Would you work a shift as an aide?

[AF_BOUND]

So I work pool at a hospital. I worked 8 hrs in the SICU and was floated to a stepdown unit and as I entered the floor the charge nurse told me that she assigned me as a tech. I told her that would not be acceptable. I was hired as a nurse and that is the role I would work.

She looked at me as if I had three heads. I again told her if she wanted to use me as a nurse I would be more than happy to help her out but I would never work as a nurse tech.

Eventually they found a staff nurse to fille the role and I took her assignment.

Has anyone ever refused to work as a tech? Any thoughts?

[cb_rn]

The problem with working as a tech (CNA) is this: Mrs. Smith who is assigned to the LPN Nancy is starting to decline and begins to have symptoms that you assess as being the beginnings of exacerbation of CHF. You report this to LPN Nancy; the only problem is Nancy doesn't agree with your assessment so she never calls the MD and you are so busy with your "tech" duties that you don't realize that Nancy has not followed up with the MD. Mrs. Smith crashes and burns and winds up on a ventilator, never is able to be weaned and dies. Now, Mr. Smith who happens to be a nurse was in the room when you assessed Mrs. Smith and knows that you felt she was having problems; knows that they were never addressed (or at least not in a timely manner) and sues.

Are you liable as a tech? NO! You failed to act as any prudent RN with similar training and experience would have in a similar situation (Pt going into CHF).

You: "But Mr. Lawyer, I was not a nurse that day I was the tech"

Lawyer: "Oh, really? When did you surrender your nursing license and get a CNA certificate? You didn't? Well then YOU were a nurse!"

And that is why I won't work as a "tech" !

Totally disagree.

How is this situation any different from "being a nurse" on the floor? If you think someone is going through the floor and the primary care nurse does nothing because she disagrees, do you just sit back and let the patient crash because its not your patient?

Are you less liable in that situation than in the one described above?

I don't know about you but my conscience and course of action wouldn't be any different in either situation. If I think something is going on I'd go through the primary nurse first but I wouldn't hesitate to pursue the charge nurse or the doc or some other avenue if I really thought there was a problem going on. Doesn't matter what hat I'm wearing that shift.

[wooh, BSN, RN]

I've heard this argument before as a reason to not work as a tech with a nursing license but I still don't understand it. As a floor nurse, I am not responsible for every patient on the floor. I am responsible for my assisgnment.

Absolutely agree. If I hear beeping in a room, go in and see that the IV is infiltrated, I'll turn off the IV pump and tell the nurse assigned to them. It's called teamwork. Just because I walked into the room doesn't mean that I'm magically responsible for all of their care.

So those that are worried about working "outside their scope" or inside their scope, or however you want to term it, do you NEVER ever help another nurse?

[wooh, BSN, RN]

I probably would in a New York minute. But, I would not want to be confused...as others have mentioned, some people take advantage by asking for assistance with their assignment like giving meds, treatments, call this doctor, etc... UNLESS I can count on those same nurses giving me assistance if the roles were reversed. All of these things are within our scope of practice, so, it may not be appropriate to say no.

My old job, on days that I would tech, I'd often be asked to start an IV (as I tended to be one of the better sticks on the floor), but I'd only do it if I had time. Sometimes I'd have to create the time, and it would be, "Sure, I'll start the IV if you'll do your own vital signs on that patient at midnight." If they needed the help because they were a bad stick, they'd go for it. If they needed the help just because they were lazy, that usually changed their mind about the request. :)

[wooh, BSN, RN]

Where I work, this happens. I don't mind being a tech. Yes, I am an RN but I can also do vitals, pass out meal trays, run down specimens to the laboratory, and escort patients-----and be still paid the salary of an RN-----so what's the big deal? I was just wondering though why the OP was refusing to be a tech.

I was a secretary (a very bad one, but beside the point) before I got my license. I actually managed to work for on call AND holiday RN pay as a secretary because they were so desperate to have one. Of course, this was years ago, I'm sure hospitals now would just tell the RNs to answer the phone and take off orders and answer call lights themselves.

[Leelee2]

I have worked the floor plenty of times as a tech when asked to do so. We are there to help, in whatever nursing type role is needed. Any LPN/RN who would refuse to do so, wouldn't be one that I would recommend hiring! As nursing staff it is still necessary to be part of the team, and a team player. What message does a refusal to help out on the floor where needed, send to the CNA's?? or for that matter, the patients!

[amarilla, RN]

As others have already posted, I wouldn't mind working as a tech on the floor as long as I wasn't also being constantly pulled for nursing duties and was still being paid nursing wages.

Through the last few years, I can recall many incidences of working short, but the ones that were always the most unpleasant were those when others didn't want to share the burden and pull together. JMO.

[Esme12, ASN, BSN, RN]

Why did they need a nurse working as a tech instead of having an extra RN to reduce the patient loads or to help out other nurses with RN tasks? In my state, you can't work as a tech with an RN license.

That is not a state regulation but a union one.......a nurse can work as a tech but a tech cannot work as a nurse. In a union facility a non union person cannot fill a union position/job not even for a shift.

Why not work as an aid........it is not beneath me to help out in anyway I can. Sometimes a floor needs help with patient care not charting or meds. An extra set of hands to give care is very valuable and should not be considered beneath any nurse.........I always looked at it as a break!:)

[NeoPediRN]

Yes I have and I'd do it again. They're nursing assistants...helping us...which means we're capable of doing everything they do. I'll always take one for the team.

[April, RN, BSN, RN]

That is not a state regulation but a union one.......a nurse can work as a tech but a tech cannot work as a nurse. In a union facility a non union person cannot fill a union position/job not even for a shift.

Thanks for clearing that up. I've never worked at a union facility so I'm not familiar with union rules at all. When we are short techs, it's basically tough luck for us. We are just expected to pick up the slack and work together to get it done, which we do. Sometimes we have an RN without an assignment that is available to help around the unit. Now that this thread has had more responses, I guess this is what the OP and others are referring to as a "tech" assignment.

[ZippyGBR, BSN, RN]

I did it recently too. I was assigned to float between two of the teams on my ward as we were short-staffed.

I enjoyed being a HCA for a day. No paperwork, no drug round just basic patient care and doing the meals and tea rounds. I'd take the job if I could keep my own pay as an RN!

exactly

the issue arises if you are prevented from acting as an RN when undertaking that role , as you rightly say it's a break/ change/ bit of 'fun' just to be able to do basic nursing care really well for a shift and not chase round doing drug rounds etc ...

not to mention the opportunity it gives for a bit of therpeutic interaction and doing things like indepth skin assessments that with the best will in the world HCAs don't do as well as an RN can do them ...

[NeoPediRN]

exactly

and doing things like indepth skin assessments that with the best will in the world HCAs don't do as well as an RN can do them ...

And nor should they...they're not supposed to assess, it's one of the things that separate a nursing assistant from a nurse.

[RNforLongTime]

I'm an RN/CCRN in a small community hospital 6 bed ICU. There are times when our unit is closed or only has 1 patient and they'll leave an RN alone for that shift with just the 1 pt(usually NOT terribly critically ill). I've been 'floated' out to the med-surg floor, the acute detoxification unit, ER and OB depts.

Most of the time, I am NOT responsible for a full patient assignment because if ICU gets an amdission, then I have to go back to my unit, which is easier if I'm only floating. I help the floor staff with vitals, answering call bells, putting in IV's, giving PRN pain medication, blood glucose checks, etc. All of which are within my scope of practice.

If I see a pt having distress, I would of course immediately report it to the pt's assigned nurse for that shift and usually follow through to make sure the issue was addressed. Usually the floor nurses are grateful for an extra pair of hands to do those little things that keep them so busy during the course of the shift.

As I've been told many times, I'm an employee of the hospital, NOT the particular unit in which I normally work. Last night the second OB nurse didn't show up for night shift. So, since I have 'some' post-partum experience, I was pulled down there to help the primary OB/LD RN with her assignment of 1 mom/1 baby. I helped out getting vitals, putting orders into to the computer, running urines over to the lab, prepping the pre-op c-section for OR(put in IV, drew labs, placed foley). I was glad to help and the OB nurse was thankful to have an extra pair of RN hands that could do all that stuff plus I'm computer savvy and she doesn't have access code to our computer system as she's a traveller.

So yes, I'm more than happy to work as an 'aide'.