RNs filling in for CNAs when a CNA calls out

1 Where I work sometimes if there are not enough CNAs or float pool coverage available they will assign the RNs to work as aides. I have written my concerns about this to the nurse manager. They say we do the job of an aide but you "work to your license" which means I have as much responsibility legally to the patients in my care as their assigned nurse does yet I get an aide's report which usually does not even tell me why the patient is there, only the chores that need to be done!

Granted this doesn't happen all that often but I resent my license being put in potential jeopardy because of the hospital's lack of planning. This is what staffing agencies exist for! The last time this happened I told the person who made the assignments out that I didn't want to do the assignment, but I didn't refuse to do it, she just changed the assignment without any hassle.

This practice is illegal in some states but the state I live in (AR) is not one of them.

What are your experiences or thoughts on this issue?
TO me that is really stupid and a misuse of staff. I work in med surg, we are short aides often, if there is an extra nurse and we are short aides than instead of having that nurse be pooled or canceled we all get one less patient! and help each other, anything else is NONSENCE

I have had to serve as a mental health tech a few times due to staffing issues. We did things a bit differently though...all staff received the same report (essentially a nursing report), and even though patients were assigned to different staff, there was no "it's not my patient!" mentality: if you were free to help any patient, you did. As far as paperwork went, I wasn't put down as the tech for the day; I was a RN whose assignment happened to be tasking for the unit.I didn't mind as long as I got my RN pay And some days, it was a nice change of pace to be closer to the front lines. To be honest, I feel that all nurses should have to do a couple of shifts as the CNA/aide/tech. It will give them a better appreciation of what these roles do and how they are as important to patient care as the nurse is. And perhaps walking a couple of miles in the tech's shoes may cause the nurse to rethink how they treat their supporting staff.

Is it the CNA role at RN pay? That's a waste of money to me. An agency CNA would probably be cheaper than an employee RN.If it's CNA and RN role, i.e. you are the primary RN without CNA support, sounds like they are getting away with understaffing.ETA: If it's a CNA role at CNA pay for someone licensed as an RN, you just report any concerning findings to the primary RN and leave it at that. All this talk about losing one's license due to occasional staffing roles like this is highly unlikely. It's more than just working below your license: it would also require a patient going bad, a lawsuit, and reporting of you to the BON.

Quote from dudette10Is it the CNA role at RN pay? That's a waste of money to me. An agency CNA would probably be cheaper than an employee RN.If it's CNA and RN role, i.e. you are the primary RN without CNA support, sounds like they are getting away with understaffing.ETA: If it's a CNA role at CNA pay for someone licensed as an RN, you just report any concerning findings to the primary RN and leave it at that. All this talk about losing one's license due to occasional staffing roles like this is highly unlikely. It's more than just working below your license: it would also require a patient going bad, a lawsuit, and reporting of you to the BON.

Quote from DeeAngelIt is an RN working as a CNA while getting RN pay and performing the duties of a CNA. The patients would be assigned a primary nurse, I would not be fulfilling both roles.

That's crazy! Now are you being paid as an RN or as a Tech because that would be really ridiculous if it was the latter.

It may be a "huge waste of money" but which would the floor prefer -- no tech/aide/CNA at all, or an over-qualified one? (I also agree that it's a good idea to work "in the trenches" from time to time; teams work better when everyone understands everyone else's perspective, IME).I don't see it so much as putting your license "on the line" if they're not expecting you to do any nursing duties that would require taking report. But if you notice that so-and-so is turning blue, they would expect you to use your RN-educated brain and do things that "just a tech" may not know how (or be licensed/authorized) to do. That's my understanding of the expectation of being held to the level of your license -- is it something that you, as an RN, should have known better than to do. You're not going to be asked to pass meds or call the doctor and take verbal orders -- because those aren't "tech duties" -- but if someone codes and you're nearby, you're expected to "be an RN" (because you are one) and do whatever it takes to save that person's life (just like you'd do for any patient whether you're working as an RN or not, whether they're your patient or not -- you don't refuse to work a code because you never received report on that particular patient).

Quote from DeeAngelWhere I work sometimes if there are not enough CNAs or float pool coverage available they will assign the RNs to work as aides. I have written my concerns about this to the nurse manager. They say we do the job of an aide but you "work to your license" which means I have as much responsibility legally to the patients in my care as their assigned nurse does yet I get an aide's report which usually does not even tell me why the patient is there, only the chores that need to be done!Granted this doesn't happen all that often but I resent my license being put in potential jeopardy because of the hospital's lack of planning. This is what staffing agencies exist for! The last time this happened I told the person who made the assignments out that I didn't want to do the assignment, but I didn't refuse to do it, she just changed the assignment without any hassle.This practice is illegal in some states but the state I live in (AR) is not one of them.What are your experiences or thoughts on this issue?

Quote from dudette10Is it the CNA role at RN pay? That's a waste of money to me. An agency CNA would probably be cheaper than an employee RN.

So what's new? You will be fulfilling the CNA's role AND be responsible in the RN role.We already do this 24/7.

Quote from Been there,done thatSo what's new? You will be fulfilling the CNA's role AND be responsible in the RN role.We already do this 24/7.

Why not just staff you as an extra nurse? The reason I ask, is because our staffing grid calls for, say, 2 RNs and 2 NAs at night with X amount of patients. But what if one NA calls out with no replacement? Our floor would just call in for 3 RNs and 1 NA, with the thought process being (and bearing in mind that this is night shift) that the RNs can help with patient care stuff like taking people to the bathroom, etc. That strategy doesn't make sense fiscally to me - like, why would you want to pay an RN twice as much rather than call in an extra aide - but oh well. I don't mind taking my patients to the bathroom and getting sets of vitals and stuff like that, plus it makes the patient load lighter for nurses.