Is this legal?

  1. As most of you know, I just recently graduated and became a LPN. I work in a LTC.
    I have been working as a LPN for one month tomorrow.
    I have also been working this facility alone. A nurse will help pass pills till 11p, then I am alone (the only nurse) till 5a.
    I had no orientation, just people "helping" me if I had a question. Kind of a "learning as you go" type of experience.
    I do not feel that is a safe practice. Especially with me being brand new yet. What if something happened? I surely wouldn't know what to do. Shoot! I didn't even know what the requisition form was for lab when they came in this AM!
    I can always go somewhere else, I suppose, but I really enjoy my job and the people, just not so much responsibility yet! Maybe in the future, I wouldn't be so worried about it, but I am now.

    What do you guys think? Isn't it illegal? And if something DID happen, I know the place would save their butts and sacrifice my license, and I worked hard for my license.

    I just am in a quandry right now....
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  2. 15 Comments

  3. by   sunnybrook83
    Julie
    First off, congrats on becoming a LPN. Secondly, congrats on realizing that you don't know everything and that you shouldn't be in the uncomfortable position you are in. I would talk to my supervisor and tell her your concerns- they are legitimate. If they do not respond to those concerns in a way with which you are comfortable, I'd look for another position. Good luck!
  4. by   nimbex
    Is there an IN house supervisor to help you problem solve? if so utilize this person like crazy until you're comfortable. Is there another unit in the facility with another LPN for you to call with questions? If so latch onto this person too.

    without a mentor.... you have a tough road ahead.... being new, it's hard to know what is ok and tough and what is crazy wouldn't touch by another nurse....

    If you really insist on staying which seems to be quite a challenge... you'll need to listen to that inner voice when it tells you you're in over your head... and have the courage to make that phone call that says "no this is unsafe".... the voice is there... not ignoring it is the trick..

    So happy you're a practicing nurse.... be careful so you can keep on practicing!

    let me share one... out of school working psyc. with a medical sick young woman.... she had chest pain with a cardiac history. I gave NTG sl. as ordered, remembered to take the BP even... alerted charge nurse who had never seen a medically sick patient before... she hid in the office... 15 minutes later still chest pain... per nursing school.. take BP give 2nd NTG. so I did... pressure in 80's... I'm panicky... try to pry out charge who takes one look at pt. and calls EMS.... still chest pain, pressure in 70's... charge says give her more NTG... so I do... scared to the bejusus!!!!!

    EMS arrives... tears me 3 new arses for causing severe hypotension with the NTG and she end up in the ICU.....

    Morale... I had NO idea what I was doing.... I had No support to problem solve... equaled poor patient outcome. Thank GOD she did just fine....

    But who do you think was legally liable? yep.... me...

    If your facility can't offer you the support "in case" something goes wrong... believe you me it will!!!!! with your multisystem sick patients.....

    Enjoying the people and the job can happen anywhere... but we're here to nurse.... I guess the question is can you nurse safely there? If not, are they willing to make accomodations until you feel you are safe?
  5. by   -jt
    <if something DID happen, I know the place would save their butts and sacrifice my license, and I worked hard for my license.>

    They could say you didnt inform them that there was an unsafe situation & if they didnt know about it, they couldnt fix it, so some of the axe will fall on you not for not carrying out your responsibility in informing them & for putting the pts at risk with your silence. So put it all in writing to the nursing administration - with the date on it - & ask for a meeting to discuss your concerns & to seek resolutions for the pt/nurse safety issue. Besides possibly making a mistake by being overwhelmed and inexperienced without adequate support, what happens if you are attacked or become ill & cant call for help? A nurse in Florida was found killed by a pt - she was alone on her unit when he flipped out.
  6. by   Dr. Kate
    If you choose to stay where you are you have to get the phone numbers of all the resource people available to you. This would include people for clinical matters, administrative issues, and what to do if the place burns down. You need to know the policy and procedure, safety, disaster, all the manuals cold. You need to develop strong working relationships with the CNAs.

    In all honesty, you're too new and inexperienced to be in this position. jt is right document and get your concerns out there. If you like long term care, maybe a larger facility where there are more people on shift would be a better starting point for a career you want to be long and satisfying.
  7. by   sjoe
    jt has it right, as usual.

    Is it legal? Yes.

    Is it wise? No.

    Does it save the facility money in the VERY short run? Yes.

    You ask "what would happen if...."

    You would get blamed, that is what would happen, and the full weight of this facility would come down on you to save its own butt.
  8. by   montroyal
    Call your board of nursing legal dept. and explain your situation. They can tell you if it is legal. In most states a RN must be on duty because LPN's are not allowed to asses patients without an RN cosigning. No matter what the BON tells you, if you feel uncomfortable, you have every right to be questioning the situation. Best of luck.
  9. by   GPatty
    The facility has about 100 beds, 60 of which are full.

    One of the incidents that really got me to thinking about how critical this situation is, is that a woman was a new admit yesterday, and at 3am, she was asking about her meds. I explained they were there, and in the cart, ready to be passed at 6a. I told the nurse when she came in at 5a, that this new lady was a bit anxious, her BP was fine, and so on and so on....
    She said, "Did you check her blood sugar?" When I said no, her reply to me was that the lady was in for unstable diabetes. I DID NOT KNOW THAT!!!
    I did not know anything! I had no report...just a few papers to go on for her DX. NO where did I see about her diabetes.
    OMG! What if something happened? She was fine though.

    There is no in house supervisor or anything. I am it. The only one. The nurse.
    Me and 1 or 2 CNA's for the whole blasted night.
  10. by   live4today
    Hi Julielpn

    I would not wish that situation on my best friend, and you are a dear friend and sister in the Lord to me. Regardless of whether it is legal or not, the concern I have is that you are a new grad with no background in what you are assigned to do all alone. An orientation would have been wise to have had, but since you did not have one....lay your concerns on the table with the person who hired you. Let them know you enjoy your job, but must give an ultimatum: Either they provide you with an orientation for at least six weeks...minimum...or never assign you to the floor without another nurse who knows the ropes around that facility until you have had the chance to get to know the patients, the procedures and policies, etc.

    Prayers to you, and hope they will be reasonable with you. It's never to late to request the "right thing", and stand by what you know is best for you. Treat your nursing license like gold...if you don't no one else will respect all the time, money, effort, and dedication it took for you to obtain it.

    I love you dearly,
    Renee :kiss
  11. by   GPatty
    Renee~
    I was supposed to have 3 days orientation, but on my very first night we were short (due to a nurse being on vacation) and although everyone answered my questions wonderfully, I certainly would have preferred a better orientation than just a question and answer period.
    I am going to bring my concerns to the administrator tomorrow.
  12. by   JonRN
    Julie.......make sure if you tell them about the unsafe conditions that you document everything, date, time, who you discussed it with, what was said etc. etc. Then if the world comes crashing down on you, you can say, they were told by me that this was unsafe etc. Could save your license. CYA.

    Pappy
  13. by   nursedawn67
    Julie at the first facility I worked as a brand new LPN, I was suppossed to have 3 days orientation, which in itself scared me to death...thats not enough time. What ended up happening was I fully orientated one day, the next day I was told go pass meds someone will be there later, I pretty much ended up on my own (yes I had others I could go to, but I felt like they didn't want to be bothered). My third day of orientation was the same as the 2nd day. No wonder about a week in to working I had a med error (which wasn't soley my fault it was many peoples faults, but got blamed on the new nurse)...I was so lost I didn't know what to do. Now when I orientate I try to make sure they are comfortable and are actually learning something from me. If I were you I would go to the supervisor and say something, I know I should have. Take care.
  14. by   Kayzee
    Ypu need to speak up and say something. This is unsafe and unfair to you. I have worked LTC, and some facilities just want a body there. Don't jeopordize your license...speak up!

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