RN vs. LPN the war continues

Specialties LTC Directors

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Specializes in Gerontology, Med surg, Home Health.

I'm the DNS of a small skilled facility. The nurse manager was hired long before I started. She is an LPN. I have no issues with LPNs in general, but given the choice, the acuity of the residents, and the CMS 5 star rating system which gives more stars to facilities with RNs, I would rather have as many RNs as possible. We have a newly created position. We are a union building and have to post every position. I have 2 people interested. One is a brand new LPN and the other is an experienced RN. The nurse manager doesn't like the RN and tries to find fault with everything she does. She loves the LPN (who has worked less than 10 shifts for us). She told me that she has decided to give the job to the LPN because she likes her. I told her I would rather have an RN for a variety of reasons. So now she's going around to the other staff and telling them she is 'over her' because I have a bad attitude about LPNs. I am at the end of my rope with this woman. She decides who she likes personally and who she doesn't and her personal opinions get in the way of everyone's work. The RN is not perfect (hmmm are you? am I?) but she has experience. Any ideas out there. I know it's a rambling post and no one can make this call but me, but are any of you going through anything similar?

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Specializes in Legal, Ortho, Rehab.

Wow...I am not a DNS, but I really don't like what is going on. She should have made an objective decision. She seems like she is trying to create a little clique (I know you didn't need me to tell you that) :). She really seems to feel intimidated. Maybe she thinks she's going to get the pink slip or demoted? Anyways, stand your ground...I believe your more logical employees will see your reasoning.

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Specializes in LTC, Hospice, Case Management.

This is actually one of the easier decisions to make. Take the whole title thing out of the mix. It is simply the person who has the most experience to do the job (and someone with 10 days on the job does not have the experience you need!).

We have discussed enough together over the years that we both know I tend to favor the LPN maybe a little more than you at times (simply because I was one for many years), but in your example today.. I don't even see the "RN vs LPN" debate. I see this as an experience vs no experience question. You are the DNS.. stand your ground. Good luck.

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Specializes in LTC.

Maybe the employer wanted to give the new grad LPN a chance. I understand where you are coming from as well. You want a Nurse with the most experience and that is acceptable. But just maybe, just maybe this LPN will learn, gain some experience and turn out to be a great addition to your facility. I hope it all works out for you and your coworkers.

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The new nurse does not get a supervisory position over another nurse with experience, initials aside.

I had someone try to get me dissing the aides today. Um, they're a great bunch and the only attitude I saw in the transaction that sparked the discussion was hers.

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Specializes in EMS, ER, GI, PCU/Telemetry.

are these both internal employees going for the same job?

if so, i would say give the new position to the RN with more experience and allow the LPN to continue to work at her current position since she is a brand new grad and needs to get some experience under her belt--has nothing to do with initials!

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Specializes in Gerontology, Med surg, Home Health.

They are both per diem nurses going for a staff job.

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I agree with those who say that experience wins over who likes who. Stand your ground. Sounds to me like your LPN nurse manager is your bigger problem in this situation.

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The nurse with the experience should be the front runner in your facility. An LPN with 10 days experience should get more experience on the floor. BTW Mermaid, that facility in NB that you thought I worked for? You were right. But I no longer work there, or anywhere for that matter. I am so tired of the LTC bull :argue: :banghead:that I am taking a chance on myself, took the TNCC and passed, have ACLS, PALS, Basic Dysrhythmia, Bachelor's in another field, 3 years as LPN, now an RN and I have applied to every hospital from Boston and points south. If I can't get a hospital job in Massachusetts, I will waitress, bartend, substitute teach, ANYTHING but LTC in NB. My son graduates high school in 2011 and I will then move anywhere where I can get a good hospital career going. Money isn't a big motivation, going to work with a smile on my face is my motivation.:loveya:

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Specializes in acute care and geriatric.
I'm the DNS of a small skilled facility. The nurse manager was hired long before I started. She is an LPN. I have no issues with LPNs in general, but given the choice, the acuity of the residents, and the CMS 5 star rating system which gives more stars to facilities with RNs, I would rather have as many RNs as possible. We have a newly created position. We are a union building and have to post every position. I have 2 people interested. One is a brand new LPN and the other is an experienced RN. The nurse manager doesn't like the RN and tries to find fault with everything she does. She loves the LPN (who has worked less than 10 shifts for us). She told me that she has decided to give the job to the LPN because she likes her. I told her I would rather have an RN for a variety of reasons. So now she's going around to the other staff and telling them she is 'over her' because I have a bad attitude about LPNs. I am at the end of my rope with this woman. She decides who she likes personally and who she doesn't and her personal opinions get in the way of everyone's work. The RN is not perfect (hmmm are you? am I?) but she has experience. Any ideas out there. I know it's a rambling post and no one can make this call but me, but are any of you going through anything similar?

Boy you can learn a lesson from my DNS, ( I am her ADNS) - NOONE talks about her behind her back, she would be all over that Nurse Manager like a wet blanket, IT is SO UNPROFESSIONAL to talk about you behind your back, if she cant be behind you and your decisions 100% she would be fired!!Decisions and the rational for them made by you are expected to be respected. SHe is seriously killing the morale in the building not to mention respect . If she is allowed to talk this way what is to stop the next CNA from talking about HER in that manner...

We have an experienced LPN who really massages the ego's of the administrator and his staff but is so totally unprofessional and would act like your nurse manager if given the chance, whenever a Head Nurse position is available, people expect her to get it but as my DON says, only people who can work with ME can get that position, and she is right.

CCM you are right about choosing an experienced RN for the position, you dont need us to tell you that, what you need to do is sit down with this nurse manager and have a serious talk, lay down the law about the professional behavior expected of her and the example she is to show the staff. You can tell her that you have heard the things she has said throughout the building, and you respect her opinion, but your decisions are made by looking at the big picture, if the RN has problems, she will help you reeducate her so the facility will benefit. You understand that she prefers the LPN and maybe another position will be made available at a later time for that as well. I would keep a synopsis of the meeting for her personal file and keep an eye out that she wont try to sabotage this new RN's standing and performance in your facility.

As DON isn't it your decision?

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Specializes in Geriatrics, WCC.

I agree whole-heartedly with Achot Chavi. Time to put your foot down with the nurse manager so she knows who is the boss here. If it was me, i would be giving her a written warning and putting it in her file for future issues. As for who to put in the position? The RN.

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i'm the dns of a small skilled facility. the nurse manager was hired long before i started. she is an lpn. i have no issues with lpns in general, but given the choice, the acuity of the residents, and the cms 5 star rating system which gives more stars to facilities with rns, i would rather have as many rns as possible. we have a newly created position. we are a union building and have to post every position. i have 2 people interested. one is a brand new lpn and the other is an experienced rn. the nurse manager doesn't like the rn and tries to find fault with everything she does. she loves the lpn (who has worked less than 10 shifts for us). she told me that she has decided to give the job to the lpn because she likes her. i told her i would rather have an rn for a variety of reasons. so now she's going around to the other staff and telling them she is 'over her' because i have a bad attitude about lpns. i am at the end of my rope with this woman. she decides who she likes personally and who she doesn't and her personal opinions get in the way of everyone's work. the rn is not perfect (hmmm are you? am i?) but she has experience. any ideas out there. i know it's a rambling post and no one can make this call but me, but are any of you going through anything similar?

as an rn and having an open mind and one who has worked with some experienced but terrible rns, i say give that giving the lpn a chance may not be all that unreasonable. the nurse manager must have some reasons for not wanting to give the position to the rn besides not liking her. as you guys are on opposite sides, she may not feel comfortable sharing those reasons with you.

lpns are often painted with a broad stroke, the type of paper received (not a aa or bsn or whatever) being something that is used constantly and the lpn as a group has lots less support (to do pr) than the rn. the one ltc facility that i've worked at and liked the most was headed by an lpn so go figure. (the distance was the problem). so, let her give it a shot, if it doesn't work out, it'll be as evident as any other nurse.

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