EMS hitch this one takes the Cake!! - page 2

by downsouthlaff 2,797 Views | 26 Comments

Ran an EMS call today to a Nursing Home (one I'm not familiar with) in a town I'm not familiar with) and in a town I'm unfamiliar with patient had a fall. We go in paperwork isn't ready this is a weekend. We go in talk to the LPN... Read More


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    Once again, I will clarify this post is not about me insulting LTC nurses it's not about how I handled my patient as an EMT, it's not about what responsibility the nurse has when we leave its about and educated Licensed Practical Nurse telling us "An RN is not a licensed nurse, they are not Licensed to do skills, they are only Registred and can only supervise" that's what I was told by licensees nurse that's what she's telling the public. Someone who doesn't know might belive her and call the state and report an RN for giving meds if they don't know any better that's not right!
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    Quote from downsouthlaff
    Shouldn't an RN know how to do all tasks that are being supervised?
    Yes, an RN should know how to perform all tasks that are delegated and supervised.

    However, the reality is that some RNs do not know how to perform the tasks they are delegating and supervising. I spent 6 years in LTC/nursing homes, the first 4 years as an LVN and the last 2 years as an RN. To be perfectly blunt, some of the RN supervisors did not know how to do some procedural skills such as starting IVs, PEG tubes, indwelling urinary catheter care, etc., and depended on the floor nurses to do these things.
    nursel56, MBARNBSN, SoldierNurse22, and 4 others like this.
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    I understand that and that's how it is at my facility too! It's not an RN or an LPN thing. Of course the MDS nurse of 13 years in an office will be shady on skills too. And a CNA who's been on restorative for the past 6 years may have forgotten how to properly take a blood pressure or change an Ostomy bag! You don't use it you lose it!! But still I definently think its very unprofessional and crazy to say that an RN is not a licensed nurse, wow!!
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    The more you view it the more you say it, THE MORE RIDICLOUS it sounds! I have been told many things by Nurses of LTC and ER you name it as a CNA and an EMT, I had one nurse tell me that you have to become an LPN before becoming a paramedic and I'm like really is that so?? Don't know where they get there info from, also had one nurse tell me that it's highly illegal to set oxygen flow to anything over 2lpm without doctors orders when I tried to see a nasal cannula to 6lpm, but to hear her say that only LPNs are licensed nurses RNs are just registered! Just wow! The things we hear lol
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    You were the only one there during this conversation, OP, so in no way am I trying to say that you didnt hear her the LPN correctly; BUT, maybe you interpreted incorrectly or she wasnt able to correctly articulate what she was trying to say. What exactly ended up happening? Did the RN help with the PEG, or did you have to wait for the LPN?
    nursel56 and jadelpn like this.
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    Quote from downsouthlaff
    And jade lpn Cms governs how facilities are staffed and ran, an RN is a licensed nurse who can do everything an LPN can do that doesn't change by facility! It's not my issue but that comment is pretty darned ridiculous. If I were the RN I would deff be insulted.! Shouldn't an RN know how to do all tasks that are being supervised?
    My point was that just because an RN is licensed to do it, doesn't mean that an RN is learned in it. LPN's who start procedures usually need to finish them. It is difficult to stop halfway and let someone else (be it an RN or another LPN) take over, to then go back and attempt to continue...not very good continuity of care. However, with that being said, who was with said patient waiting for you? The RN who this would have been reported to by the LPN as the house supervisor? Then the RN (or whomever) should have had all said paperwork. In any event, as an LPN and an EMT, I find in my various practices that sometimes in the level of stress that seems to be the case in this situation, who knows what the LPN meant or didn't mean. Ultimately, however, the supervising RN would perhaps be responsible to be sure that the patient who fell (assuming that it was reported to RN, hence why she was involved at all) has all the necessary paperwork ready for you. People say the dumbest things in the heat of the moment. However, your focus is on getting the patient out of there and to an alternate level of care.
    SoldierNurse22 likes this.
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    Is it possible that you encountered an LPN that was trying to take care of a patient that fell, a malfuctioning pump, an irritated family, and all the other activities of an LTC facility and just wasn't getting her point across very well?
    nursel56, WunMsJayLPNtoRN, jadelpn, and 1 other like this.
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    Was the RN working under a temp lic. ? i know they are limited as to what they can do when working under a temp lic while awaiting to take there boards.
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    From what OP said, it sounds like the LPN had a problem with prioritization and professional attitude.
    OP, how did the RN react? How did you, the RN, and the LPN proceed with the situation from there?
    What can we learn from this?

    Summit RN EMT
    nursel56 and nrsang97 like this.
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    Quote from downsouthlaff
    Ran an EMS call today to a Nursing Home (one I'm not familiar with) in a town I'm not familiar with where a patient had fallen. We go in paperwork isn't ready. This is a weekend. We go in talk to the LPN In charge of patient. She informs is that she's busy with a PEG tube machine that's malfunctioning and all the while the family is outside fussing about the machine! The Supervising weekend RN sees our frustration and offers to take over handling the tube functions while the LPN comes and gives us all our required documents. What does the LPN reply? "I'm The only Licensed Practical Nurse on today, so I'm the only one who can actually do the skills and be liable for them, the Supervising RN is only Registred to supervise but not in charge of direct patient care. "

    Fixed for grammar, punctuation and added possible misheard/ omitted words in bold.


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