AGENCY RN vs STAFF RPN for Unit Lead Role

[nomorenursingstudent]

Hi guys,

I am a RN who's currently practicing in Ontario.

I am currently working full-time at COVID unit with four months contract at one of the local hospital in the suburban city near Toronto. It's been about two months since I started working at this hospital.

I just wanted to hear your opinion on the unit lead role as the hospital is always making staff RPN as a unit lead despite me or other RNs from agency are working for the same shift. I felt that it was out of RPN's scope when full-time RNs from the agency are working for the same unit. It feels just wrong to be managed/ordered by RPN since I never worked under RPNs before...

What do you guys think ?

[Closed Account 12345]

It may different based on where we live, but here in the U.S., practical/vocational nurses can *administratively* supervise in a healthcare setting even though they can't *clinically* supervise RNs. An experienced, competent RPN who has worked in the unit for a long period of time is very likely a better leadership resource than a registered nurse from an agency with a short contract. I imagine the staff nurse knows the organization's policies and procedures, culture, physicians, who to contact for various situations and how to reach them (supply needs, pharm, patient relations, social work, house sup, etc.), the documentation system, etc. much more than a visiting nurse. As long as she's not trying to dictate your nursing care for your assigned patient load, I don't see a problem.

If she is trying to manage your nursing care, that's a different situation. I'd kindly and professionally address with her that your license requires you to coordinate and manage your nursing care while making clinical decisions according to the RN scope and standards of practice.

I'd also say hear her out and truly consider her clinical advice/suggestions regardless of who has what license. That doesn't mean you have to agree or take the advice, but chances are she has valid feedback at least some of the time, and it's worth respectfully hearing her out.

[nomorenursingstudent]

Since this Covid unit is new and just opened two months ago, we are receiving nurses from different floors such as float pool and continuing care and etc. It would be reasonable if “experienced” RPN was to take the admin role than the agency RNs like you mentioned. However, unit lead role is soley dependent on whether they are “staff” or not. for example, I had a case where new grad float RPN who just joined the hospital a month ago, first time working at Covid unit became an UL over RN who worked on this unit for two months. Since we, agency RNs all had been here since the unit opened, most of the times, we rather guide staff nurses how to do things on covid floor.