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?

[Caffeine_IV]

Yes they can. I go on experience/knowledge base. A good teaching nurse is a good teaching nurse period. I precepted with an LPN who was everyones go-to person. She followed policy and procedure without fail and knew the who, what, when, where, why and what if of ALL that she did. I can learn from anyone.

[agldragonRN]

:angryfire:angryfire:angryfire:angryfire not nice.

i can answer this question and i always know why. if i don't know why, i look it up. i am not a trained chimp that gives pills for a banana. i don't think i would want to work for you if you turn your nose up at lpn's like the vibe you give off in this post.

taking a chemistry and statistics class doesn't make you a better nurse.

and btw, i took chem 1, chem 2, and organic chem 1, a&p1 and a&p2, physical and forensic anthropology (our final exam was actually being able to put back the peices of a human skeleton together and estimate the age, sex and race of the person), calculus 1, 2, 3, and 4 and statistics, trig, microbiology, medical ethics, diet therapy, etc, etc, etc..... i was going for pre-med before i went for my paramedic, and got a degree in ems before the lpn. you don't have any idea of what the lowly lpn has in her/his educational background. my best friend in lpn school had a bachelors in chemistry and biology. another girl in my class had a master's degree in engineering. but i suppose once we took the nclex-pn that bought us down to the level of uneducated workers who do what we're told.

assuming just makes an.. well, you know.

thank you for your post! i do not understand why people think lpns are stupid. just because that bsn don took all those classes does not mean she is a better nurse. i myself took many of the classes you took(from my previous degree) plus physics i and physics ii. i always know why i am doing something and i look stuff when uncertain. nobody knows everything even if you are the don with the bsn.

you are correct that people just assume that once we have that lpn title, we are just a pill pusher and do not know anything. i am not so surprised that you had those classmates with high degrees. i had one guy in my class who was a chemical engineer and several with bachelor's. you just don't know what that lpn's educational background is.

back to the topic, i think in ltc, it would be fine for the rn to be trained by an lpn since there are not that much difference in the job description. in other settings, i can't give comments since my only experience is ltc.

edit: oh when i was a dialysis tech, pcts were training rns with the "technical stuff" for a couple of weeks then an rn takes over.

not so stupid lpn :angryfire,

angel

[agldragonRN]

bingo!! you hit the nail on the head with this explanation and i couldnt agree more. i didnt take all those extra pathophysiology, chemistry and all the other extra required to get that bsn for nothing. and believe me i am far from a "paper pusher" lol. i'm a don and rn's are precepted by rn's only in my unit. (by the way i also work on the floor same as my staff nurses 4 out of 6 days) i have had some great lpn's but as you said when it comes down to that additional knowledge base it has to be there when needed. i dont practice nursing on a conveyor belt mentality based on just doing the deed. my nurses need to know why they are doing things and the rationale to back it. not just giving an anti-hypertensive because they have high blood pressure - what is the physiological action of that med to expect a reduction in b/p and how as a very simple example. i always wanted to know why and how not just doing.

(sarcasm alert)

do you mind telling me what school you went to for your bsn? i surely would like to go there someday to learn this physiological action of the anti-hypertensive meds and the rationale behind them that you are talking about because as an lpn, i am clueless regarding those.

[pagandeva2000, LPN]

Bingo!! You hit the nail on the head with this explanation and I couldnt agree more. I didnt take all those extra pathophysiology, chemistry and all the other extra required to get that BSN for nothing. And believe me I am far from a "paper pusher" lol. I'm a DON and RN's are precepted by RN's only in my unit. (By the way I also work on the floor same as my staff nurses 4 out of 6 days) I have had some great LPN's but as you said when it comes down to that additional knowledge base it has to be there when needed. I dont practice nursing on a conveyor belt mentality based on just doing the deed. My nurses need to know why they are doing things and the rationale to back it. Not just giving an anti-hypertensive because they have high blood pressure - what is the physiological action of that med to expect a reduction in b/p and how as a very simple example. I always wanted to know why and how not just doing.

These comments are quite insulting, to be honest. And to assume that ANY nurse, LPN or RN does not know what the rationale is to our skills is appauling. There are no LPN based pharmacology texts, drug guides or nursing care skill books. In those aspects, we read the same things RNs do. Do I take out my drug guide and then say "Oh, I need an LPN one?". Nope, I pull out my Mosby's, Lippincotts, etc the same as you would. I can see if you feel comfortable having an RN precept an RN; that is your choice, even your right as a DON. It seems, however, that you may think low of any staff that does not have RN after their name. Conveyor belt mentality? My goodness...what a motivator...

[pagandeva2000, LPN]

:angryfire:angryfire:angryfire:angryfire not nice.

i can answer this question and i always know why. if i don't know why, i look it up. i am not a trained chimp that gives pills for a banana. i don't think i would want to work for you if you turn your nose up at LPN's like the vibe you give off in this post.

taking a chemistry and statistics class doesn't make you a better nurse.

and btw, i took chem 1, chem 2, and organic chem 1, a&p1 and a&p2, physical and forensic anthropology (our final exam was actually being able to put back the peices of a human skeleton together and estimate the age, sex and race of the person), calculus 1, 2, 3, and 4 and statistics, trig, microbiology, medical ethics, diet therapy, etc, etc, etc..... i was going for pre-med before i went for my paramedic, and got a degree in EMS before the LPN. you don't have any idea of what the lowly LPN has in her/his educational background. my best friend in LPN school had a bachelors in chemistry AND biology. another girl in my class had a master's degree in engineering. but i suppose once we took the NCLEX-PN that bought us down to the level of uneducated workers who do what we're told.

assuming just makes an.. well, you know.

Even BSN nurses look up information when they are not sure; physicians, also. Any person with common sense should look up a detail they are not sure of. I keep a medication digest that is sent to me quarterly, I read the updates, participate here in allnurses for feedback...I mean, really!

I agree with you flightnurse2b; this person is literally reducing us to being trained chips doing tricks for bananas.

[kermitlady]

I agree that the OP is being quite offensive in her opinion of LPN's. I wonder what she would think of the RN-BSN I know who tried to give a suppository PO and couldn't figure out the dynamap. But, hey, she MUST know what and why she was doing everything because she had the illustrous "RN" after her name.

*please excuse the heavy dose of sarcasm, just came off a really bad shift and the above mentioned nurse really does exist unfortunately

[libnat]

no offense to anyone but i have a hard time seeing there is no difference on average considering the time/schooling difference.

besides that, i'd be happy just to have someone precept me who was a good teacher and knew what the hell she/he was about. a superiority complex will do nothing but ruin any sense of team that might exist. a preceptor is a preceptor, if they couldn’t teach you what you needed to learn they probably wouldn’t have the job.

[Indy, LPN, LVN]

Wow, this subject got heated slower than I expected. I was trained in ICU by several excellent LPN's. The RN program that I graduated from, is and was related to the LPN program at the same school. Some of the instructors have worked for both programs and for the most part, are very strict with their students. Having spent a lot of time with both the RN and LPN graduates of this program over several years, I see some things.

One, the LPN students had quite a bit more clinical time. Two, they had as much responsibility for knowing rationale as the RN students did. There was a bit more emphasis on care planning, concept mapping and pathophysiology in the RN program, and that came at the cost of less clinical time. Meaning, of course, you might could explain yourself to death in clinical but hands-on, boy that could get funny sometimes due to lack of practice.

Basically I think an RN can learn quite well from anyone if he or she is willing to look for the opportunity. That bed bath that took me and my partner like 2 hours the first time, the CNA's showed me how to do in 15 minutes, and still do a good job of it. There is no one that you can not learn from. If the RN has paid attention to the education they've already had, they will figure out how to prioritize, delegate, ask for help and how best to use the help they have, based on who they are learning from at that particular time.

We have an RN who is just about completely incompetent, but has great faith in the power of her initials, and who really is annoyed that she sometimes has to work the floor with an LPN in charge. Well sister, if you can't do the charge job, you just can't do it. She can't prioritize, and her delegation consists of not doing anything and passing it all off to the next charge nurse with an hour's worth of excuses. This kind of thing makes everyone else, but most especially the LPN's that are stuck with her, climb the walls.

With regard to my ICU experience: I am fortunate that the nurses who trained me always want to learn more about acute and critical care. We share knowledge and it benefits all of us. It's always a bit of a jolt to have people who haven't worked with these excellent nurses say or do things that highlight the scope of practice differences, because we come close to forgetting such things when we work together.

[pagandeva2000, LPN]

no offense to anyone but i have a hard time seeing there is no difference on average considering the time/schooling difference.

besides that, i'd be happy just to have someone precept me who was a good teacher and knew what the hell she/he was about. a superiority complex will do nothing but ruin any sense of team that might exist. a preceptor is a preceptor, if they couldn't teach you what you needed to learn they probably wouldn't have the job.

i feel that there is, or should be a difference between the education as well as the expectations of rns and lpns. but, to say that lpns are basically trained monkeys with no rationale for our actions, doing things blindly "because she [the rn] told me to" is absolutely insulting.

i believe that the reasons why some lpns believe that 'well, we do the same thing' is because in the real world, there are many times when we refer to some rns for things that we get no sound rationale or reason which sometimes equate to no sense at all. i am not trying to start a flame war or perpetuate the never ending lpn versus rn war. it is that most of us began working under the assumption that the rn is supposed to guide and mentor us and that is not always what happens. most times, it is best to work with the person who does a particular skill every day in order to master it. an example of it is that recently, i was transfered to the ob-gyn clinic and even more recently was assigned to be a temporary team leader of a corridor. i have no idea how the assistants set up their rooms or even what equipment they use. i went to my team of assistants and asked them to show me how they set up a room to prepare for the provider. then, i asked one of them to write a list of what goes where for my reference, so, if they are behind, i can assist if i have no patients. a nurse may have to learn from respiratory or phlebotomists how they do their skills. the bottom line is that i take the ultimate responsibility of what happens there, so, i have to learn what they do, how they make their jobs easier in case i have to pitch in. the assistants are not paid monkeys, either. a cna showed me how to catheterize a patient when i worked in med-surg. had no idea outside of the faded memory of what i saw in school. she watched me do it later. no egos here.

i don't expect to teach rns what i have not learned or what i am not legally responsible for, myself. that, they do have to consult with their rn peers. but it does not mean that i have no rhyme or reason for what i do.

[libnat]

there must also be a fight over the differences of asn vs bsn nurses as well. i am not even in nursing classes yet but in my success in nursing school class they brought in speakers and the teacher even said we would be expected to know more, do more, be more, and have a greater grasp of all things nursing vs our asn counterparts. i actually thought, hell if asn is oh so much easier i shoulda done that. it is an attitude promoted in school.

[LilPeonNo1]

I am an LPN in LTC and I absolutely refuse to precept and RN for the position. I don't feel I am qualified to tell someone with more extensive education than mine what, how and why to do it.

[nerdtonurse?, BSN, RN]

Sorry it took me so long to get back to the thread, I was picking my fleas and eating my bananas.....

I guess I'm in sort of a unique position. I'm an LPN, now in a RN program at the same community college. Here's the differences I've seen, one year into the program....

textbooks -- the textbooks do appear to be written for someone with slightly lower language skills in the LPN program than the RN program. In reality, I took one look at the book, said "this is BS" and bought a copy of Brunner and Suddarth's med surg book to consult while I was in LPN school. The RN book our class was assigned isn't making me any happier (I'm thinking more like a 8th grade reading level vs. a 10th grade learning level, none of them strike me as "college level" language), and so I'm using a CCRN study guide to augment my learning. And I guess when I go for advance degrees, I'll continue to use the "next level" books...

Clinical vs. AP: Yes, while we have to take the AP I and II for the RN program, I and a LOT of the successful LPNs went ahead and took them either before LPN or during the program. I don't see a lot of the patho discussed in my classes (which disappoints me mightily). As a result, I don't see the RN students with either really good clinical skills or outstanding patho/physio knowledge -- just sorta halfway, both ways. Part of that is because of the poor performance of prior classes, we aren't being assigned very critical patients and the non-LPN students don't realize it. If I wasn't in the middle of nowhere (due to my parent's health issues) I would have went to another school.

Instructors: A lot of the instructors I see will tell you they have become instructors because they have health problems that prevent floor work anymore. Good floor nurses will tell you they can't afford to be a teacher. I've had some good teachers in nursing, but I have yet to have a really great one -- and I'm sorry, but with a BA in English, half of a MA in English, and a MS in Computer Science, I've had a lot of different teachers and I've had really, really great teachers. I see a lot of people on the academic side who think a MSN means they are a good nurse. It means they got a diploma. And statistics...give me a break. Go thru a Master's level class in algorhythms, and then you've done some math...I've got an "M" myself, and I saw computer people get "M"s that weren't common sense smart, they could just reproduce answers for a test. "M" doesn't impress me. If I had my way, we'd be taught not by people with a Master's in Nursing Education, but people who were nurse pracs....

Students: Oh, my GOD....do you know how many of the people in my class want to be nurse practitioners, nurse anesthetists, go into forensic nursing, yet can't understand why they need to be an RN first, can't pass chemistry, yet think they know it ALL? Seriously. I watched two of the "anesthetist wannabes" arguing that they needed to go directly into "anesthetist" school, and that making them get a RN and practice for a year in a critical area was "stupid." One of the wannabes has failed chemistry -- twice. Oh, yeah, honey, I'm gonna want you to put me to sleep...

And, for the record, as long as I make over an 87 on my final tomorrow, I'm getting an "A" -- not bad for a chimp who's in school full time and working full time for her bananas....