dont know what to do....

the reason my DON wants to be called before we send ANYONE out is "she is an RN and has better assessment skills **even over the phone**"

No. The true reason your DON wants to be called before residents are sent out to the hospital is "the bottom line." Most LTCFs have contracts with certain ambulance services, and the facility must pay several hundred dollars for each transport to the hospital. Your DON might be misguidedly attempting to save the facility money by keeping the census up and the ambulance bills low by not sending any residents out.

After all, it's not her license in jeopardy if and when the patient dies.

first of all, you are new at being an lvn. you're going to make mistakes. we all made lots of mistakes when we were brand new graduates for probably a year or two when we got out of school. you learn from these mistakes and move on.

secondly, your don is not crooked. nothing you said in your post indicated to me that she was crooked in any way. she delegated tasks to you which is within her scope of authority. when i was a nurse manager in the acute hospital someone had to follow up on every incident report. our director of nursing delegated that task to the nurse managers. there were times when i delegated that task to my assistant managers if i felt it was appropriate or i was busy with other more pressing issues. it is nothing more than an investigation of the facts of an incident.

thirdly, residents change their minds all the time. and their vital signs change. it goes with the territory of being a nurse. so, if you blame a patient for making you look like a dummy you better decide now if this is the profession you want to be in because it's going to happen again and again, i guarantee it. a patient has the right to change their mind. it doesn't make us dummies. we just shrug our shoulders and go with the flow.

now you know that you should have gone into the meeting and interrupted the don. next time you will do that. when i worked in ltc, our don or administrator wanted to know about any transfer outs. the primary reason was because our facility got stuck with the bill for the ambulance service if there is no stipulation in the contract that the family was going to pay for ambulance service. how would you nurses know about that for every patient? there might be special information from the family that the don knows about that you nurses don't. the family may have been in the don's office ranting about the patient's bill or something else and you don't know what those conversations were either. in addition, the don has the right to know what major thing is going on with every patient in the facility. getting transferred out is a major thing and the don needs to know about it asap. she is ultimately responsible for the welfare of those patients.

just because you are an lvn doesn't mean that your assessment skills need to be lesser than an rns. where did that attitude come from? there is nothing in this world that says you can't practice and improve your skill at this. you can get a copy of health assessment made incredibly visual or you can access the free incredible weblinks of information on this thread on the nursing student forums:

https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html - health assessment resources, techniques, and forms (in nursing student assistance forum) and start practicing assessment every chance you get. you have one of the greatest places in the world, ltc, to practice and no end of patients to practice on. you won't learn this stuff in a day, a week, a month or even a year. it takes time. but you constantly pursue it. make it your personal pet project. concentrate on one body part at a time. eventually, you should be able to get just as good as an rn at it if you want to be. don't short sell yourself or i will personally look you up and come over and give you whatfor. my mother was an lvn who worked in icu and ccu. she was damn good at it too. i get so angry at you lvns who think you are lesser than rns it makes me want to slap you.