Would you work a shift as an aide?

I've done it...wouldn't mind doing it again. It's not out of my scope of practice as a nurse...patient care is patient care....

f a patient is in obvious distress but a nurse is ignoring it, I would certainly go up the chain of command. That doesn't mean I would personally take on the patient's care, just that I would notify the appropriate person of the patient's situation and then let them talk with the primary nurse about what should be done. Of course, I did the same even before I had my RN license because that's the reasonable thing for anyone to do regardless of their position.

I see it this way too. When working as a tech, you do not take report from another RN. You have not legally taken on that patient as an RN. You cannot give meds/tx. You cannot call the MD. You cannot discuss tx/rx with the family either. Should you do these things you are in hot water. As a tech, you can notice a crisis, inform the RN. If you feel the need, you can go up the ladder. If a patient crashes, you can be supervised and assist as ordered in your tech role.

In my state, the BON states RNs can work as CNAs. Sheesh, in this economy at least it's an option.

I do understand the concerns of being blamed. OK, I would make a copy the shift assignment sheet. If my tech documenting software allows space somewhere, I would note what I informed the RN/Charge of.

If you are qualified to work as a tech or aide you may have to. Some nurses think they are "too good" for this and refuse, even though they get nurses pay. If someone refused to do that as you did, you would have been fired immediately. Your main concern should be for the patient and their needs, not your job title. Keep that in mind.

I love doing aide work. It is alot less mentally taxing. I was considering leaving nursing when I was assigned to be a CNA for a shift. During that shift I discovered that I still loved nursing and helping people, its the paper work and feeling like a walking pill machine that I hate. Sometimes it's just night to mix things up a bit.

If you are qualified to work as a tech or aide you may have to. Some nurses think they are "too good" for this and refuse, even though they get nurses pay. If someone refused to do that as you did, you would have been fired immediately. Your main concern should be for the patient and their needs, not your job title. Keep that in mind.

I don't think it is a point about being "too good" to perform any of the tech duties. In my facility we would shift to primary nursing and give 3-4 patients to the nurses and they are responsible for vitals etc. Why not use the RN as an RN? To me it makes no sense to use a nurse as a tech and is a poor use of resources.

Thankfully, I work with far more forward thinking people and we do not fire someone for not taking a role they were not hired for.

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.

Why not use the RN as an RN? To me it makes no sense to use a nurse as a tech and is a poor use of resources.

Unfortunately, sometimes a place is so desperately short-staffed that if a nurse is willing and able to work as a CNA, it is not only a good use of resources, but is also completely necessary and the only option. No one calls on a nurse to do a CNA job for the same amount of money they'd make as a nurse just for the hell of it- there are times when it's the only option and you are really saving the place by taking the position. On August long weekend I remember we were so short-staffed it was ridiculous- EVERYONE was calling in "sick." There were multiple CNA's coming in on their days off and working double shifts every day for the four days, not to mention I ended up working alone on a floor (one RCA to 14 residents instead of 1:7) with only occasional help from the nurse who was floating between two floors. It was madness. They called everyone on the list 3 times looking for someone to cover a nightshift, and all of us were working overtime anyway, so the evening nurse said she would stay for the graveyard shift as a CNA.

If she had not done that, we would have had no night shift CNA at all. All the other options were exhausted and you can't just leave the building empty of CNA's for the whole night! She took it with a smile because even though it was not her regular job, she knew they needed her. We work as part of a healthcare team. That's teamwork.

Having long ago come into Nursing from a broken family (Defunct Major Airline) I have a saying that makes my co-workers laugh when the going gets tough ref: floating,...

"At my salary, I'll serve french fries in the cafeteria if they want me to."

As for a use of resources:

If it comes down to a facility paying a nurse to use her PTO and go home or having an extra set of hands on the unit just in case census goes up or to keep everyone from running around like maniacs because they are so busy -- which do you think is smarter?

My bets are on having too many nurses on occasion is better (more cost effective) than having to pay someone overtime to cover shifts they can't cover with regular staff. For a profession that constantly talks about how we are understaffed, why are there people looking a gift horse in the mouth? I can't tell you how much it helps when there is an extra body on the unit for whatever reason. I won't question it, I'll just enjoy it because I know come tomorrow things can go back to being crazy busy.

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.

Why not use the RN as an RN? To me it makes no sense to use a nurse as a tech and is a poor use of resources.

I believe the OP mentioned that he/she worked the first 8 hours of a shift in an SICU then was floated for the last 4 hrs. Let's say RN to patient ratios were not insane where he/she was floated. Would you, as one of the other floor nurses want your assignment all chopped up? Or give it up completely? Or would you prefer a little help from a float nurse/tech in keeping things smooth for the last few hours of a shift? As it stood, another nurse had to give up her assignment 2/3 of the way through her shift, stop, give report then change duties. Some nurse who might not have been part of the float pool.

I personally consider that very intelligent use of resources (once more assuming the rest of the nurses weren't just dying from high ratios).

As for liability. . . I imagine one would have the same liability if one walked into another nurse's room and saw her patients for any reason, or if you had patients from different nurses sharing a room. In my situation (NICU) our patients are grouped in large rooms with 3-4 assignments, we are all responsible to some degree but not fully if we feel we see a patient in distress. As a tech/float nurse you may be in all the rooms, but are not expected to fully assess and evaluate every patient. If anyone, the charge nurse would have that responsibility. Of course you have some increased responsibility above that of a true tech. (Hey Cathy, I just reset your IV pump and that hand looks awfully puffy).

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.