all her patients' care instead. You have X # of patients and you do all thier care. However, the total # of patients is less as census is lower. There for you have the time to devote to total care.

Of course I can mop a floor. That is not the point. The point is is money well spent paying me $25 an hour to mop floors or shower a patient while sending home the house keeper or the CNA who maybe make $10-12?

Send the nurse home if you insist on keeping on having someone do nothing but CNA chores.

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We do it all the time. As a matter of fact, last spring we were short a tech and I was called in on my on call nite to fill in- I have NO problem making my night differential plus time and a half to tech. It's hard physical work, but it's nice not to be the one responsible for everything sometimes.

You're still legally responsible - you don't put your license on hold for that shift. Just because someone else is assigned as the patients' nurse - you are always held accountable to your highest level of licensure.

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But there is a difference.. a legal liability one. You can't just say in court "I wasn't being a nurse that day". That's why "being the nurse" requires a license, and involves so much assessment, planning, intervention, and, unfortunately, documentation. I've felt this pressure from CNAs before - because I have stuff to do that they don't value, or don't even know about, they assume that I should be doing the stuff they're hired to do. Don't get me wrong... I'll always help a patient in need, and I'll help the CNA if I possibly can. But I think that nursing is one of the few PROFESSIONS that has a lot of trouble truly delegating tasks to others, and has trouble standing by that delegation. Goodness knows, doctors don't seem to have that problem!

This is so true it is just maddening. Too many nurses seem to be too worried about what the CNAs, housekeepers, etc will think about them. Some of them are even pressured and bullied into feeling this way by their own colleagues. They don't want to delegate a task to people who were hired to do it because they are afraid it will look like they did not want to do it. Who cares what people think? They are there to do their jobs just like we are. Of course another factor is the ultimate responsibility for patient care: meaning if someone to whom a task is delegated fails to do their job, it is the nurse's fault.

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