Skill level not high enough for acute care

[hope3456, ASN, RN]

So a RN was 'asked to resign' from a M/S unit....thru the grapevine I heard this is what the mgr used as a reason - although I happen to know it was for something else. Anyway, that is beside the point. This unit also employs LPN's.

It just got me thinking....how is 'skill level' determined and how is it 'high enough' for acute care? So these LPN's 'skill level' is high enough for acute care but not the RN's? Loaded statement, IMHO. Although it brings up the argument - what is more important - education or experience?

[westieluv]

Having adequate acute care nursing skills comes from a combination of education and experience. Sure, they teach you how to do it in nursing school, and if you're lucky, you had several opportunities to practice new skills during your clinicals, but once you're out working in the field, experience is what makes you adept at what you do. For example, maybe you were able to place an N/G tube once or twice as a student, but once you're on the floor working independently and the order comes for an N/G, suddenly, you panic and try to remember every little thing that you did and what you were told. However, after working on that Med/Surg unit for a year or two, placing an N/G comes as naturally as writing your name, and you are laughing at the thought that you were ever intimidated by it. That's just one example, but you get the idea, so yeah, I think that education and experience are both critical to having really good clinical skills. Also, just because someone is an LPN doesn't mean that they are inadequate or less skilled than an RN. I am an RN, but I have worked with LPNs whose clinical skills did circles around a lot of new grad RNs who thought they were all that just because they had "RN" after their name. LPN doesn't mean dumb, it means that those nurses chose a different career path, just as RN doesn't mean dumb next to a doctor, we just chose a different career path.

[hope3456, ASN, RN]

I agree with you westieluv - it depends on how much experience you are able get ultimately matters more than your title. There are LPNs who have far more experience than RNs. So how are new RNs supposed to gain this experience when everyone is so ready to deem them 'low skill level' and let them go?

[caliotter3]

A person labeled "low skill level" may need extra training or time to come into their own. There are reasons behind the label. I have seen people that were "low skill level" despite years on various jobs. Quite a different situation from someone who is only five weeks into their first job after graduation. I wondered how some people managed to hold onto their jobs as well as their licenses for so long. One has to look at the quality of the supervisors who allow such individuals to continue showing poor performance, year after year, with no expectations of improvement to a mimimum "skill level".

[hope3456, ASN, RN]

Perhaps it should be attached to your license - how 'high' your skill level is? I'm surprised there is no such designation already based on the responses to this thread. Should a RN get a chance to improve skill level such as thru a refresher course? The fact she was able to complete nursing school and pass nclex means nothing?

[ivyleaf]

One someone gets fired, usually there is more going on than slightly sub-par performance. At least in my experience.

[Pedsnurse77]

My skill level has nothing to do with what boards I took (RN or LPN)

LPNs in general are task based where RNs are rationale based. Their skill level depends on the person performing the skill not their licensure.

I can see where either could be lacking in skill level. To me this is experience based not you earned your degree because you read about it in a book so your competent. There are many new grads (RNs ESP) who have never put in filets etc. because they don't have the SKILL base to do so. However they can quote the steps right from the procedure book.