Quote from walkmygardenpath
I am a LPN and work under an RN whose skills I question. She seems to be declining mental and emotionally. As time passes, her abilities are more erractic. I have contacted my superiors, but since I have been the only one to formaly state my opinions, nothing has been done.
Here is some examples. The other day, I was caring for a man with bladder cancer. He had come to us post turp. He had a super pubic cath in place. On my shift, I noticed he was bleeding frank blood, and began to irrigate. The bleeding was a gross amount and upon vitals, I noticed he was begining to go into shock. I immediately called the RN supervisor and requested he go to the hospital, he was CPR and had no wish to die this night.
My first mistake with her, was I that I, and LPN told her an RN, what needed to be done. This caused her to become resistive to my plan. I know she has this prejuice, and tried to be careful with my wording. But she didn't like the fact that I made the decision to send him. So she immediately nixed the plan.
Then she noticed the cath sticking out of the abd, (supra pubic) and said there's your problem - look at the tubing he's pulled it out. It was perfectly placed. She confused the tubing length of the lenth of a cath placed through the penis. At this time there were two n/ars in the room with us and we were all trying to explain that this was a supr pubic cath and this is why the length of the cath on the outside was so long. But, she wouldn't hear of it and began to yank at the tubing, causing great pain to the pt. Finally another RN came in and just called 911.
So no one is willing to report the many times this nurse is acting irrationally, so she continues to make bad decisions and wrong choices. Any suggestions?
I worked with such an RN years ago when I was an LPN.
She even refused to call the fire dept when our alarm system detected a fire. she just disabled it. finally, I called 911 and the fire dept did find smouldering wires in the crawl space.
Another time, pt was admitted for pain control. He was on MS Contin q 12 hr, no order for breakthrough pain. Day shift did not give the MS Contin. The day nurse said "Pt can no longer take po meds, and I didn't want to give it rectally."
I begged the nurse for 9 hrs of a 12 hr shift to get orders for breakthrough med. The RN refused.The pt had all the signs of severe pain, which i carefully documented.This pt retained his own pcp and we could not use standing orders for him. LPNs were not allowed to call docs for med orders per facility policy. I finally did it anyway, and got an order for sc MS04. The RN was furious and tried to get me fired. I was not fired but I was written up for insubordination. I told my NM that I had not considered politics or egos when I did what I did, only the pt. My name was mud at that place for a while because of that, but they finally got over it. I quit to go back to school. They even called me and tried to get me to come back after I became an RN.
Keep a notebook of inappropriate things this nurse does. I did and was able to show documentation that another RN I worked w/ had a history of leaving the unit without RN coverage. She would leave the unit to drive her daughter to school. She would also sleep on the job. I have documentation of this, as well.
Make sure you chart your findings, thoroughly, and that you chart that you reported them to the RN. Include her name, time and any comments. Chart objectively- what was observed said and done, only. Do not chart anything subjectively.
The "old girl" network of RNs backing RNs over LPNs is alive and well. In my experience, NMs (who are always RNs), tend to back the RN over the LPN when any problems come up.
Having been a CNA, and LPN and an RN, I have experienced all sides of this first hand.
Sounds like you are doing well in your job. Good luck to you.