LPN'S Supervising RNs'? How would you feel? - page 2

I would like to start out by saying that I do respect LPN's and I am in favor of advancing in everyones careers. I am an RN on a PCU. Our hosp changed the "directors" title to Clinical Care... Read More

  1. by   Jules A
    Quote from hogan4736
    I had a boss who was (and still is) an LPN, in Phx...She was required to inactivate her license (for a management job)...She was and still is (31 years w/ same company) a center manager (DON) for a nationwide HMO (Cigna) managed care facility (primary care, urgent care, OB)...Best boss I have ever had, and ever will have...
    A back office LPN that understands how to run a business...
    End of story...
    I am a proud 11 year RN, BSN, ACLS, DAD, LUV, LMAO, ETC...
    Get over it...
    Depends on the person and the situation...
    My dad quit college and made tons of cash...
    Tradition is overrated

    I agree with you when it comes to the game of alaphabet soup after someone's name. I've worked with highly educated buffoons and undereducated genius'. My guess would be that the bon might have a beef with the LPN if they are in fact operating out of their scope but I don't really see how it would affect the RN. Just my two cents but I'd much rather have a fair and competent boss no matter what their education level happened to be.
  2. by   smoo
    The LTC facility I worked at had LPN's in ADON positions that supervised the RN's who were floor nurses. They also had charge nurses that were charge of the hall even if they were working with other RN's. Not sure how it is in other LTC facilities in the area.

    smoo
  3. by   ZASHAGALKA
    ftp://www.bne.state.tx.us/LVN-guide.pdf

    In Texas at least, LVNs must be supervised by an RN. Fine. But, that does not mean that LVNs must be under all RNs, just that an RN must be ABOVE them.

    Texas specifically describes a role for LVN as a coordinator of care:
    Assign specific tasks, activities and functions and maintain
    appropriate supervision of licensed and unlicensed
    personnel in structured health settings for clients with
    predictable health care needs in accordance with designated
    job descriptions and/or job duties.

    The BNE does NOT define the nature of the 'licensed' staff about which an LVN can 'maintain appropriate supervision'.

    I would have to say that it's perfect legal in Texas for an LVN to maintain appropriate supervision of RNs, provided an RN is in a supervisory role over the LVN.

    ~faith,
    Timothy.
  4. by   Vagon
    Sorry is this comes off as mean but that seems utterly ineffective and backwards. RNs are more highly trained, why would it be wise to have an LPN supervise them? Sure there are some older LPNs who may have the experiance to but it just isnt fair to the RNs who put out more time for school in my opinion.
  5. by   txspadequeenRN
    I have been a nursing supervisor most of my nursing career. The reason for this is because I was at one place most of my nursing career and since have moved onto bigger and better things. I was a weekend supervisor of a Large nursing facility specializing in Alzheimers. There were about 40 employees under me at any time and yes this included about 4-5 RN's. I didnt get the job because of titles (and I was asked to do the job i did not apply) I got the job because I knew the place, the job, the poilcy/procedures,the employees and the families like the back of my hand. No one had been there longer and no one could hit the floor and take on any hall like I could. The RN's I worked with they didnt care because I dont have a greater than thou attitude at work . I work as a CNA ,a nurse whatever to get the patients taken care of. I also am well aware of my limitations and have NO problem whats so ever finding a RN to either reaffirm my thinking or assist me with a problem. Its all political and a title battle with type of issue. What difference does it make if your supervisor is a LVN, go to work and do your job. He or she is in that positon for a reason and Im sure you will find out that person may be a great resource for you.
  6. by   JoeyDog
    I have a similar story. I worked in an ICU (as a CNA) and could not figure out why the majority of the RN's talked poorly about the nurse manager. Basically it seemed like none of them had any respect for her. One day I finally asked why the nurses seemed to dislike her so much. I was told it was b/c she wasn't even a nurse...she was a Respiratory Tech!

    I have no idea how that situation ever came about as the Nurse Manager (RT) was the one who hired me, but being just a CNA I wondered how that could have been legeal. She was finally replaced with an RN,BSN, I beleive she went back to working as an RT.
  7. by   clee1
    Legal? Unknown; I'm not a lawyer. However....

    In the "real world", sometimes practicalities take priority over the "letter" of the law.

    Take my situation, for instance. I am currently a MA, working in a LPN slot at an urgent care clinic while I'm in nursing school. There is ALWAYS an MD in the building; the one RN we have is the Practice Coordinator; she works 9-5 Monday thru Friday and handles all of the administration for the facility. All of the back-office people work under the supervision (and license) of the Dr.; regardless of our level of licensure or title.

    Including myself, there are 3 MA's and 3 LPN's on staff, as well as 2 xray techs and two lab techs, and a few front-office types. One of the LPN's is a seasoned veteran with more than 20 years of experience, the other LPN's and MA's are fresh out of school. However, when I am in the building, I function as the charge "nurse". How is that possible?

    Well, the seasoned LPN, while clinically excellent, couldn't lead a 2 yr old to the bathroom and HATES paperwork. The other LPN's and MA's have very little experience. As a former EMT and experienced MA, it falls to me to "take care of business" almost by default. Also, I am the only current ACLS and PALS holder on staff, including the Docs.

    You be the judge: who is most competent to lead the back-office staff?
  8. by   UM Review RN
    Quote from clee1
    Legal? Unknown; I'm not a lawyer. However....

    In the "real world", sometimes practicalities take priority over the "letter" of the law.

    Take my situation, for instance. I am currently a MA, working in a LPN slot at an urgent care clinic while I'm in nursing school. There is ALWAYS an MD in the building; the one RN we have is the Practice Coordinator; she works 9-5 Monday thru Friday and handles all of the administration for the facility. All of the back-office people work under the supervision (and license) of the Dr.; regardless of our level of licensure or title.

    Including myself, there are 3 MA's and 3 LPN's on staff, as well as 2 xray techs and two lab techs, and a few front-office types. One of the LPN's is a seasoned veteran with more than 20 years of experience, the other LPN's and MA's are fresh out of school. However, when I am in the building, I function as the charge "nurse". How is that possible?

    Well, the seasoned LPN, while clinically excellent, couldn't lead a 2 yr old to the bathroom and HATES paperwork. The other LPN's and MA's have very little experience. As a former EMT and experienced MA, it falls to me to "take care of business" almost by default. Also, I am the only current ACLS and PALS holder on staff, including the Docs.

    You be the judge: who is most competent to lead the back-office staff?

    I sincerely apologise if my response was taken to mean that I didn't think that an LPN was capable of doing the job. I personally would only feel uncomfortable because of scope of practice issues vs management.

    In other words, if I had to send a patient out to the ER (supposing that I worked LTC) and the LPN forbade me as my supervisor? I would be in a pretty pickle legally, wouldn't I? Because if my clinical assessment said send that patient to the ER, I would certainly have to go over the LPNs head and get that OK.

    Now, if the BON assured me that all was good and legal, and that I couldn't get into trouble, then fine, problem solved.

    But please understand that my take on the issue had more to do with clinical issues than with management capability or intelligence.
  9. by   clee1
    Quote from Angie O'Plasty, RN
    I sincerely apologise if my response was taken to mean that I didn't think that an LPN was capable of doing the job. I personally would only feel uncomfortable because of scope of practice issues vs management.

    In other words, if I had to send a patient out to the ER (supposing that I worked LTC) and the LPN forbade me as my supervisor? I would be in a pretty pickle legally, wouldn't I? Because if my clinical assessment said send that patient to the ER, I would certainly have to go over the LPNs head and get that OK.

    Now, if the BON assured me that all was good and legal, and that I couldn't get into trouble, then fine, problem solved.

    But please understand that my take on the issue had more to do with clinical issues than with management capability or intelligence.
    No apology necessary here, friend.

    You certainly would be in a fix if your hypothetical situation happened; but I cannot imagine that any decent supervisor, of any level of licensure, would fight you sending a pt to the hospital if necessary.

    I wouldn't, for sure! And for sure I'd never let a supervisor require me to do anything contrary to the requirements of my license. Sorry, but I've worked too hard to let a power-trip mess with my livelyhood!

    To me, it is ALL about taking care of the patient. In my situation, I try to be cognizant of the "legal" issues involved - those that seem to cause you uneasiness - and deal with them as appropriate. As I said though, in my situation, the Doc on duty bears the ultimate responsibility and we all march to his tune.
  10. by   rambisisking
    Quote from tigress_8207
    That is just rediculous.I would be mad as hell.Think you need to find out why that happened.Just doesn't sound right.



    OH MY! Yes this has to be fixed... We can't have something like that occuring. If this makes you mad as hell you might want to take a look at what is going on around the world, listen to the news and find something to really get your feathers ruffled about, something that is really a travisty. This should not be an issue, it wouldn't be if not for ego. If anyone is worried about the legality of it then find out the answer, other than that what is this about?
  11. by   rambisisking
    Quote from txspadequeen921
    I have been a nursing supervisor most of my nursing career. The reason for this is because I was at one place most of my nursing career and since have moved onto bigger and better things. I was a weekend supervisor of a Large nursing facility specializing in Alzheimers. There were about 40 employees under me at any time and yes this included about 4-5 RN's. I didnt get the job because of titles (and I was asked to do the job i did not apply) I got the job because I knew the place, the job, the poilcy/procedures,the employees and the families like the back of my hand. No one had been there longer and no one could hit the floor and take on any hall like I could. The RN's I worked with they didnt care because I dont have a greater than thou attitude at work . I work as a CNA ,a nurse whatever to get the patients taken care of. I also am well aware of my limitations and have NO problem whats so ever finding a RN to either reaffirm my thinking or assist me with a problem. Its all political and a title battle with type of issue. What difference does it make if your supervisor is a LVN, go to work and do your job. He or she is in that positon for a reason and Im sure you will find out that person may be a great resource for you.
    Yes, I had a similar experience for about 17 years at one facility and had many of the responsibilities that you have mentioned. At one point when the admin. and assist. admin were both gone, I was given the keys and was in charge because the DON went in early to have her baby. Also we had an unbelievable CNA, who we all relied on for just about everything, I and several others talked her into getting her Admin. lincense and in time I was working for the CNA who used to be under my direction, who I trained, and she was Marvelous...Lets open our eyes and ears and our minds may follow.
  12. by   Jules A
    Quote from JoeyDog
    I have a similar story. I worked in an ICU (as a CNA) and could not figure out why the majority of the RN's talked poorly about the nurse manager. Basically it seemed like none of them had any respect for her. One day I finally asked why the nurses seemed to dislike her so much. I was told it was b/c she wasn't even a nurse...she was a Respiratory Tech!
    I have no idea how that situation ever came about as the Nurse Manager (RT) was the one who hired me, but being just a CNA I wondered how that could have been legeal. She was finally replaced with an RN,BSN, I beleive she went back to working as an RT.
    Since you didn't write about what an incompetent manager she was I'm assuming her lack of an "acceptable" degree was the reason they resented her? Sad. While I do appreciate the hard work and scope of information learned with an advanced degree I don't think that it automatically makes someone more qualified as a manager. My feelings are that the education we receive is a mere foundation and most of the real stuff comes from being on the job.
  13. by   banditrn
    Yes, education is important - up to a point. After that, experience takes over. I don't care as much about the # of letters after a name as I do about a nurse's proficiency in what they are doing.

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