rn taking orders from an lpn? - Page 2

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  1. Sep 18, '11 by
    Quote from tofunurse<3
    I feel better about my decision after reading that article. My goodness I had no idea that "dumping" was that common of a practice. Its sad really. I'm still bothered that my DON put me in the position she did, not calling ME DIRECTLY with the orders and not being there to answer questions when I needed her. But I do believe I did the right thing and I just hope for the best when I go back to work on Tuesday
    You have federal law on your side...they got squat
  2. Sep 18, '11 by
    First of all i nmy opinion an LPN should NEVER be supervising an RN or functioning in a supervisory role. And I have NOTHING against LPN's (I was one for 4 years). LPN's can NOT take a verbal order. I think you did EXACTLY the right thing!
    tofunurse<3 and VICEDRN like this.
  3. Sep 18, '11 by
    Quote from tinkerbell9681
    LPN's can NOT take a verbal order.
    Maybe not where you live, but here LPN's take v/o all the time.
    itthybitthythpider, reeveslpn, Crux1024, and 4 others like this.
  4. Sep 18, '11 by
    Quote from Hospice Nurse LPN
    Maybe not where you live, but here LPN's take v/o all the time.

    They can do it all day long here too. I did it for 19 years and never had a problem!
    Crux1024, MsHelloKitty,LVN, Debilpn23, and 2 others like this.
  5. Sep 18, '11 by
    Quote from tofunurse<3
    I feel better about my decision after reading that article. My goodness I had no idea that "dumping" was that common of a practice. Its sad really. I'm still bothered that my DON put me in the position she did, not calling ME DIRECTLY with the orders and not being there to answer questions when I needed her. But I do believe I did the right thing and I just hope for the best when I go back to work on Tuesday
    Trust me, that was purposeful. She was keeing her hands clean. Had you not accepted pt back and the facility caught he// , you can be sure that you would have been the first one under the bus.

    Good job and excellent judgement on your part. I know it wasn't easy with all the push back from senior staff.
    yooperPN, itthybitthythpider, michelle126, and 10 others like this.
  6. Sep 18, '11 by
    I love LTC centers "dumping" patients on my ER and refusing to take them back. I clear my patient load and start the phone calls...

    I take great pleasure in contacting the state offices for medicaid/medicare to investigate you and shut off your funding. On the weekends I have a state ombudsman to intervene and advocate for residents "not able to return" and have gone as far as to remove/deny CMS funding for the facility as well.

    I have been responsible for multiple fines levied on nursing homes and have completely shut down 2 centers for stupid decisions, poor care and neglect. (Soon to have a 3rd attempting pending appeal from another jugement by US Department of Health & Human Services)

    There better be a significant change in level of service that exceeds your centers ability to care for patients or you're looking to be out of business soon. Dumping is horrible for the patients and families that entrust their entire care to you and your staff. Be careful about deciding who you deny returning to your facility.


    LPN, RN, DON??? I don't care where the order comes from. I don't play that game...
    Crux1024, tofunurse<3, kalevra, and 7 others like this.
  7. Sep 18, '11 by
    Quote from EmergencyNrse
    I love LTC centers "dumping" patients on my ER and refusing to take them back. I clear my patient load and start the phone calls....

    Not to derail the thread, but this does go both ways. I'm sure from an ER stand point you don't see that but I can't tell you how many times a discharge planner will "sell" us this sweet little old guy only to get him and he is a complete wild cat ready to punch everyone around him including other residents, trying to elope, etc on 100 different psych meds that mysteriously weren't on the original MAR when we agreed to accept.

    I do agree with you tho. No matter who does the dumping it is extremely unfair to the patient and their family. I think it happens because resources for these tough patients are so limited.
    itthybitthythpider, michelle126, SuesquatchRN, and 10 others like this.
  8. Sep 18, '11 by
    I'm just a student so ya'll give me some schooling please... Where would the patient go if not back to facility? What if they didn't have living arrangements?
  9. Sep 18, '11 by
    OP, good for you for doing the right thing. No matter what happens at your job next week, I think you can sleep well at night and that's what matters most. If you end up shopping for a new job, then I think this story (whether you tell it or not) is proof that you are ethicall nurse if nothing else.

    Best of luck to you and sending you positive vibes.

    (and no, in this state, I would not have taken orders from an LPN or taken the order that you described without clarifying it first with the DON)
    canesdukegirl, tofunurse<3, leslie :-D, and 1 other like this.
  10. Sep 18, '11 by
    Quote from SeeTheMoon
    I'm just a student so ya'll give me some schooling please... Where would the patient go if not back to facility? What if they didn't have living arrangements?
    That's the issue with the dumping laws. The nursing home in this situation would be violating federal law if they didn't take them back because that is their residence at the time- even if temporary...UNLESS they sign out of the LTC (would be against medical advice, and the person would have to be able to act on their own rights and make their own medical decisions) It gets complicated
    Hospice Nurse LPN and tofunurse<3 like this.