What do you all think? Good idea or bad idea.

[downsouthlaff, LPN]

Ok, just an idea. Maybe this will happen in the long term future maybe not who knows. But anyway i was thinking what if there would be a change to the nursing assistant today. What if boards of nursing would come up with a new role. Instead of the umbrella nursing assistants we know today, what if there was a new uniform professional "Licensed Nurse Assistant". This would require anyone who works in a facilty (hospital, nursing home, pysch, home health agencies) where there supervisors are nurses to be licensed nurse assistants. These nurses assistants would have to obtain licensure by the BON. Training would be anywhere from 4-6 months minumum. And some tasks could be added to the scope of practice from the traditional CNA today. The LNA would still be the one responsible for all the personal care tasks as they are today, but would be granted more tasks like Checking blood glucose level, maybe handing a patient there oral medication after the nurse prepares it, doing simple non sterile wound dressings, inserting catheters, giving enemas, handling the automatic oxygen machines, etc.Some of the pros of this in my opinion would be more professionalism from nursing assistants, more accountability, betrer educated, would be safer for the patient than someone who has no training at all. Some of the cons would probably be more liabilty issues, employers would probably habe to pay slightly higher wages, the nurse would have to supervise more closely, etc.I know that New Hampshire is the only state that has something similiar to this but still not like this, but still not to this extent. So nurses how would you feel about getting rid of unlicensed assistive personelle, and having a uniformed BON credentialed Licensed Nurse Assistant. CNAs how would you feel about this. Would this work for the better or would this be a bad move. Im talking doing away with the PCTs and the PCAs and the Nurse Techs and mental health techs, and the traditional CNA and having one board of nursing LNA who has had 4-6 months of training and has passed a board of nursing license exam. Would this be a good move? Or is the tradional nursing assistants today a better form of assistant.?

[besaangel, ASN, BSN, MSN, CNA, RN, APRN, NP]

So nurses how would you feel about getting rid of unlicensed assistive personelle, and having a uniformed BON credentialed Licensed Nurse Assistant. CNAs how would you feel about this. Would this work for the better or would this be a bad move. Im talking doing away with the PCTs and the PCAs and the Nurse Techs and mental health techs, and the traditional CNA and having one board of nursing LNA who has had 4-6 months of training and has passed a board of nursing license exam. Would this be a good move? Or is the tradional nursing assistants today a better form of assistant.?

I think this is a great idea, especially for CNAs like myself who are moving into the RN model. Yes there are pros and cons to everything but I think becoming a LNA is a great idea. Even being certified under the NLNAC would ensure safer, more stringent practices and more help for Rns.

[downsouthlaff, LPN]

Thanks for your reply! And from what ive seen, i think New Hampshire has the right idea, i think Licensing and Regulating Nursing Assistants through the Board of Nursing is a better fit than having anybody off the streets doing patient care in a hospital setting. And we need more profesionalism among CNAs. Thats the area that lacks most. So im thinking that the role of a nursing assistant should go less ancillary and more professional, like Physician Assistant or Physical Therapy Assistant, or atleast a little bit more professional and a little less ancillary. And with 6 months of training and having to pass a License exam, we would definently have better educated, more accountable, more professional nursing assistants, who would be much more safer for patients than someone with 2 weeks of training or with no training at all. Also I think nurses would love to work with NAs who could do more, and were more mature and professional. I think this mighy be something we see in the future.

[downsouthlaff, LPN]

And even if they dont add to the scope ill still think its a better idea to lose PCTs, PCAs, MHTs, NTs, and let the BON outline a curriculum and training requirements that of course comply with NATCEP, and OBRA of 87' , and of course add and subtract as the wish by state, and Outline a minimum requirement of completion of a NA program and then take an NA license test, and make it the law that in order to assist nurses in the delivery of the nursing processin any medical facility, one must be a Licensed Nurse Assistant. Safet for patienrs everybody wins!

[besaangel, ASN, BSN, MSN, CNA, RN, APRN, NP]

I agree, I really didnt enjoy working as a HHA in home care because I felt like all I did was add mileage to my brand new car and give ppl baths and do physical assessments (that was it!). then again I wasnt being challenged or practicing any of the skills I learnt during my CNA training/clinical such as heart rates, resp and BP but was understandable cuz as you mentioned, most CNAs arent given formal training and couldnt do these tasks. Only 2 out of the 60+ of us were furthering our education and less than 20 were certified.

I think CNAs should be required and encouraged to do more...

[downsouthlaff, LPN]

And this is not to imply a way to replace LPNs/LVNs or anything like that, it's simply a way to improve patient care in all facilities, and to help the nurse more. It also ensures an RN or LPN who is delegating that this person is Licensed by the board and competent to do that tasks because of the curriculum outlined by the BON, and license by the BON. It's better and safer for nursing to have RN, LPN, LNA unified, than RN, LPN, and UAP of a thousand types!! Makes sense dont it! And leave the complex nursing tasks to nurses like assessments, patho, injections, but the LNA would have a more professional, functional, role than they do now.

[besaangel, ASN, BSN, MSN, CNA, RN, APRN, NP]

^^I concur

[danceyrun]

I am a nurse tech and I check blood sugars, insert and d/c foleys, do some dressing changes, and am able to initiate/titration O2 therapy. Sometimes it just depends on the state and the facility.

[Mewsin]

The scope of practice for CCAs (Continuing Care Assistants, instead of nurses' aides) here is different from in the US. Our course is 10 months long and includes material from the practical nursing program. (Good for me because that is one less class I need to take this semester) I would like to see a regulating body for aides though.

[downsouthlaff, LPN]

Thanks for the replies everyone! Just seems to make more sense to me to have one formal LNA. It would be better organization. It's good that many boards of nursing are starting to take over the regulation of CNAs/STNAs/LNAs here in the US for LTC and Sub Acute Care, but it would be better In my opinion to have a LNA license that transfers from hospital to home health to LTC to Pysch, much like a Nurses license does.

[Esme12, ASN, BSN, RN]

New Hampshire is not the only state with this program. Vermont has a program similar to this. Many states have decided that CNA/LNA are governed through the BON. Depending on the facility you work....the CNA's I have worked with in down here in MA do glucoses, vitals, foleys, lab draws....no meds unless they are specifically trained as a med aid. What you have described is the role of the LPN...which hospitals won't use for the CNA is cheaper.

It's good in theory.....but I doubt facilities will want to pay more money for another tier of care giver

[downsouthlaff, LPN]

And to me when they use the term Patient Care Tech, or Personal Care Assistant or Direct Support, it paints the picture that PCA/PCT and the Nurse are two seperate entities working for two seperate reasons. It makes it look like the Nurse is only responsible for the complex medical care, and the PCA is responsible for personal care. This is not the truth though, the truth is that in the absence of Aides, the nurse would have to do everything the Aide does, and is responsible for nursing care. Nursing care includes what we as CNAs do, it's the basic parts of care, and the RN/LPN is still responsible for seeing that that care be giving, whether there's an Aide or no aide. I think the term Personal Care Assistant or Patient Care Tech is great the Tech is working independently under the supervision of a social worker as a caregiver, or PCA would be a good term for someone who cares for people in assisted living with little nursing supervision, but I think Nurses Aide or Nursing Assiatant is a better term to use because patients understand that an aide/assistant only assists, and it's ultimately the Nurses responsibility.