What to do? Aides doing the work of nurses?

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Specializes in Peds(PICU, NICU float), PDN, ICU.

ok, so I took a new job and after being employed for a little bit I found out the aides aren't even aides. My understanding is you have to be an aide to work as and represent your self as an aide. These "aides" who have been hired off the street with no experience are allowed to suction trachs, change trachs, do feedings through feeding tubes, change Mic-Key buttons, give breathing treatments....

A few are CNA's but most aren't. They claim because its a "home" and not a facility they can do this. My understanding is they don't fire anyone because they don't want to pay unemployment. The aides know this. They do the minimum and nothing more and they know they can get away with it. If one is to ask them to assist with something they say its not their patient or they're busy or whatever excuse they can think of. I guess they don't know the meaning of "aide/assistant"

I've had these "aides" ask me what O2 is, seen them (not on my shift, under my supervision) give albuterol treatments through a face mask to patients with trachs.... I walked in on an aide setting up a room and the trach patient was alarming for low sats (the reason I went to the room). Her back was turned and I asked why she didn't come get me and she replied "he wasn't gurgling so I didn't think it was a problem." This place doesn't train for anything. A CNA there actually got mad at me when I asked her to pull the rails up when she left the room because I found the rail down. She said "well I was coming right back". I replied to her that unless she has a hand on the patient that she needs to keep the rail up because the pt. is a falls risk and even has a sign saying pull rails up. She rolled her eyes and said I didn't know what I was talking about!!!

They wanted nurses to pre-chart, draw up all meds at once to be ready to give...I refused to do it that way.

I quit because I felt I was putting myself at a major risk. What can be done for the safety of the patients? If I report them I'm afraid of them retaliating. How can I protect myself? Thanks!

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Specializes in CCU & CTICU.

Thank goodness you left! What a horrible sounding place! :no:

You're outta there. Report them!

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The stock holders of this particular institution are quite happy with the conditions because they are making money. Meanwhile the licensed people are the ones that will take all the heat when something goes wrong.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Report them.

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Specializes in Emergency Medicine.
... the licensed people are the ones that will take all the heat when something goes wrong.

Very true. Welcome to the world of licensed care.

You choose healthcare as an occupation, you go to school, you study and you take a test to certify or license you in a particular field or discipline. This identifies that you have met a certain standard. A standard of education & training. It defines a certain scope of practice that makes you marketable for certain jobs. Don't be appalled when I tell you you don't need any license at all.

Licensure being necessary?

I'm not going to tell you that I don't think it's a good idea not to have training but the answer is NO you don't. You're get medical training on different levels and see what problems can happen, things that can go wrong. It's scary to thing there are unlicensed people performing tasks that you should have formal training. Well it happens ALL the TIME.

Families of sick and injured have to take care of their loved ones. Not everyone can afford skilled nursing. Families perform many tasks that I'm sure you new grads think only you should be able to do. poke.gif In most cases they provide excellent care. In%20most%20cases%20they%20provide%20excellent%20care.This from the most basic of assisted ADL's to the most profound of total care like neuro rehab, quad dependent, foley, trach & vent care. They monitor IV therapy, tube feedings and even administer IV-push medications. In most cases they provide excellent care. Some fall short but it's their choice to make. You can argue about whether this is good or bad but it's completely legal.

Don't get caught up in your particular license or status. Ultimately it serves to identify YOUR particular scope of practice to protect you when working under your license. You can go to WORK knowing you have met a definite standard. Someone can hire you knowing you have met that too.

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Very true. Welcome to the world of licensed care.

You choose healthcare as an occupation, you go to school, you study and you take a test to certify or license you in a particular field or discipline. This identifies that you have met a certain standard. A standard of education & training. It defines a certain scope of practice that makes you marketable for certain jobs. Don't be appalled when I tell you you don't need any license at all.

Licensure being necessary?

I'm not going to tell you that I don't think it's a good idea not to have training but the answer is NO you don't. You're get medical training on different levels and see what problems can happen, things that can go wrong. It's scary to thing there are unlicensed people performing tasks that you should have formal training. Well it happens ALL the TIME.

Families of sick and injured have to take care of their loved ones. Not everyone can afford skilled nursing. Families perform many tasks that I'm sure you new grads think only you should be able to do. poke.gif In most cases they provide excellent care. In%20most%20cases%20they%20provide%20excellent%20care.This from the most basic of assisted ADL's to the most profound of total care like neuro rehab, quad dependent, foley, trach & vent care. They monitor IV therapy, tube feedings and even administer IV-push medications. In most cases they provide excellent care. Some fall short but it's their choice to make. You can argue about whether this is good or bad but it's completely legal.

Don't get caught up in your particular license or status. Ultimately it serves to identify YOUR particular scope of practice to protect you when working under your license. You can go to WORK knowing you have met a definite standard. Someone can hire you knowing you have met that too.

i dont think your reference for home and the OPs are the same....

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Specializes in Med/Surge, Psych, LTC, Home Health.

I believe you are correct, and everything that you said is all fine and dandy... but if I put my mom or dad in a place like this, I expect the people being paid to work there to be properly trained, licensed or not. Doesn't sound like the folks working there were properly trained at all.

Very true. Welcome to the world of licensed care.

You choose healthcare as an occupation, you go to school, you study and you take a test to certify or license you in a particular field or discipline. This identifies that you have met a certain standard. A standard of education & training. It defines a certain scope of practice that makes you marketable for certain jobs. Don't be appalled when I tell you you don't need any license at all.

Licensure being necessary?

I'm not going to tell you that I don't think it's a good idea not to have training but the answer is NO you don't. You're get medical training on different levels and see what problems can happen, things that can go wrong. It's scary to thing there are unlicensed people performing tasks that you should have formal training. Well it happens ALL the TIME.

Families of sick and injured have to take care of their loved ones. Not everyone can afford skilled nursing. Families perform many tasks that I'm sure you new grads think only you should be able to do. poke.gif In most cases they provide excellent care. In%20most%20cases%20they%20provide%20excellent%20care.This from the most basic of assisted ADL's to the most profound of total care like neuro rehab, quad dependent, foley, trach & vent care. They monitor IV therapy, tube feedings and even administer IV-push medications. In most cases they provide excellent care. Some fall short but it's their choice to make. You can argue about whether this is good or bad but it's completely legal.

Don't get caught up in your particular license or status. Ultimately it serves to identify YOUR particular scope of practice to protect you when working under your license. You can go to WORK knowing you have met a definite standard. Someone can hire you knowing you have met that too.

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Specializes in Emergency Medicine.
i dont think your reference for home and the OPs are the same....

They aren't mandated to have licensed staff depending on how the facility is categorized.

Don't misinterpret what I'm saying. I think they should but unless you HOLD a license you have no specific restrictions on what you can do.

Hire unskilled and unlicensed personnel... me? Oh no. But it's not illegal to do so.

I believe you are correct, and everything that you said is all fine and dandy... but if I put my mom or dad in a place like this, I expect the people being paid to work there to be properly trained, licensed or not. Doesn't sound like the folks working there were properly trained at all.

Yes! And it's up to YOU to verify that any institution meets certain standards. That they're licensed. Their staff is qualified. Too bad that so many people are unconcerned, uninformed or lazy to do their own research. They just don't.

These "sheeple" rely on someone else to do this and when something bad happens they get upset. Then it's "How could something like this happen?" Well, God loves stupid people.

Stay informed. Empower yourselves. When you see a problem with one of your patients or their family members has questions you can take the opportunity to educate them.

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You need to report this facility to your state's facility licensing Board. It might be Health Dept., Senior Services, something like that. Check with your state Congress Representatives and Senators to learn the correct people to contact.

If they get paid by Medicare, you need also to report them to CMS. Google for the phone number/address.

Do it anonymously if you are scared, but do report. This facility is not giving safe and proper care to the dependent people who look to them to be safe and protective. Since you are aware of it, you should listen to your conscience and report it.

A pox on those snippy, arrogant aides who think they are all that. No, I don't mean it - I do want them to get properly trained, though.

I wonder if you could turn this into a positive if you encounter it again in the future. Try getting the place to hire you to train the aides and make the place agree that YOU get to determine who gets fird and who doesn't.

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Specializes in LTC.

Id report them! You can do it anonymously.

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Report them anonymously and immediately. The patients are in grave danger.

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Fortunately you have removed yourself from the situation. Now just go ahead and report the facility and you will have fulfilled your obligations to the poor residents who are subjected to this. I once worked somewhere where a nursing assistant who, of course, "was a nurse" in her own country, was caught by a family member providing meds to their loved one. The charge nurse was fired immediately. I suppose the facility was only covering their rear in case the family went up the pike with their complaint. But the person responsible was dealt with nonetheless.

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