New Grad LPN offered a Nurse Supervisor position in Post Acute - page 3

by markblpn

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Hello! So I just recently got my license and this is going to be my first time ever working in the field of nursing, other than my clinicals. I accepted a full time position as a LPN Nurse Supervisor for a Post Acute wing in... Read More


  1. 0
    Quote from markblpn
    hello!

    so i just recently got my license and this is going to be my first time ever working in the field of nursing, other than my clinicals. i accepted a full time position as a lpn nurse supervisor for a post acute wing in a ltc facility. i have been on the job for almost two weeks. running the cart for both mar and tar is not a problem. i usually have 12 patients and can get it all done within my 8 hour shift...however, all the paperwork, computer work and constantly having to assess and supervise my aides is really taking a toll. i do have previous supervisor experience in hospitality but its nothing like this. i love all the patient care experience i am getting in post acute but i have found it extremely difficult to get to all the documenting, calling po's, ordering labs, assessing new admins, and making sure my aides are doing their job.
    i think i can do this but i have no previous experience with doing any of this paperwork, calling docs, labs, etc and as of yet, i have not received any training on how to do so. this place was supposed to give me orientation but my first day of orientation was with a nurse who had not worked in post acute for over a year, the second day was spent passing meds only, and every day since i have just been told to treat and pass meds...

    should i consider looking elsewhere, where i can actually go through an orientation process so i can learn how to do the things that are not being taught to me here or am i being unreasonable?
    are you really in a supervisory role like supervising other nurses(lpns) and cnas? or are you the floor nurse who supervise cnas?
    if it is the former, then it would be hard to supervise other nurses who have more experience than you. how would you be able to help the nurses when you did not even receive proper orientation? if it is the latter, then 12 patients is good for sub-acute/rehab. it is 15-20 patients to 1 nurse on my sub-acute floor.

    i know job openings are scarce now due to this economy that's why you cannot really be picky so i just want to wish you luck.
    Last edit by agldragonRN on Aug 11, '11
  2. 0
    Quote from cat_lpn
    in ltc/ltac lpn's are supervisors.. not in the sense that they manage other nurses or are unit managers, but that they are direct supervisors to the cna staff.

    it's just a regular position in a ltc/ltac as a staff nurse. they just call it 'lpn supervisor' since you're 'supervising' the cna. you're the 'charge nurse'. it's different from a hospital.
    not in my ltc facility. i was never an lpn supervisor when i was an lpn. i was a floor nurse. we always have a "real" supervisor, who supervise all nurses(lpn/rn) and cnas.
  3. 0
    i was never allowed to do the initial assessment in my ltc facility when i was an lpn. if it's the lpns patient, then the rn supervisor and lpn would assess the patient together then the rn supervisor must co-sign the assessment forms immediately. only then can the lpn call the doctor to verify the medication orders from the hospital.

    i am still a floor nurse so i just co-assess & co-sign my lpn coworker if he/she has readmissions or new admissions so that we don't have to bother the supervisor.
  4. 0
    Did the restriction to RNs only doing the first assessment have anything to do with SNF vs ECF patients?? I mostly worked in TX, and LVNs did the full admission on ECF residents...the RNs had to see the SNFs, so we had an RN on the heavy Medicare wing and arranged admissions for M-F 8a-6p when possible. That way pharmacy had time to get the meds ready for the nightly delivery as well.
  5. 2
    Quote from markblpn
    Hello!

    So I just recently got my license and this is going to be my first time ever working in the field of nursing, other than my clinicals. I accepted a full time position as a LPN Nurse Supervisor for a Post Acute wing in a LTC facility. I have been on the job for almost two weeks. Running the cart for both MAR and TAR is not a problem. I usually have 12 patients and can get it all done within my 8 hour shift...However, all the paperwork, computer work and constantly having to assess and supervise my aides is really taking a toll. I do have previous supervisor experience in hospitality but its nothing like this. I love all the patient care experience I am getting in Post Acute but I have found it extremely difficult to get to all the documenting, calling PO's, ordering labs, assessing new admins, and making sure my aides are doing their job.
    I think I can do this but I have no previous experience with doing any of this paperwork, calling docs, labs, etc and as of yet, I have not received any training on how to do so. This place was supposed to give me orientation but my first day of orientation was with a nurse who had not worked in post acute for over a year, the second day was spent passing meds only, and every day since I have just been told to treat and pass meds...

    Should I consider looking elsewhere, where I can actually go through an orientation process so I can learn how to do the things that are not being taught to me here or am I being unreasonable?
    Sounds like they dumped quite a bit on your plate at once, but for less than 2 weeks in you sound like you have a handle on it more than most new grads who take jobs like that. It isn't uncommon to see posts here from new nurses put into situations they aren't prepared for - normally they start out with Heeellllllp! ! ! Sometimes it is obvious they are being dumped on and expected to pass meds on 50 residents right away. I don't think long orientations are the norm anyway.

    You will probably pick up speed as you get used to the paperwork, as well as the phone calling. Feeling you have your med cart and the time constraints of that under control is important!

    I would ask about how you feel about the place in general . .are they responsive to your questions and do you feel you can work in a team that's supportive or do you feel they'd be just as happy to toss you in the deep end and walk away? If there's a foundation there where constructive change can occurr I probably would stay longer and see how things shake out.

    If delegating is just something you aren't really used to there is a chance - if they are surly and/or insubordinate that's another far more difficult thing to adapt to.

    I guess the bottom line is that for me any new job takes several months to get used to get in the groove so it's best to try to hang on until that happens before you decide unless it is an obviously unsafe situation and they are trying to take advantage of you. Best wishes.
    Hospice Nurse LPN and xtxrn like this.
  6. 1
    Lots of great advice for the original poster!

    As everyone is saying: LPNs doing assessments varies tremendously from state to state and depends on the work setting.

    It would probably be a good idea for the poster to read the nurse practice act for her state regarding the scope of practice for LPNs.
    OgopogoLPN likes this.
  7. 0
    Quote from hospice nurse lpn
    the op works in ltc. in my state, an lpn does the initial assessment in an ltc setting. reason being, after 5 pm there are no rn's in the building. just can't make the poor pt wait until the next day for an initial assessment. the scope of practice varies from state to state.
    wow, hospice nurse, that's amazing that you have no rns in the building after 5pm! i'd say that company that owns your ltc needs to be educated on the need for at least one rn there.

    i agree with traumarus--the op needs to read and know her nurse practice act and the scope of her practice. in any ltc i worked in, there was at least one (or two ) rns. we lpns practice under our own licences but must have a supervising rn.

    op: i also recommend you ask for more training/orientation. as a new grad, you are indeed asking for help to ensure the best care for your patients--word it that way to your supervisor--how could he/she say 'no"? the patient load is not unreasonable for ltc. most ltcs in our state have patient loads of 25-45. it's normal not to get done with all your work in 8 hours. i know i (as well as many others)never did when i worked in ltc(and i spent many years in that area before leaving for greener fields). i do wish you the best and hope you get more orientation!
    Last edit by Midwest4me on Aug 11, '11 : Reason: grammar
  8. 2
    Quote from midwest4me
    wow, hospice nurse, that's amazing that you have no rns in the building after 5pm! i'd say that company that owns your ltc needs to be educated on the need for at least one rn there.

    i agree with traumarus--the op needs to read and know her nurse practice act and the scope of her practice. in any ltc i worked in, there was at least one (or two ) rns. we lpns practice under our own licences but must have a supervising rn.

    op: i also recommend you ask for more training/orientation. as a new grad, you are indeed asking for help to ensure the best care for your patients--word it that way to your supervisor--how could he/she say 'no"? the patient load is not unreasonable for ltc. most ltcs in our state have patient loads of 25-45. it's normal not to get done with all your work in 8 hours. i know i (as well as many others)never did when i worked in ltc(and i spent many years in that area before leaving for greener fields). i do wish you the best and hope you get more orientation!

    that's extremely common. in all of the ltc/snf facilities i worked at in tx (or interviewed at), lvns were in charge after hours- unless they could get a 3-11 rn....but an rn on 11-7 was pretty much unheard of in smaller towns. in the one i worked at in a larger market, rns in the building wasn't consistent. they did have to have 8 hours/day on the weekends (state requirement)- and there was usually a part time rn who did that as the w/e supervisor. but they all had an rn on call for any emergency situation. that was very consistent. and if needed, whoever had call would go in if needed. but if someone was having enough trouble to call the on-call rn, the doc generally had to be notified- so the rn may get a call after the lvn talked to the doc and got orders; depended on the situation.


    i had some limitations on being on call, but would go in for any iv problems. at another place, i had the "death beeper" and would go in to pronounce someone so the funeral home could be notified.

    there are a lot of ways ltcs work- and the lvns i worked with - the vast majority of them- were outstanding. they knew those residents, and took pride in giving good care. same with a lot of cnas (of course there was turnover, but some had worked there for over 25 years).
    nursel56 and Hospice Nurse LPN like this.
  9. 0
    Quote from xtxrn
    . . .I had some limitations on being on call, but would go in for any IV problems. At another place, I had the "death beeper" and would go in to pronounce someone so the funeral home could be notified.
    Well dang - sort of a Grim Reaper Beeper - now why is my crazy mind offering up possible ringtones for your beeper?
  10. 1
    Quote from nursel56
    Well dang - sort of a Grim Reaper Beeper - now why is my crazy mind offering up possible ringtones for your beeper?

    Queen's "Another one bites the dust" is stuck in my head now.
    nursel56 likes this.


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