Can an LPN train/precept and RN?

[yfloridanurse]

Where I am presently working I seen some practices that I do not think is beneficial. Have you ever have the experience where an LPN train an RN being their preceptor?

I beleive LPN are an asset to anunit, and they can be very prepared but their Scope of Practice differs a lot from the RN as well as being the RN the delegating part to an LPN. What is your opinion in this type of practice?

[Lacie, BSN, RN]

I see this frequently in the chronic dialysis setting and like you I disagree. When first entered dialysis my preceptor was an LPN. When it came down to me asking rationale or what the pathophysiological basis was behind particular actions - well she didnt have a clue besides to say "This is the way we always did it". Not good enough for me. I think it is a dangerous practice. (Ok here comes the backlash for my opinion, LOL) I've been a nurse for 30 years and have worked with some great LPN's but I am and will always be of the opinion only RN's need to be training RN's.

[Straydandelion]

Being out of nursing for awhile I had a long preceptorship when I came back. The preceptors were LPN's, yet the NM was also available for regularly scheduled meetings to answer questions I may have. This worked out very well. So I would say it depends on how the preceptorship is done.

[SuesquatchRN, BSN, RN]

The scope isn't very different except for certain specific practices, many of which don't come up at all in certain settings, especially LTC.

[classicdame, MSN, EdD]

Regardless of how many differences, there are some and the RN should be precepted to her duties within her scope of practice. Question: Would you think it ok to have an RN precept a med student?

[Bettie P]

I see this frequently in the chronic dialysis setting and like you I disagree. When first entered dialysis my preceptor was an LPN. When it came down to me asking rationale or what the pathophysiological basis was behind particular actions - well she didnt have a clue besides to say "This is the way we always did it". Not good enough for me. ...

That wouldn't have been good enough for my practical nursing instructors either! We were told over and over that it's not good enough to know what to do, you must know why you are doing it. Rationale was their mantra. I'm sorry that you ran in to a nurse who was trained instead of educated. :uhoh21:

[yfloridanurse]

No, unless you are precepting them to do nursing duties, that normally a doctor does not do. Otherwise we are short handing the peson being precepted. Like I said, I belive LPN are good and they have a wealth a knowledge but there is an educational gap, mostly rationale wise, otherwise they will have the RN behind their name and not an LPN, is as well as AS and BSN. I graduated from an ASN program, but when I pursue my BSN, there were a lot of information and knowledge that was never gven during ASN program. My concern with LPN trainign an RN either new or experience, that is moving into a new area, is how do the LPN would be able to teach something to the RN if by their scope of practice they are not allow to do it and most likely do not know how to do it. I believe greatly in educationa nd I believe preceptorship is as important as education is. The better the foundation the better outcome for the nurses. I never seem this practice done elsewhere, but I am afraid is happenning more than I thought. Thanks all for your answers and input.

[kermitlady]

A bit off-topic, but I have a question for some of you.

Why does it seem like quite a few of you believe that LPN's are not taught the rationale behind nursing actions?

I would really like to know where you received this information because where I live, LPN's better know exactly WHY they are doing anything. "This is the way we've always done it" is just not good enough.

[kermitlady]

To answer the original question. I think it greatly depends on the setting where the RN is training. If it's in ALF or LTC then I don't see a problem with it but if it were in an ER or ICU or something along those lines, I'd say absolutely not.

[chevyv, BSN, RN]

I agree that LPN's should not be precepting RN"s. The rn scope of practice is more advanced than the lpn. I'm currently a lpn and am graduating as a rn in a couple of weeks. The scope of practice is much more advanced as far as knowing the hows and whys. I've learned so much more by continuing on to become a rn. I'm not bashing the lpn role, but there are legal standards to both roles and the lpn is not held to the same standard because the level of education that the state agrees with is more limited. Doesn't mean one is better able to care for pt's, just legally the scopes are different.

[nerdtonurse?, BSN, RN]

Re: the original question....in my state, the list of "RN only" things is fairly small, and in others it's very large, so we may be doing an apples and oranges thing. In my state, I can't declare a death with another nurse like an RN, I can't hang IV chemotherapy (but I give PO all the time), I can't initiate a care plan, if I do the initial assessment, an RN has to validate it (which usually consists of someone yelling, "Nerd, you done yet? Good, you're validated.") and an RN has to do most of the "official signatures" for things like restraints. In my facility, I can spike and hang blood because of extra training I've had. Some states, LPNs can't touch it. In most other things, we function identically, so I could be a learning resource to a new RN for specific things -- and have been.

What I would suggest is go for the smartest, best teacher in any circumstance. We have a LPN who's also an EMT, and she can hit a vein that nobody else on the floor can even palpate -- I learned more about starting IVs from her than I did my RN preceptor. When I finish RN school and precept, she's who I'll get to teach the newhires how to stick somebody. Another LPN is also a respiratory tech -- she taught me more about ABGs than I've learned in either LPN or RN school, and I've used what she taught me to help my struggling RN student classmates. The RN I learned the most from was an old ICU nurse, and she dragged me to the edge of my license and taught me how to live there, and there are folks alive today because of the things she taught me. She fought to get my ability to access a portacath blessed, and there have been nights on our floor where I'm the only nurse, regardless of license, who's ever accessed one, so who does it? That's the difference between a born teacher and a teacher in it for the money alone (2dollar/hr differential at my hospital).

Yes, there are things that only RNs should do. But rather than the current one preceptor/one preceptee thing we have at our facility, I think a more cafeteria approach would be beneficial to the newhires. If you've got an LPN on your floor who can find a vein in anybody, vs. an RN who can't hit a subway tunnel, who would it be best for you as a nurse to learn that particular skill from?

[GooeyRN, ADN, BSN, CNA, LPN, RN]

I was precepted some by an LPN. She had 30 years experience. At that hospital, there was little LPN's couldn't do, and did mostly the same as the RN's. (except hang blood, IV push, PICC/TLC lines, telephone orders and a few other things) Learning the routine from the LPN was fine IMO. I didn't need help with the other stuff, so I saw no problem with it. I needed to learn the routine and paperwork. I think she taught me just fine.