Clinical Care Councils/Unit Based Practice Councils?

nrsang97, BSN, RN · Oct 11, 2008

We have a unit governance council and a Neuro practice committee. Sometimes they are very effective in bringing about change.

I just was appointed to our UGC. So I have no idea how things will go. I go to the first meeting on Wed.

Our UGC consists of our RN's from both shifts, NA's from both shifts, and Ward clerks, our educator and ANAM.

lpnflorida · Oct 12, 2008

Yes, I have been a member in our Hospital Systems Clinical Practice council term of two years.. A member of units Performance Inititives Team for the past 8 years. Our unit based Wound Care team, once upon we were not a team it was me. I have sat on numerous committees from a products committe to wound care system team... Most of this I did not initially volunteer for. I was volunteered by my former DON in one case, and two different supervisors for the some of the others. Not to sound victimized I had a choice to say no.

cherrybreeze, ADN, RN · Oct 13, 2008

Yes, I have been a member in our Hospital Systems Clinical Practice council term of two years.. A member of units Performance Inititives Team for the past 8 years. Our unit based Wound Care team, once upon we were not a team it was me. I have sat on numerous committees from a products committe to wound care system team... Most of this I did not initially volunteer for. I was volunteered by my former DON in one case, and two different supervisors for the some of the others. Not to sound victimized I had a choice to say no.

Do you enjoy it? Even if you didn't volunteer yourself to do it, what made you decide to? What kinds of things has this group accomplished?

I think it's good to see that LPN's participate as well....our CCC is all staff RN's (but our UBC is made up of RN's, LPN's, CNA's, and HUC's).

lpnflorida · Oct 13, 2008

Yes, I very much enjoyed being a part of the group and the process. It allowed me to keep a voice for not only nursing in general but a voice for LPN's . We review policy and procedure and then vote to continue or vote to make changes. The various committees then or area in which is impacted the most by the policy is the one who will usually make revisions and then represent to the council.

My experience has been when there are only RN's they only look at thing from their perspective. Add to the mixture an LPN and we can give from our perspective. I do believe every facility which still employs LPN should have them on the higher councils, groups what ever name one wants to put to them. Again who better knows what I can do in my scope of practice than Myself. Sitting on council at times allowed me to voice and clear up a couple of misconceptions in regards to LPN's.

Why on your CCC are there no LPN"s? Our requirement was it was only bedside nurses who could belong to the council which consistented of a primary member and one secondary from each unit within the system.

cherrybreeze, ADN, RN · Oct 13, 2008

Yes, I very much enjoyed being a part of the group and the process. It allowed me to keep a voice for not only nursing in general but a voice for LPN's . We review policy and procedure and then vote to continue or vote to make changes. The various committees then or area in which is impacted the most by the policy is the one who will usually make revisions and then represent to the council.
My experience has been when there are only RN's they only look at thing from their perspective. Add to the mixture an LPN and we can give from our perspective. I do believe every facility which still employs LPN should have them on the higher councils, groups what ever name one wants to put to them. Again who better knows what I can do in my scope of practice than Myself. Sitting on council at times allowed me to voice and clear up a couple of misconceptions in regards to LPN's.
Why on your CCC are there no LPN"s? Our requirement was it was only bedside nurses who could belong to the council which consistented of a primary member and one secondary from each unit within the system.

It's hard to say why there are no LPN's....some of the things we address are only RN issues (but of course not all). We do look at LPN concerns, however, that are raised and brought to that council from the unit-based councils. One of the issues we've looked at (and continually look at) is the LPN (and CNA) "task lists," and we've added things to both that we define as in their scope of practice. I also have to say that there aren't a WHOLE lot of LPN's in our hospital in general. On my floor in particular, we have 5; 4 on day shift, one on noc's (sadly, none on pm's, which is my primary shift!). I would have to look at our "definition" of the CCC to be able to better answer that (and now for my own curiousity, I will do that!).

I think of the committees that we have and the issues we're currently looking at, one is a medication team (and much of this involves IV meds), we look at our discharge process (which LPN's aren't involved in as far as the paperwork, final teaching, etc), documentation committee (one of their main issues now is the admission paperwork, which again our LPN's don't do), vaccine assessment protocols, education (for patients, which is the primary responsibility of the RN), JCAHO issues. There are SO many more, I can't think of them all right now, but a lot of them fall more under the RN's primary scope than the LPN's (even though of course the LPN's and CNA's alike are involved in the OUTCOME).

I find being involved to be immensely gratifying, it makes me look at my job as a whole in a totally different light. I have never been a "sit in a chair for 8 hours" kind of person, but it's amazing how fast an entire day goes by when this group meets! Being a part of how processes are implemented, and having a say/role in the decision making process really makes a person not only feel more valued, but less like things just "happen" to them. I wish overall more people got involved in such things, rather than sitting on the sidelines and griping about *changes*. I now know, for example, that NOTHING is done/changed without evidence to back it up (I've never heard the words "evidence-based practice" as many times as in the last year!), and that makes things a WHOLE lot easier to digest. Some of the new things coming down the pipe are exciting, even if they are relatively small, and I'm happy to have had a hand in making them happen!

lpnflorida · Oct 13, 2008

I see, well things are a bit different here in Florida as far LPN Scope of Practice perhaps compared to Wi. I never worked in WI. I did work in MN and it was limited in the facility I was.

We do admissions and discharge paperwork. RN's do sign them off but again I understand from the RN side of some who would prefer we be med nurses only and be happy/content with our lot in life.lol..... I am not saying you mind you. That is why an LPN voice is so important, they can cut through some of this mentality making the RN/s really examine the purpose to what they are saying and back it up by knowing what our Scope of Practice really is, versus what the facility might only allow. Big difference often times, which then of mean the facility is simply not utilizing their LPN's to the full scope of Practice at all, but only trying to hinder them more...

cherrybreeze, ADN, RN · Oct 13, 2008

I see, well things are a bit different here in Florida as far LPN Scope of Practice perhaps compared to Wi. I never worked in WI. I did work in MN and it was limited in the facility I was.
We do admissions and discharge paperwork. RN's do sign them off but again I understand from the RN side of some who would prefer we be med nurses only and be happy/content with our lot in life.lol..... I am not saying you mind you. That is why an LPN voice is so important, they can cut through some of this mentality making the RN/s really examine the purpose to what they are saying and back it up by knowing what our Scope of Practice really is, versus what the facility might only allow. Big difference often times, which then of mean the facility is simply not utilizing their LPN's to the full scope of Practice at all, but only trying to hinder them more...

I totally hear you...our LPN's CAN do admission paperwork and the RN can sign it, but they DON'T. I think this is a shame, to be truthful. Most of our LPN's have been there a long time, and don't want to do things any differently than they always have. There is a distinct group...those that want the new challenges of new tasks, and those that think we're "dumping work on them" by doing so. They see it as the RN not wanting to do as much. So, it's not just some of the RN's that want to do it themselves, it does come from both sides.

I knew I was picking poor examples, but I am not sure how to fully explain myself (been a long weekend, sorry!). I think part of the reason is the sheer fact of how many MORE RN's we have than LPN's. For me, I love having an LPN on my team for the day, and not just because they can pass meds :chuckle but because they just do so much....in general. IMO. I think EVERYONE should work up to their maximum ability, but sadly not all feel this way. On either end.

litbitblack, ASN, RN · Oct 13, 2008

I was on the clinical practice council and in all i think it does a world of good. Its a way for the nurses and care team as a whole to make changes instead of admin making changes or one person making changes. I enjoyed while I was there. On the lvn thing, I have been both so I kinda know both sides, as an lvn I would look at the RN and think they really didn't do anything, they are just blah blah,,,,,THe only difference was that i couldn't hang blood or give pushes....then I got my RN and saw the real world. lol...so i see both sides. Alot of lvns don't want to do the work that they feel is the rns job. even though they can. lvns are task oriented. they arent trained to look at the big picture. The ones who have been lvns a long time don't usually like change. it takes someone with patience and good rapport with the nurses to basically say your going to do this (whatever it is and this is why.(i am a why person,tell me the process) before they will do. I love lvns. i was one for 5 yrs. i think it made me the nurse i am today and how i practice because of the insight i recieved. they really don't get enough credit for what they do.

lpnflorida · Oct 14, 2008

litibank,

I hear what you are saying and in many ways agree, however I will say I am not just task oriented. I do look at the bigger picture. Then again that was not something I learned over night. It has taken many years, attending many different CEU conferences, and reading and keeping up.

I am happy for anyone who becomes an RN. I try not to lump new grad LPN's or those with only a few years experience against those with alot of years behind them and the gumption to learn..While I work within my Scope of Practice is does not mean I do not understand or have made a point to read and learn the principles behind why I do what I do. Or how to interpret what the lab values of a patient might indicate. Is it something as a LPN I should know? Maybe not, none the less it is of value for me when attempting to bring the information to attention of the RN I work with/under who has not had the time to look up my patients labs etc.

Then again I do not lump new grad RN's against those RN's with years of experience and who have kept up to date either.