Are LPNs Second Class Citizens?

[flashpoint]

Lately, the RNs I work with have been treating the LPNs and CNAs like dirt. I'm not the only one with this complaint and a lot of us are getting very frustrated. Classic example...today we had 14 patients...LPN had 7, CNA had 2, one RN had 3, the other RN had 2. All 14 were 2 points on the acuity scale they use, so no, the LPN didn't have 7 easy patients and the RNs to difficuly patients. The charge nurses have also been denying the LPNs and CNAs breaks or paging them 10 minutes into their breaks and telling them to come back to the floor. Also, one of them has been making really rude comments, like "Stupid CNA" and "Worthless LPN" when talking about other staff.

Management is aware and is going to "have a talk" with the RNs at the next RN meeting...on Nobember 15th. Also they're going to have the charge nurses justify a difference in more than 3 acuity points when making patient assignements. So...until November 15th, I guess we have to put up with it.

Is this the norm in other places? Are RNs everywhere being assigned lighter loads? Here, the responsibilities are really no different except the patients who are assigned to RNs do not have to be assessed by the charge nurse. We have a med nurse who give all meds including IV (except PRNs). Does anyone know any logic behind giving the RNs such light assignments compared to the LPNs?

Venting more than anything here. A lousy few weeks. I'm leaving the unit in a couple weeks...can't wait to get back to the ER.

[barefootlady, ADN, RN]

A good LPN is worth her weight in gold. CNA's too. I am sorry you are being treated this way, but if often happens. I have heard for years that hospitals are going to do away with LPN's only to find that LPN's are sorely needed. I would talk with the other LPN's on the floor and possibly other floors to see if this is a widespread problem. I would talk to my HN once again after the meeting, if there is no change, go to the DON. Try to get the other LPN's that say it is bad on their floors to go with you, present the problem and attempt to present some solutions to the problem. I hope things improve for you soon.

[Marie_LPN, RN, LPN, RN]

To answer the title of your thread : only if you allow people to treat you like you are second class.

"Nobody can make you feel inferior without your consent"---Eleanor Roosevelt

[Tweety, BSN, RN]

Fortunately this is not the norm everywhere.

I'm not sure I understand the assignments though, the CNA had 2?

What are the RN's duties in relation to yours, what in addition to the 3 or 2 patients is the RN doing with their time? Do they have additional duties?

Also remember the wise one sjoe "we will get as much crap as we take". (Of course sjoe would ask, "what does your union say?")

[Brownms46]

I wouldn't be waiting until Nov. 15th to have this taken care of, nor would I put up with it for the two weeks you will still be there! If my nurse manager wouldn't take care of it, I would go higher, until I hurt a nerve! And the first time I heard these deragotory statements made again, I would stop them dead in their tasks right then and there!

You're definitely a better person that I:)!

[Tweety, BSN, RN]

Originally posted by Brownms46

[b I would stop them dead in their tasks right then and there!

You're definitely a better person that I:)! [/b]

Good point. I wonder if someone could get fired for comments like those.

There was a phrase foing around our hospital. "FERN's on the phone for you...." (Meaning f***ng ER Nurse). The VP of Nursing was firing any nurse who said that phrase. Calling a professional nurse and CNA worthless, would seem to be at least worthy of a write up.

I would document, report, and confront.

[michelle95]

I have to say that the LTC facility that I work at treats us (LPN's) pretty good. I think they realize we know what we are doing and can usually do a better job than they can.....I am NOT saying that RN's don't do a good job, but, where I work, they are not used to being on the floor.

Where I used to work (at a hosp), we were treated pretty good, too.

It just depends on where you are working and who's working with you.

[purplemania, BSN, RN]

There is no excuse for rudeness regardless of one's licensure status. But I have a question: When you say the CNA had 2 pts do you mean they were "Assigned" as in primary care? Every patient had a nurse, right? Please say yes.

[jnette, ASN, EMT-I]

Hate that for you. And NO.. a resounding NO (!)... LPNs are NOT treated like this everywhere !

At my NC hospital where I do medsurge, the LPNs do EVERYTHING the RN does... yes.. IVs, IV pushes, hang blood, take orders... literally EVERYTHING except for the initial patient admission asessment. Other than that, they do it ALL (heck, I had an LPN precept me my first week of orientation there!) and we treat them with great respect, as we do our CNAs. Treat your staff well and they will be invaluable to you... treat them poorly and they can break you.. and WILL.

At my dialysis clinic our LPNs know more than most of the RNs as they have been there longer and have pretty much "run" the place from the get-go well before they started insisting on having more RNs. Before I started there, there was but ONE RN, and she was the DON... everyone else was LPNs. So remember the quotes posted above and just chalk it up to plain ol' RUDENESS and ingnorance, Kiddo ! I make it a point to consider the source, and if the source is some rude and ignorant "idget"... I do like a duck and let it roll right off my back... they're not worth wasting my emotional energy by getting upset over it.

[flashpoint]

Yes, the CNAs were doing primary care...it's allowed on a swingbed patient. The swingbeds patients get an RN assessment and the med nurse gives all meds to all patients (the primary nurses give PRNs, but the med nurse does PRNs for CNA's patients).

I went in for a meeting today and I looked at the assignment board...pretty similar to yesterday. Two LPNs have 7 patients each, a CNA is doing vital signs, glucometers, and helping with baths, two RNs are splitting charge and one RN is floating between the other two RNs. Sigh... no med nurse today. One of the LPNs was suppsed to be the med nurse, but the charge nurse gave her patients so she could split charge with the other RN.

LPNs can do pretty much everything the RNs can do. LPNs cannot hang blood - the charge nurse does that and the LPN monitors the patient. LOL...doesn't make a lot of sense to me. Also, sometimes the RNs will make rounds on their patients, but other than that, they don't do much that is different.

[chad75]

I say this with compassion,

You can only be treated badly if you tolerate it. I have been in those situations and have put my foot down. Yes I have been labeled an ass by lazy RN's (if it doesn't apply let it fly), but I refuse to be stepped on. If there is no logical reason for the RN's to have less patients then the LPN's I would call the NM, or the house supervisor if I couldn't work it out with the charge or if I received no satisfaction that way I would work my shift if I received report and then follow the chain of command the next day (sometimes a nights sleep helps put things in perspective).

I don't think a lot of nurses understand the severity of the nurse shortage. I could be employed at pretty much any hospital with in a matter of 24 hours,not to mention all the satelite units, nursing agencies etc. I do not, and will not tolerate crap like that.

[Burnt Out, ASN, RN]

LPNs are not treated like this at the hospital I work, although they are not wanting to hire anymore....

LPNs do primary care at the hospital I work at in most units. If the LPNs have 5 patients, the RNs have 4 because we have to sign behind their assessments and give their IV pushes. If the LPNs have a patient that has to get blood, we (the RNs) have to start it...I guess you can tell LPNs don't have much autonomy at my facility....and I have seen a lot of CNAs and LPNs that know more than half the RNs;)