Feeling 'uncomfortable' with an assignment

caliotter3 · Feb 23, 2008

All I can say is if she is skittish, she is skittish. It is something to do with her as an individual, not agency nurses in general. But my observation of agency nurses that I observed in LTC, was that there were many who did not possess basic skills. They were very obviously not suited for their jobs. This is what happens when agencies hire anyone who walks in off the street. Usually due to lack of experience, although have also met people working for agencies that were obviously just all around poor employees with reputations of having been let go from every full time job they held. Some of these people also displayed poor attitudes. I wondered how even the agencies put up with them.

bigredrn57 · Feb 25, 2008

Why was this nurse alowed on such a unit? It sounds like management wanted a warm body. She was also probably paid less than a qualified RN. It is also obvious the LPN did not know what she was getting into. Whose fault is that? As far as attitudes go. I find it interesting to note that agency usually end up working in areas with an endemic morale problem. The problem is already there or there would not be a need for agency. :idea:

CapeCodMermaid, RN · Feb 25, 2008

Yah---the nursing shortage doesn't have anything to do with it. We could all go through the day singing and helping eachother out and we STILL wouldn't have enough nurses to staff the building. Morale does not play that big a part:twocents:

KaroSnowQueen, RN · Feb 25, 2008

I can't get past the 15 patients part!!!! Tell me this is in an LTC and not in acute care!!!!

CapeCodMermaid, RN · Feb 25, 2008

SNF. sub acute

Haunted · Feb 26, 2008

I can't get past the 15 patients part!!!! Tell me this is in an LTC and not in acute care!!!!

I second that! But even in a SNF 15 patients sounds like a lot. Also, I didn't know LVN's could flush PICCS. But, good for the agency nurse for being upfront from the beginning and making that call.

susan farmer · Mar 7, 2008

Flushing PICC lines is outside the licensure of an LVN and LPN. She totally did the right thing to try to leave. You should become familiar with scopes of practice before asking registry to do something, and then blaming them for not doing it (when they are right in not doing so). :uhoh3:

CapeCodMermaid, RN · Mar 7, 2008

Unless you know the practice acts from all 50 states, I suggest you stop giving advice about it. In this state, LPN's in long term care do everything RN's do except pronouncement of death.

Perhaps she should not work for an agency if her skills are so limited. Or at least take the initiative BEFORE accepting the assignment (and the keys) to find out which unit she will be on.

This particular nurse also said she doesn't 'do' admissions. Anything in YOUR practice act about that?!?

Altra, BSN, RN · Mar 7, 2008

There are states where LPNs are unable to do initial assessments in LTC - thus not being able to "do" admissions.

The fault here is not with this nurse. Somewhere between HR at your facility and the recruiter at the agency, communication broke down re: the specific requirements of the position. I don't see this as a case of "skittishness" - just a poor mismatch. This is what comes from the "a nurse is a nurse is a nurse" mentality so often prevalent in nursing management which ends up treating nursing professionals as day laborers.

Simba&NalasMom, LPN · Jun 11, 2008

I second that! But even in a SNF 15 patients sounds like a lot. Also, I didn't know LVN's could flush PICCS. But, good for the agency nurse for being upfront from the beginning and making that call.

Wow, I wanna work where you two work!! In some buildings I've been in, 20-25 is not an unusual census to have on a skilled/rehab unit. Most with that number use med aides, but still...overwhelming for established staff much less agency nurses. IV scope for LPNs varies by state; in OR we can do everything except hang blood and push narcs, whether it's a peripheral start (I have to admit, I would not be too comfortable starting a peripheral line as I've never had occasion to do one), a PICC or a central port.

As far as the PICC thing goes, I'm not "IV certified" but hanging IV ABX to a PICC via a Baxter pump isn't exactly rocket science...if you can hang a feeding, you can hook up a person to a PICC. In my experience it's mostly a frustration as a lot of people don't leave it primed for the next nurse so you have to deal with it beeping a lot and bleeding air bubbles. :chuckle

I decided to start working agency and have a few years LPN experience and am pretty nervous, but these posts are making it a little easier; like the OP said, I can't imagine going into an agency situation and not knowing how to hang to a PICC, or do a foley (I've run into that from agency nurses as well), or work a wound vac, etc...yikes.

iwanna · Jun 11, 2008

In state of PA, LPNs are not allowed to hang blood or push drugs into IV.

And, every facility is different as far as scope of practice for LPN. In hospital I was not allowed to take phone orders from dr., but in LTC it is allowed. The regulations in the LPN scope is very strange. Like an LPN is more competent in LTC than in the hospital. But, whoever is assigning these LPNs should be aware of the scope. And, if any nurse is uncomfortable with doing something then they should not put anyone at risk by attempting it. I say good for her!

Do you agency nurses feel that you are resented where you are working at? I have heard that some nurses resent agency nurses because they make more money. I can remember working in a place that I would have welcomed agency nurses. Mainly, for the fact that I would not have worked as many hours because nobody wanted to pick up another shift.

I thought that I would like to try agency nurses, but only feel qualified to work psych. I have only worked in behavioral health. So, now I am trying to get job in hospital for the med-surg experience. I know that I would be eaten alive, if I even attempted agency nursing at this point.