2 hospitals to drop licensed practical nurses - page 24

the changes at mercy and unity hospitals are meant to improve care, but unions say the remaining nurses will be stretched too thin. all 90 licensed practical nursing jobs at mercy and unity... Read More

  1. by   SmilingBluEyes
    In the event LPN's do work on my unit (we are an all RN unit but LPNs do occasionally float to us) I AM responsible for signing off on their assessments and must do all IVP meds. THAT is pretty much the extent of my accountability for their actions. I think there is nothing wrong with that-----and I do feel accountable in this manner. It's a matter of what our BON expects, as well as hospital policy.

    I guess I am not understanding where you are coming from RN34TX, so I will leave it at that. Where I am, RN's cannot escape accounability for their patients in their care-----and if an LPN is assigned, the RN IS accountable for head-to-toe assessments and RN-only functions. How that can be ducked or dodged, is beyond me.
  2. by   Dixiedi
    Quote from SmilingBluEyes
    Generalizations like this do NOTHING to foster any sort of unity or help us understand your point of view. I am very pro-LPN but I take REAL offense to this post.
    I agree with you 150%!
    I have been a LPN for about 30 years. I have never worked with an RN who was "supervising" my work. Nor have I worked with any RN who ever "washed" their hands of any LPN when an error occured.
    I remember a medication error back in '78 or '79. We were doing team nursing at the time and I was making my way down the hall with the medicatio cart. My team leader walked up to me as I was pulling the meds for bed A from the drawer and signing them off. She handed me a Coumadin tablet and asked me to give it to "her." I did.
    Later I found that the "her" who was to get the Coumadin was the lady in bed B! It was BOTH of our faults! Mine for not checking the NAME and hers for not checking the NAME! She didn't place blame on me and I didn't place blame on her. We did however work together, I hustled down the hall to assess my patient and she put a call into the nursing supervisor. Nobody was placing blame on each other. After I gave a dose of Vitamin K to the lady in Bed B and Coumadin to the lady in bed A, the supervisor did ask us how we could have prevented this. We both knew the obvious answer.
    Case solved and lo and behold, the RN did not place blame on me and me none on her. We both failed.
  3. by   txspadequeenRN
    This whole thead gets more silly by the minute. LVN's will never go away there is just not enough nurses to go around. The hospitals in my area go all RN then change back to allowing LVN's to work the floor when things get tight. It is a big old never ending circle . Chicago BSN seems to have a problem with anything less than a BSN. Which in my book is nonsense. I personally to think everyone should climb the ladder and be a CNA, then LVN then RN.... get the total nursing experience from all angles. I also think the BSN is a greatly overrated thing. For one to say that entry level should be BSN just gets my fire a rollin. I might not have felt this way if I had not had to show X BSN grads how to set up O2 or my personal favorite was when the BSN grad ask how she could get the patient his meds from a glass vial without cutting his lip. I am not saying that every BSN grad is dumb or incompetent but even though a BSN grad may have more class or even clinical time does not mean he/she knows what to do with it. You are not the super nurse because of your degree status. However, this can stand true for all nurses as well. I would like to add that I am a BSN student BUT..... would have NEVER entered a 4- year program without being a LVN or ADN first. Ok now send me the flames.... I can take it!!
  4. by   RN34TX
    Quote from SmilingBluEyes
    In the event LPN's do work on my unit (we are an all RN unit but LPNs do occasionally float to us) I AM responsible for signing off on their assessments and must do all IVP meds. THAT is pretty much the extent of my accountability for their actions. I think there is nothing wrong with that-----and I do feel accountable in this manner. It's a matter of what our BON expects, as well as hospital policy.

    I guess I am not understanding where you are coming from RN34TX, so I will leave it at that. Where I am, RN's cannot escape accounability for their patients in their care-----and if an LPN is assigned, the RN IS accountable for head-to-toe assessments and RN-only functions. How that can be ducked or dodged, is beyond me.
    That's exactly where I'm coming from and that's exactly my understanding of the extent of RN responsibility with respect to LPN's in a med/surg setting.
    Outside of admission/head to toe assessments, hanging blood, or other "RN only" functions, I'm not understanding where all of the "RN's are responsible for everything an LPN does" or "An LPN works under an RN's license" type of comments are coming from.
    I wasn't trying to say that "all RN's" try to wash their hands of accountabilty or I'd be talking about myself as well.

    That post about Coumadin clearly involved two nurses (one an RN) from the beginning and that's not the type of situation I'm talking about.
    I'm talking about if the LPN gave the Coumadin alone independently, and made an error.
    Would the RN in charge who was nowhere near the area at the time, be held responsible for this error?
    Not in my LPN experience.
  5. by   kadokin
    Quote from SmilingBluEyes
    In the event LPN's do work on my unit (we are an all RN unit but LPNs do occasionally float to us) I AM responsible for signing off on their assessments and must do all IVP meds. THAT is pretty much the extent of my accountability for their actions. I think there is nothing wrong with that-----and I do feel accountable in this manner. It's a matter of what our BON expects, as well as hospital policy.

    I guess I am not understanding where you are coming from RN34TX, so I will leave it at that. Where I am, RN's cannot escape accounability for their patients in their care-----and if an LPN is assigned, the RN IS accountable for head-to-toe assessments and RN-only functions. How that can be ducked or dodged, is beyond me.
    I don't know that anyone is talking about "ducking or dodging" anything. Where I work, If it requires an RN signature, the RN performs the task. That may be what is confusing. If a task can be completed independently by an LPN, we assume the LPN is liable for that. Of course, all pt's under the RN's care are the RN's responsiblity as far as general well-being and safety and so forth. But if there is a care issue d/t an LPN's mistake, we assume the LPN will be held accountable for their actions. The RN, of course, generally follows up if any further monitoring, rxs need to be done b/c of the mistake. I think I know what I'm saying. Does that seem any clearer to you? Can you understand why it may be a little confusing?
  6. by   kadokin
    Quote from Dixiedi
    I agree with you 150%!
    I have been a LPN for about 30 years. I have never worked with an RN who was "supervising" my work. Nor have I worked with any RN who ever "washed" their hands of any LPN when an error occured.
    I remember a medication error back in '78 or '79. We were doing team nursing at the time and I was making my way down the hall with the medicatio cart. My team leader walked up to me as I was pulling the meds for bed A from the drawer and signing them off. She handed me a Coumadin tablet and asked me to give it to "her." I did.
    Later I found that the "her" who was to get the Coumadin was the lady in bed B! It was BOTH of our faults! Mine for not checking the NAME and hers for not checking the NAME! She didn't place blame on me and I didn't place blame on her. We did however work together, I hustled down the hall to assess my patient and she put a call into the nursing supervisor. Nobody was placing blame on each other. After I gave a dose of Vitamin K to the lady in Bed B and Coumadin to the lady in bed A, the supervisor did ask us how we could have prevented this. We both knew the obvious answer.
    Case solved and lo and behold, the RN did not place blame on me and me none on her. We both failed.
    Thank you for that view of teamwork in action. I wish everyone worked in an environment where ALL understood that errors are opportunities for learning and TEAMWORK w/ MUTUAL ACCOUNTABILITY is the ONLY WAY to get the job done. Bravo to you two.:spin:
  7. by   tntrn
    It must vary from facility to facility and not just state to state. I am "just up the road" from where SmilingBluEyes is, and before our LVN's were demoted to aide status or left altogether because they had way too much pride to allow, we had LVN's who worked on the PP side of our birth center. They did everything and signed for themselves. If there was blood to hang, one of the RN's would do that and sign for it, but never did we review her assessments and all other work and sign for that at the end of the shift.
  8. by   SmilingBluEyes
    Quote from RN34TX
    That's exactly where I'm coming from and that's exactly my understanding of the extent of RN responsibility with respect to LPN's in a med/surg setting.
    Outside of admission/head to toe assessments, hanging blood, or other "RN only" functions, I'm not understanding where all of the "RN's are responsible for everything an LPN does" or "An LPN works under an RN's license" type of comments are coming from.
    I wasn't trying to say that "all RN's" try to wash their hands of accountabilty or I'd be talking about myself as well.

    That post about Coumadin clearly involved two nurses (one an RN) from the beginning and that's not the type of situation I'm talking about.
    I'm talking about if the LPN gave the Coumadin alone independently, and made an error.
    Would the RN in charge who was nowhere near the area at the time, be held responsible for this error?
    Not in my LPN experience.
    Well where I work, whether the RN was "around" or not, yes, she would be held accountable, as would the CHARGE NURSE.
  9. by   SmilingBluEyes
    Quote from kadokin
    I don't know that anyone is talking about "ducking or dodging" anything. Where I work, If it requires an RN signature, the RN performs the task. That may be what is confusing. If a task can be completed independently by an LPN, we assume the LPN is liable for that. Of course, all pt's under the RN's care are the RN's responsiblity as far as general well-being and safety and so forth. But if there is a care issue d/t an LPN's mistake, we assume the LPN will be held accountable for their actions. The RN, of course, generally follows up if any further monitoring, rxs need to be done b/c of the mistake. I think I know what I'm saying. Does that seem any clearer to you? Can you understand why it may be a little confusing?
    I am sorry I was not more clear: I was referring to a prior post by RN34TX . Personally, I am not confused what LPN responsibilities are or are not where I work. If others are, it would behoove them to know their NPA's and policies/procedures where they work, as well as chain of command. JMO.
  10. by   Q.
    Quote from yayalpn
    I am A LPN right now but I know for a fact LPN's have more clinical skill hours than RN's. We had 8 hour clinicals plus class for 18 months. How many hours do RN's have to do?
    I don't understand your point.

    Wait. I DO.
    We need standardized nursing education! Then there this senseless argument of who had more clinical hours can just GO AWAY!
  11. by   Miss B
    How sad is this. The LPN is oh so needed. The hospitals need to take a better look a this situation and make some changes.
  12. by   Sahara311
    Originally Posted by yayalpn
    I am A LPN right now but I know for a fact LPN's have more clinical skill hours than RN's. We had 8 hour clinicals plus class for 18 months. How many hours do RN's have to do?
    I totally understand this.... I just graduated LPN and in our particular school, we have layover time from the day ADN program on the same units. By the time we all were about to graduate(now mind you, they are a year ahead of us in class and clinical time), they were trying to wrap their minds around caths and trachs. They had seen it in textbooks, but had never actually done it.

    Now, don't get me wrong, I only took the seat in the PN class to get around the 2-3 year wait to get into the ADN class, and i aspire to ARNP, but I totally agree that nurses should climb the perverbial nursing ladder. And actually at my CC, PCT or CNA is a now a pre-req for the RN program.
  13. by   Q.
    Quote from Sahara311
    I totally understand this.... I just graduated LPN and in our particular school, we have layover time from the day ADN program on the same units. By the time we all were about to graduate(now mind you, they are a year ahead of us in class and clinical time), they were trying to wrap their minds around caths and trachs. They had seen it in textbooks, but had never actually done it.
    See, now you demonstrate my point totally.

    What's with the "" attitude over an RN education? I mean, my God, your post could be interjected into an ADN/BSN debate and we wouldn't be any the wiser.

    What if I commented how LPNs have NO clue about anything deeper than connecting tubes together because they haven't even been able to wrap their minds around something called the nursing process?

    This is precisely why we need ONE type of nursing education and ONE type of nurse. This petty, immature comparison of nursing education is so ludicrous, half the time I have to remember what the thread is about.

    LPNs say the ADNs don't have enough clinical hours and don't know how to "do" trachs when they graduate.

    ADNs say that BSNs don't have enough clinical hours and don't know to "do" trachs when they graduate.

    Am I the only one who sees how ridiculous this is?

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