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

[downsouthlaff]

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.?

[downsouthlaff, LPN]

Thanks for your post Esme 12, I think your right in saying that, facilities probably would hate this because of wages, but in my Idea, the difference between an LPN and LNA would be that the LPN still would do assessments, communicate with physicians, give the narcotics, but the LNA would be a more technical role, like passing oral meds under close supervision, doing BGL checks, wound dressings, enemas, more charting, have a little more medical knowledge inserting and d/c catheters, handling O2, cutting diabetic nails, and this woukd be the standard of nursing assistant practice in all areas of nursing. And it would be good to have a nursing assistant who was more "Nurse Like" like PA is "Physican Like" but still not to replace the knowledge, skill, and expertise of a Licensed Nurse (LPN/RN) just a different typed of nursing assistant that is more professional than ancillary.

[blackvans1234]

I think the major thing preventing CNA's from gaining more autonomy / proccedures is the lack of formal education in the certification itself.

I'm a CNA and took a summer course to do it, It was 3 weeks, 5 days a week, with one week of clinical.

Without further education, a CNA can't really appreciate the anatomy and physiology behind the skills. Example, dressing changes and maintaining sterile technique. When you change a dressing, you need to assess it, what does purulent drainage mean? Depth of the wound, is that granulation tissue forming?

I'm a CNA in nursing school, and it is slightly frustrating that I can't do more skills, however CNA's that are not going for further education will have a difficult time adapting.

Just being the devils advocate.

[cbOmahaNE]

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.

I'm a CNA and a Medication Aide in Nebraska. I work at two different Nursing Homes and the level of care I'm allowed to provide differs between the facilities. In one, I do everything except injections, IVs and catheter changes, and in the other facility, the Nurse Aides can't even apply ointment-the nurse has to do it.

I agree that there can definitely be more professionalism among CNAs but that is up to each individual to be a professional. All the qualifications in the world won't make you good at something unless you take pride in your work.