Frustrated!!N/M probs

[NurseStyles]

I really need to vent here. I have been a med surg nurse for 4 years. Up until about the last 6 months, I have pretty much enjoyed my job. I do have a couple of concerns that really piss me off, and I sometimes want to talk to the DON, but then sometimes I think I am just overreacting and need to just accept things as they are.

1) I do not think LVNs should orient new RNs.

2) One of the PM nurses spends the first 30-60 minutes of the shift in the NM office talking about other nurses, mistakes, problems, etc. they have almost a sickening relationship. Thisi PM nurse is now usually charge with few to no patients. The NM will not let any other PM nurse orient new staff except her. Even if she is orienting 3 or 4 nurses at a time. This PM nurse does not like to take patients, etc. She is also intimidating to new nurses. After only 1 or 2 days, she basically sets them on their own and doesn't follow or help much. Due to the new ratio laws, we need have a PM charge nurse position open...full time, 80 hours a p/p. This PM nurse asked the NM "Do I even have to apply for this position, or do I already have it?" The NM said, you will get it, but it is full time. "The PM nurse only works 60 hours a p/p and will not do more. This PM nurse thrives on other people's mistakes. If a patient has a tiny complaint, she goes in, makes it all better, feeds off of it, then tells the nurse how much the patient complained about him/her. As charge with no patients, she does not help. she complains about how bored she is...NO JOKE! She spends plenty of time reading magazines and going out to smoke. I cannot take it.

3)The nurse manager......She does not speak to us, does not say HI when passing us in the hall. The only words she has ever spoken to me are: You are getting an admit...or The lottery is up to 30 million, do you want in? or...I have some packets for you to fill out.....or I think she knows what she's doing, she doesn't need your help.....or then she goes behind my back to report things. She will say things within my ear shot such as "I will jsut leave this here for HER To clean up then". but never says a word to me. If I ask her to start an IV that I can't get, she tells me to call the doctor to put in a central line. Me and several other nurses feel we cannot approach her. She either looks at us with a blank, evil stare when we tell her things, or does not follow up when we have issues that need taken care of. The only person she talks to is that PM nurse...and about everything. I want to go to the DON, but i don't really see what could be done or how it could possible help things.

Thanks for listening.

[Tweety, BSN, RN]

Why oh why to people like that seem to find themselves in charge. As a charge nurse I'm ashamed of her. I don't have any advice to offer. If you don't feel you can do your job without all this resentment it might be time to go. Perhaps if others transferred or quit NM might get the message.

With the RN shortage there have been times when the best and the brightest to orient a new grad RN has been an LPN. Sometimes the preceptor who is an RN calls in, is on vacation, or whatever, sometimes I feel very confident scheduling a new grad with a LPN. RNs on our nightshift come and go and the LPNs seem to be the stable, most experienced one. As a rule I don't think a new grad should be permanentally assigned an LPN, but in a pinch for a day or so, I support it. (I hope this doesn't open up a big debate or flame war. :chair: )

[nursenatalie, ADN, RN]

I am a new grad and after I completed my orientation on days for two weeks I went to nights and was oriented by an LPN. I dont know why you think this is unacceptable? This particular NURSE was the most qualified staff member for the job. I received a more thorough and helpful orientation in one night than I had in two weeks. This LPN was chosen to orient me over the other 3 RN's who work nights, and rightfully so. Thank God I wasnt oriented by the nurse I spoke of in my previous post (see, is it time for this nurse to retire?) just because she can sign RN behind her name:eek:

[PMHNP10]

Originally posted by nursenatalie

I am a new grad and after I completed my orientation on days for two weeks I went to nights and was oriented by an LPN. I dont know why you think this is unacceptable? This particular NURSE was the most qualified staff member for the job. I received a more thorough and helpful orientation in one night than I had in two weeks. This LPN was chosen to orient me over the other 3 RN's who work nights, and rightfully so. Thank God I wasnt oriented by the nurse I spoke of in my previous post (see, is it time for this nurse to retire?) just because she can sign RN behind her name:eek:

Logic tells me that if for no other reason it would be because LVNs have a smaller scope of practice. This would possibly come into effect in situations where IV meds need to be pushed or blood administered, or admission assessments performed. Of course that depends on what the local laws are for LVNs. I'm in no way putting down LVNs and whether they can be competent nurses...no doubt they can. I'm not even saying my aforementioned assertions are really all that important. They are just what came to mind.

[nursenatalie, ADN, RN]

In my state LPN's can push IV meds, hang blood, TPN they do require an RN to co-sign on admission assessments in our facility. Is this the reason for you (NurseStyles) not wanting an LPN to orient? To me it really helps clear up role differentiation. Are you afraid that, I as an RN, might get confused after being oriented by an LPN and try to have someone co-sign my admission assessment. The horror!

[NurseStyles]

I forget sometimes that I am talking to nurses all over the country/world here.

In California, LVNs cannot administer any IV medications or tpn or do anything involving a central line. They do not do care plans. I agree that the LVNs that I work with are some of the best nurses we have, however, if a new RN has questions on pushing IV drugs or piggybacks, or what not, the LVN is not going to be able to teach him or her or to make sure she or he is doing it correctly because she or he has not had any education in iv administration....things like that. The reason they orient RNs with LVNs is so the new often inexperienced RN can do all the LVNs IV meds so that the charge nurse doesn't have to do it. To me that is unsafe practice.

Definitely no offense whatsoever to LVNs. Sorry if my earlier post was misinterpreted, that was actually the very least of my frustration anyway.

Thanks.

[Agnus]

Is this PM nurse you speak about an LVN? I am confused because I don't get what LVNs orientating RNs has to do with your story about this PM nurse.

[Noney]

I'm not sure about this, but I think that in Ohio an Rn techincally cann't be trained by an Rn. I remember something about this in school.. I could be wrong. That said when I was an lpn in ltc I freqently oriented rn's. However there wasn't much difference in our job descriptions other then the iv related thongs and we rarely had iv's. Now working in acute care I wouldn't think an rn would get adequate training from an lpn, at least at my facility.

Nurse Styles it sounds like your working in an unpleasant enviroment. Have you given any thought to transferring to another unit?

Noney

[TinyNurse, RN]

IMHO, the scope of practice for RN and LPN/LVN is different.

There is no reason an RN should be oriented by an LPN.

In my schooling for ADN, I always worked directly with the RN.

skilled LPNs are smart and give guidance, but should not orient, and as a new RN, I would find this unacceptable and I would go talk to someone immediately.

xo Jen

[barefootlady, ADN, RN]

Sorry, I have to agree with Tweety, sometimes an LPN is exactly the person who needs to be helping to orient a new grad RN. I respect the LPN who has years of experience, she/he can often give tips on wound care, dressing changes, foley cath insertation, and cath care that some RN's never think of.

I agree the new grad should not be assigned with the LPN exclusively, I don't think an institution could call this an adequate orientaton, but LPN's have some great knowledge and are often an overlooked source of education and an under-appreciated member of the nursing team.

It sounds like this NM has developed a "hands-off" policy in the day-to-day running of this unit. It sounds like she depends on this CN to keep her informed of unit problems. It also sounds like you are ready for a change of scene. I doubt there will be much change in the way this unit is ran until a mass exodus of nurses occurs. Take some time to evaluate your honest feelings and goals. Investigate other departments and how the NM runs that department. If you feel that a change would be beneficial to you then go for it.

I wish you the best of luck in whatever decision you make. This post should remind us all that "the good old girl/buddy system " is alive and well in most of our institutions today. Good staff, caring staff often feel unappreciated and unwanted by these type of managers.

[nursegeorge]

Using the chain of command in your hospital and exacting documentation of specific incidents? If you have been happy up until now, then you have three choices: 1.) do what I outlined above (and possibly be branded as a trouble maker...hopefully not though.) 2.) Stay quiet, leave the unit. 3.) Stay quiet and suffer in silence.

I personally have been at this for over 20 years now and agree with whomever said she was ashamed of the actions of your so-called "charge" nurse. It is disgusting that a Professional RN would act like that, but unfortunately, it happens all the time everywhere! Start documentation on what you see, when you see it , dates and times, names etc. Then when you feel you have enough evidence to hang the charge nurse without a doubt, then go to the NM. Carbon copy the director of nursing also. You have now cornered your NM and she must do something about it with the documented evidence!! (If you don't want to take this bold of a step, then present it to your nurse manager first...she will probably try to sweep it under the rug.) Either way, you must be strong enough to endure the backlash that will happen. You had better be prepared to be scrutinized intensely by the NM and the Charge nurse. I hate that it is this way in the nursing world, I wish it would change, but that is the way it is. (And we wonder why more men don't get into the profession? Way too much back stabbing and pecking and eating our young!!)

As far as the LPN/LVN orienting a RN. I have mixed views on this. At times the most qualified nurse is a LPN. I work with a few RN's that I really think are incapable of orienting a new grad and there are some LPN's who are the absolutely best nurses I've ever worked with. Whoever is chosen they must be at an expert level in their skills and have enough self-confidence that they don't need to tear someone to shreds to make themselves look better, smarter, you know the kind. I have written an article on this very topic..."Eating Our Young." Hopefully it will be in Nursing Spectrum in the near future.

Anyway, good luck. Make it a better world and I don't envy you your charge nurse...Wish I could come there and work with her for a week or two, I'd go toe to toe with her for you and orient you on how to professionally take someone down a few notches! LOL LOL....

Best of luck,

nursegeorge (btw, I'm not a male.)

[cannoli]

I'd get the heck out of Dodge.