I am a new NP and have been working in LTC for a little over 6 months. I am having a very difficult time adjusting to this type of environment. I have worked with LPNs, however, my experience with LTC LPNs has not been positive. Just like in the hospital, we have great nurses and then we have nurse who are not so great. In LTCs I have encountered too many not so great nurses. I worry that although I speak slowly and I think clearly and spell lots of what I am ordering the order is transcribed wrong and sometimes not at all. One great example while on call this weekend, I got a call from a facility telling me about a resident who's BS was over 500 on the 7-3 shift, I got the call at 7pm. The nurse told me the pt did NOT have a hx of diabetes and the patient was given insulin without an order for insulin. I asked why was the BS checked, the nurse could not tell me. So I asked many questions, ordered a work up for diabetes including fluids and to call me back with BS at HS (no call back). I tried to call back and no answer at the facility. Only after I spoke with nurse practitoiner for this facility that I found out that this patient was diabetic and did have orders for management of diabetes....Oh my goodness.
I am not bashing LPNs, I would just like some suggestions. I have spoken with DONs and I have spoken with administrators to no avail. If anyone has any suggestions I am completely open.
LTCAngel, I have been a nurse for over 20 years and I agree with you that lumping LPNs under one umbrella is unfair. As I stated I am NOT bashing LPNs. I have worked with and trained LPNs as a instructor. I have also mentored RN grads.
Many of the LPNs that I am currently working with are great! However, I have encountered many that have raised my concerns for residents. I have spoken with adminstrators and DONs and many times nothing is done. Some of the LPNs describes these LPNs as a warm body; similar to how some agency nurses where called when I worked the night shift in the ER. I understand I work with a variety of people some excellent, some not so great, some irresponsible, however my concern remains with the residents.
My intention was not to insult any one or profession but to get suggestions for help.
Last edit by momnurse6 on Dec 28, '12
: Reason: Incomplete thought
Momnurse6,I wasn't trying to say that you were saying any one group of nurses is better than another and I'm sorry if you took it that way. I understand that you probably work with more LPNs. I think it def sounds like a continuity of care issue and I would hope that as others have said that the DON handled the situation but you just weren't privy to it. If these things keep happening, maybe you can ask the DON for a Nurse's Meeting in which you outline what you expect from them when you get calls for orders and the follow up that you require. Education can go a long way in solving many problems. We have a wonderful NP that has been at our facility for about the same amt of time and I would welcome a meeting in which she outlined her expectations and ways that she wanted us to communicate with her. Fortunately, I don't think she's had the same issues you have. I feel having our NP has taken a lot of burden from our doctor and she is available M-F all day to deal with a myriad of issues that in the past we would have had to call the doc and try to explain the problem but he wasn't available in person to actually assess the resident the way our NP is. Sorry for rambling. Sounds like you are doing a great job and you are very contientous and caring.
Last edit by LTCangel on Jan 12, '13
: Reason: Grammar, spelling