frustrated long term care nurse

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    I am a GA LPN, originally. Due to personal reasons I relocated to NC. In GA I had no difficulty locating a job. I worked in the hospital which recruited me before I was even out of the program and graduated. In this area of the country there is absolutely no discrimination as to your initials. The only difference in our hospital between LPN AND RN scope was morphine push. Only RN's could administer morphine per IV. In NC, I could not get a position in the hospital as an LPN. And thus worked as an office nurse. Again I relocated this time for good to another state. The differences in scope of practice are enormous and I have been in a deep depression ever since entering this state. Once again I was faced with the same circumstances-- "Well, we only have limited postions for LPN'S in our hospital." At this point as a single mother I took my current job as a staff nurse in a long term care facility. I have actually embraced geriatric nursing and have fallen in love with long term care. My delimma is such: there must be a RN in the building according to state law. Constantly I am reminded that I cannot flush ears in our facility, I cannot add med's to an IV bag, I cannot hang TPN., the list goes on and on. Even though I did all of these procedures, administrations, etc. in another state. I understand that I am not in Kansas anymore TOTO, but still it is a very bitter pill to swallow. Never the less, in our area there is of course quite a nursing shortage, especially RN'S for long term care. We lost one of our Night shift charge RN'S and in order to gain experience and help the facility I agreed to take the postion until they could hire another RN. Unfortunately, my relief RN resigned. This left myself as the only full-time NOC Charge.In desperation my facility placed an ad to encourage RN'S to apply for the position and initiated a high hourly wage without benefits. The problem is- the RN'S that have come on board only work on-call , have no background in long term care and are quite ineffectual in their performance. When they are charge and I work as staff nurse I have to carry my floor and carry them as well. To add insult to injury, they make 11.00$ more an hour than I do. The kicker in all this nightmare is they will not release me from working 3 12 hr shift, and 1 8 hr shift with only two days off. The only alternative is to transfer back to eve shift, and this is not an option as my husband is a CNA at the facility and works eve shift. We both cannot work this shift together and maintain our family. The personnel nurse for scheduling is well aware of my problem and appears quite happy to have painted me into a corner so to speak. I know that I can go somewhere else but I would lose benefits, and basically my alternatives in this community are office nurse or long term care. Unfortunately, Dr.s don't pay office nurses here beans and I would have to take a 2-3$ pay cut per hour. I am sure this is quite long and drawn out but I really could use anyone's two cents in this manner.

    And please for the record, I AM NOT BASHING RN'S. I understand that RN'S have more education that I do and I envy every freaking minute of it. I am not able to persue my RN because I have a very unstable child that demands much of my attention. Believe me, it was all I could do to get through 15 mnths of LPN school.

    IF THERE IS ANYBODY THAT HAS BEEN IN MY BOAT OR SIMILIAR, COULD YOU WRITE BACK.
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    [QUOTE]Originally posted by sandigapeachlpn:
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    [QUOTE]Originally posted by sandigapeachlpn:

    I am not in the same mess you are in but I was in the past.I work in Pennsylvania. Here in the Northwestern part The LPN can only work in doctor's offices or in nursing homes. The hospital's only carry LPN's on a PRN basis. I often find that most facilities can put you in a corner in a hurry and they keep a stranglehold til you crack. In PA it is legal for the LPN to do a central line but they are not allowed to do any sub Q injections.LPN's are allowed to take orders but not allowed to do admit assessments.

    I found myself in the same boat you are in right now. We can't keep RN supervisors on the 11-7 shift. That puts me as the head nurse for the shift. We have excellent pay and good benefits but our problem is our 7-3 shift. This shift is never in a good mood when they come in The AM CNA's run the building and get away with telling the nurses off. You write them up and it gets dismissed by the DON and you are called on the carpet because their is a shortage of CNA's in the building and we can't be writing them up because they will quit and we will be even shorter. The RN sups get discouraged because they can't even defend their own staff. The 7-3 CNA's want the 11-7 CNA's to have seven people up on each of three hallways and showered. That is twenty- one residents up by the time 7-3 comes in. Here is the kicker. The facility has fifty resident's in it's upstairs( we are excluding the downstairs. They have their stuff together.)Now twenty- one out of fifty in the AM. Also twenty- one do themselves. That leaves six aides to do eight people.I guess what makes this so horrible is that the 11-7 has only two aides on at a time. So in general the RN's get discouraged and quit. Then you get new RN's who don't want to come to work. So How I got out of my shift is since I am an LPN an RN has to be in the building and the ADON has been doing the upstairs and that leaves me to do the downstairs. If their has to be an RN in the building then it is time for your DON to take hold of the reins and do the job herself or the DOH will ride in on you like the U.S. Calvery.
  7. 0
    To Sandygapeachlpn, look online and see what is out there in distance learning for LPN's wanting to continue to R.N. You can do most online (at 2 in the morning!!if you want, in your pj's!!).

    Good luck!!
    Last edit by LEN-RN on Nov 5, '05
  8. 0
    [quote=JBarger LPN]
    Originally posted by sandigapeachlpn:

    I am not in the same mess you are in but I was in the past.I work in Pennsylvania. Here in the Northwestern part The LPN can only work in doctor's offices or in nursing homes. The hospital's only carry LPN's on a PRN basis. I often find that most facilities can put you in a corner in a hurry and they keep a stranglehold til you crack. In PA it is legal for the LPN to do a central line but they are not allowed to do any sub Q injections.LPN's are allowed to take orders but not allowed to do admit assessments.

    I found myself in the same boat you are in right now. We can't keep RN supervisors on the 11-7 shift. That puts me as the head nurse for the shift. We have excellent pay and good benefits but our problem is our 7-3 shift. This shift is never in a good mood when they come in The AM CNA's run the building and get away with telling the nurses off. You write them up and it gets dismissed by the DON and you are called on the carpet because their is a shortage of CNA's in the building and we can't be writing them up because they will quit and we will be even shorter. The RN sups get discouraged because they can't even defend their own staff. The 7-3 CNA's want the 11-7 CNA's to have seven people up on each of three hallways and showered. That is twenty- one residents up by the time 7-3 comes in. Here is the kicker. The facility has fifty resident's in it's upstairs( we are excluding the downstairs. They have their stuff together.)Now twenty- one out of fifty in the AM. Also twenty- one do themselves. That leaves six aides to do eight people.I guess what makes this so horrible is that the 11-7 has only two aides on at a time. So in general the RN's get discouraged and quit. Then you get new RN's who don't want to come to work. So How I got out of my shift is since I am an LPN an RN has to be in the building and the ADON has been doing the upstairs and that leaves me to do the downstairs. If their has to be an RN in the building then it is time for your DON to take hold of the reins and do the job herself or the DOH will ride in on you like the U.S. Calvery.
    I'm in PA too. Our LPNs can do SQ injections, admit assessments, IVs except for Picc and central lines and push meds. I've never heard that they cant do Sub Qs, we'd be sol with insulin and heparin injections.
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    I work in LTC in the State of Michigan, about the only things I can't do that an RN can is...iv push meds (which rarely are done) and insert an IV, I think that is about it. And in these parts of the woods, LPN's make more money in LTC or home health then in a hospital or office.
  10. 0
    No one in my building, RN or LPN,adds meds to an IV..everything is premixed. We used to have a rule where LPN's couldn't do a dental assessment!!! Excuse me, you can start an IV on me but you can't count my teeth?!?! Now about the only thing LPN's can't do is a pronouncement. Someone dies and they have to call the RN.
  11. 0
    At my facility LPN's cannot start IV's or push meds. They can do a dental assessment, but an RN has to co sign the assessment. It is a JCAHO that the RN has to co sign.
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    At my facility in NYS there has to be a RN only if there is an IV solution hung in the building. RNs have to do PICCs. LPNs can do most everything else.
  13. 0
    I worked in Assisted living, and they let the LPN's do almost everything an RN can do (except for delegation/assignment). Maybe check out that as an option...it is really LTC, but a little more grey in the areas between SNF and general LTC...

    Of course there is the option to get your RN, but I find many of the LPN's I know love their positions and wouldn't trade it for an RN to save their lives..LOL! But I also suggested to a few that there are other options also! Respiratory therapist, MRI techs, ultrasound tech, emergency room tech..the list goes on, and allows for much of the same technical tasks as RN's. In fact, I am looking into a few of those myself .

    Good luck to you! And don't be depressed about being better than some old State rules that proably haven't caught up with the times...just remember you are a shining example of those rules no longer applying in the real world anymore..and that is something to crow about! (not to say an RN's position is an old rule folks...just saying that if in one state a LPN qualified to do one thing should give them an advantage for experience like we get!).


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