On working with LPNs in the clinical setting

Specialties Geriatric

Published

Hello all. I recently obtained my ADN and just landed my first job. It seems that in my area of the U.S., newly graduated RNs must work in nursing homes/LTC in order to sharpen their 'prioritization and delegation' skills for around a year or so before being taken into consideration for the care of more acutely ill patients. Same for the home health care setting. Everywhere I have checked asks that RNs have one yr. of previous work experience before consideration. So, here I am, working at a nursing home in my area. I was planning on just taking this in stride, but for some reason, I seem to get a lot of gruff from LPNs where I work! Several of them don't want to take the time to count their narcotics drawers at shift change, they sign their name without paying attention to what they are doing, and just rush through their med passes. I try and explain that I am new to nursing and want to take the time with what I am doing, but many of them just roll their eyes and get in a huff. I don't have as much of a problem with other RNs, they seem to understand where I'm coming from with regards to these matters. Is there any advice someone can offer me to help me to deal more effectively with these LPNs? Not sure if they are saddened by their career choice or what the problem is, but I just need some advice on how to deal with working alongside them. Thanks so much...

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Oboy....

OK, the best advice I can give is to jettison the idea that LPNs are "saddened with their career choice" which results in them being sub-par nurses. Of course they give you gruff if this is your attitude.

Are the LPNs actually refusing to count narcotics with you? I doubt very much this is the case. More likely they're just counting "too fast" for your taste. Likewise with them "rushing" through the med pass. LTC is fast paced. You have to pass those pills fast. Just because a nurse is fast doesn't mean he's sloppy or unsafe.

The fact is you a) seem to think LPNs are bitter they aren't RNs and b) you seem to think LTC is just a last resort for new grads. I'm sure this mindset comes across loud and clear. If all the LPNs are reacting the same way to you, than the problem is most likely you and your attitude.

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I don't mean to offend anybody in any way. I wanted to become a nurse after getting a degree in health info management and actually went the ADN route because it was faster for me. I already know it doesn't automatically make me smarter or better in school than a LPN. I'm a new nurse and this is just what I've been noticing. It's true that LTC is a last resort for me. I would so rather be working in another area of nursing. I really appreciate your opinion and will give it some thought. :)

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Oboy.... OK the best advice I can give is to jettison the idea that LPNs are "saddened with their career choice" which results in them being sub-par nurses. Of course they give you gruff if this is your attitude. Are the LPNs actually refusing to count narcotics with you? I doubt very much this is the case. More likely they're just counting "too fast" for your taste. Likewise with them "rushing" through the med pass. LTC is fast paced. You have to pass those pills fast. Just because a nurse is fast doesn't mean he's sloppy or unsafe. The fact is you a) seem to think LPNs are bitter they aren't RNs and b) you seem to think LTC is just a last resort for new grads. I'm sure this mindset comes across loud and clear. If all the LPNs are reacting the same way to you, than the problem is most likely you and your attitude.[/quote']

This! I am an LPN and do not plan on going back for my RN. I love geriatrics and work in that field as an LPN. If I went back to school I would actually be making less to do a job I don't want.

I also assume your attitude is coming across as if they are beneath you. Your post came across that way and it was just a small entry.

I wish everyone would realize there are good LPNs and RNs as well as bad ones of each. It is totally dependent upon the person and not the title. The same way having a BSN doesn't automatically make you a better nurse than an ADN.

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Specializes in Pediatrics, Emergency, Trauma.
I wish everyone would realize there are good LPNs and RNs as well as bad ones of each. It is totally dependent upon the person and not the title. The same way having a BSN doesn't automatically make you a better nurse than an ADN.

We can start...here. :yes:

OP, as a former LPN and 1 year RN, one of the things that I enjoy is learning from ALL nurses, regardless of licensure and scope.

Another thing is to respect the experience that you are receiving; one of the MANY adages is "forget what you learned in nursing school"; meaning, maintain your legal practice, but learn the ropes for the area you are working in, which includes the "culture" of the unit or facility.

One of the many things your co workers don't enjoy is someone in the trenches that don't want to be there. :no: The best way for you to improve that is to improve your attitude to working in LTC; and embrace the many aspects of nursing you will use; learning about focused assessments, therapeutic communication, teaching, family focused care; wound care, care planning, multidisciplinary team work, supervision and leadership. :yes:

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Specializes in Primary Care.

I'm confused at the whole LPNs being saddened by their career choice statement. But just like you were offensive in this post (even though you may not have done it intentionally) it maybe a similar situation at your job. It sounds like you are a floor nurse just like the LPNs and not in a supervisory role so you can start by treating your coworkers like your equals. It could also be you're looking for negatives since this was your last resort for a job.

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I agree with this so much. LPNs don't rush through a med pass by choice, they have to! Also, it becomes second nature as you learn your residents and their meds.

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Specializes in LTC, Memory loss, PDN.

i'm not offended or insulted - just giving my advice

watch a good war movie and try not to act like the butter bar (just kidding)

seriously, perhaps you could view it as a problem with co workers

rather than a LPN/RN issue

get a good perspective of what time constraints your co workers

are dealing with

understand that you may take all the time with what you're

doing when it's your time you're talking about, but when you're

on someone else's time, you may have to respect their time as well

I do hope that at least some of your co workers will also be

flexible and understanding or at least remember when they

first started

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Specializes in LTC, Memory loss, PDN.

now, when it comes to signing off on narcs, you count everything

all the stuff that "no one else counts", or " no one ever uses"

when counting, i'm rather inflexible

i want full names, dosage, etc., not just the number

if that takes too much time, that's just too bad

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Specializes in Gerontology RN-BC and FNP MSN student.

How can you even accept the cart if you didn't count the narcs?

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How can you even accept the cart if you didn't count the narcs?

I count the narcs, but I'm always being given an attitude about it. This nurse (LPN) will stand across from the cart and whip through everything. She even waits to sign several doses of pain pills till the end of the shift when I insist that we count. She rushes through it and huffs about it. It's unbelievable to me. The thing is though, I never HAD a clinical rotation in a LTC facility. *I* am the one *getting* the attitude bc I have never worked in LTC, not the other way around. In school, we were at hospitals where the narcs were mechanically dispensed. And like I said, I am a new nurse. The "orientation" at this supposedly good facility is a joke! People don't wanna do it! They're all ****** off about being bought out by HCR or something...

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I just answered you older post, but wished I'd seen this first. There is a reason why you can't get a job in acute care before doing some time in LTC first. You need to learn how to run 30 patient's comprehensive care on a daily basis first. All the Meds, treatments, labs, assessments and coordinate other disciplines, family, MD, specialists. You need to be a team player and get your basics. The RN/LPN thing will serve as antagonistic only, so just drop that and talk about nurses. But I understand it seems that there's an obvious generalization that can be made where you work and this is part of your dilemma. So knowing your last post and this I can only say you can't move on to where you really want to be until you become proficient at this. Sorry to say, it was your choice to do the easier route of ADN vs the longer route of getting the straight education for HIT, your real goal. You had to do what YOU had to do. Don't blame the LTC because you are forced to do it this way. Lastly, stand up to the nurse rolling her eyes at you in narc count. She needs to understand you are a new grad not stupid. And that you are not going to tolerate disregard for procedure when it comes to controlled substances. She needs to document her narcs before you come to do count. Count will be done with both of you checking the book the card then the book. Liquids will be checked for color, viscosity and odor, not just approximate amount. If there's a problem with this, you will refuse the cart until it is done per policy. If it is habitual, you will report her. Now that's one objective problem. The other things are subjective. Unfortunately it seems you're standing in judgement of more seasoned nurses when you should actually be seeking their help with survival tips. I would offer to share some of the humble pie you will need to eat to get back to the position you belong. It would benefit you to ask for help from your COworkers no matter what the alphabet soup after his or her name. Otherwise I don't see you being able to get the experience you need to move on to what you really want to do.

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