The Value of CNA's
A nearby city hospital's recent implementation of an RN centered model of patient care, thereby eventually eliminating CNA's, is certainly a thought-provoking topic. The fact that this hospital's decision to implement such a plan was based on research that concluded that there were better patient outcomes with an RN centered model, would cause any healthcare institution to reconsider its current ways. Although you can not deny this research, I wonder if perhaps there is a way to improve patient outcomes without eliminating the CNA position all together.
Although it would not be easy and it would certainly require an investment, (though hiring more RN's will as well) I think some sort of improved communication model between RN's and CNA's could have a significant impact. Afterall, poor communication between the RN and CNA is what often leads to mistakes and misinformation so if that aspect could be improved and the overall RN/CNA relationship could be improved, perhaps the same improved patient outcomes could result. This model could be shared from the time an RN and CNA orient to the hospital and continually reinforced every 2-3 months. Audits could be completed to insure that accurate information is being passed between RN and CNA and that documentation is cohesive. Managers on each unit could also help this by encouraging social gatherings outside the hospital or unit get-togethers.
This may seem very idealistic, as I am sure it is, but I feel strongly that there must be a way to avoid so many qualified individuals losing employment in a field in which it requires a unique individual. I also am viewing this from the perspective of an RN on a surgical floor. My patient load is typically only four but on the days when we are fully staffed with CNA's I feel that my care is improved because I can focus my care. Four thoracic patients that need three walks in a 12 hour shift is a very difficult task to accomplish without the help of a CNA.
I believe there are countless reasons as to why a CNA is valuable, but one in particular is that it is often a stepping stone to the role of an RN. About half of the CNA's on my unit are in school to become an RN. Without the experience of being a CNA, which many RN's were at some point, how will the patient outcomes be then with new nurses that have less experience with patients?
I hope that other hospitals can come up with more creative solutions if similar research yields the same conclusion.