Dealing with nursing staff (RPN's)

[Mito]

Hello All,

As a senior nursing student on a med/surg floor we have a great deal more responsibility than we did in first year (no real suprise there). With multiple tasks to do ie meds, treatment, prn's for pain and ng tube insertion and management , some things like am care have to wait until later in the day.

We had a very busy day today and my pt's had to wait until late am for their am care (you know hands face, peri back etc..) and ofcourse this is fine with our teacher as long as everyone gets their care before we leave in the early afternoon.

So at the end of the day the RPN for that zone says to my teacher that it is a real problem that the pt's didn't get their am care first thing in the morning. My rationale was that their meds , vital signs, assessments and prn's for pain come first and then the am care.

So I informed my teacher that I didn't not need the help of the RPN and that I was capable of managing my patients and all of their care. I really think this particular nurse was looking for a problem where there was none. Does this sound familiar to any of you guys? How do you deal with this situation?

Mito

[OBNURSEHEATHER]

Originally posted by mark_LD_RN

appyhorsefan--- explain from your post how that eliminates all responsibility of the nurse if you screw up.

if you cause a patient harm while that patient is being cared for by me as a nurse or as an instructor. Ihave shared liability.

Exactly. This is the only point I was trying to make. I never said it wasn't your responsibility too, just that it was also mine, and this is why we watch so closely. And unfortunately, sometimes we get "detail oriented."

I also said that I thought you prioritized correctly, given the circumstances. Like Connie, I feel the RPN was "ratting" on you. I was simply trying to get you to see both sides of the coin, something that may come in handy to you through out your nursing career.

Heather

[fergus51]

I still don't see how this is a question of liscencing? For the RN, yes. For the RPN, I just don't see it. I think that's where the confusion comes in. When I was a student, the LPNs were not in any way responsible for RN students.

[SherRN]

Detail oriented yes indeed thats me! Love that line! I agree it looks better than anal retentive and obsessive compulsive!:roll :roll :roll :roll

[mark_LD_RN]

it depends on the tasks and who it was delegated to, if it was tasks the lpn(rpn) could be responsible for and the student was under her it would be a question of licensure. I have seen some programs that allow LPN's to oversee rn students for the basic skills levels.

let me say I still don't think the rpn handled it the right way. but mito as a nursing student still should be respectful of other nurses. remember even an LPNcan have ususful information. learn what you can fromn you ever you can. one of the best nurses i know is my freind buddy and he is an LPN.

[Jotie]

Hi All... This has been a very interesting post... As a student RN I am always sh**ing myself when I am out on prac (clinical as you call it) especially the first few days until I get my feet and sense the personalities of the nursing staff. There have always been the staff who will make the prac really interesting and are willing to give you a good go and there are those who veiw you as a low life of some sort (but we all have to start somewhere huh)

I am always just so aware that I am in a position (as a student) that could be perceived as being a right pain in the orifice. Meaning that the last thing that some staff want is to have a student following them around or taking over their duties. I am very aware of this and it can make it hard for both student and the nursing staff. In my mind there has to be a better way of training whether that be going back to the hospital based trainging I don't know.

It is a scary scary scary though of graduating and all of a sudden becoming totally responsible, but, talking with fellow students I am not alone with this feeling and I am sure it will be experience that will be the greatest teacher. I just have to say that I admire and thank from the bottom of my heart the nursing staff who have taken on the responsiblity to allow me to learn the skills needed to become an RN. They are gems.... Stars :) :)

I just hope that once I am working as an RN and a student is feeling as nervous and as lost as I have in the past that I will be able to understand where they are coming from... After all.... the nusring shortage and situation is not going to improve by not allowing students to learn and to learn well. But there has to be a fair way for this learning to happen.... Maybe if the nursing staff gets paid double time to do their work, watch the students and take responsibility for them... then it might become fair...lol :)

[OBNURSEHEATHER]

Welcome to the board Jotie! I think you're going to make an excellent nurse

Heather

[fergus51]

Mark, I understand where you are coming from, but I don't see how an LPN can lose her liscence because a bed bath was not done early enough. This RPN was trying to stir up some $hit. That's all. I have seen more than a few nurses (LPN and RN) who like to stir things up and watch the results.

I think the confusion is stemming from the fact that LPNs in the US have a VERY different scope of practice than LPNs in Canada. We use LPNs here in my city more like you use NAs. In our facility they only do am care, turning, toiletting, vs, etc. They are not allowed to do any meds, dressings, catheters, assessments, etc. even though many do know how and are great sources of information. This is why they are not supervising RN students who do the LPN and RN stuff, at least at our university program at our facility.

[OBNURSEHEATHER]

Originally posted by fergus51

Mark, I understand where you are coming from, but I don't see how an LPN can lose her liscence because a bed bath was not done early enough. This RPN was trying to stir up some $hit. That's all. I have seen more than a few nurses (LPN and RN) who like to stir things up and watch the results.

I think the confusion is stemming from.....

I don't think there was any confusion. I believe Mark and I both said in our posts that the alleged "offense" was a load of crap. We were just trying to get the original poster to see why sometimes the nurses seem to follow on their heels, and that if she was so confident that she didn't need the nurses (RN or LPN or whatever) to care for her patients, than perhaps she could just "test out" of clinicals.......

Heather

[fergus51]

Heather,

I just think we're putting words in Mito's mouth unfairly. Everyone seems to agree the RPN was being ridiculous, but then Mito gets painted like an arrogant know it all. Saying she could give care without the RPN doesn't sound unreasonable or horribly arrogant to me. We were expected to do our care without relying on the LPNs by 3rd year. And saying you don't need one manipulative hag's "help" doesn't mean that you don't value actual help from other nurses or think you know enough to test out of clinicals (not that this is even an option anywhere I know of).

[mark_LD_RN]

Originally posted by Mito

Hello All,

I informed the teacher that I didn't need the help of the RPN and that I was capable of managing my patients and all of their care.

Mito

I don't know about you but stating one that she did not need the rpn's help and two that she was capable of managing her patients care all by her self. does seem to imply that she did not need help.

I don't think that was the best of attitudes to have, I know i would not like that as an instructor. I want my students to be confident but to think as just a senior nursing student you do not need the nurses help is a little out there. I even need help every now and then myself. and that is the main point I was making as well as that nurses have shared responsibility for the patients.

like i said I also think the RPN did not handle it right. some nurses are very scheduled and not doing something on schedule is just as bad as not doing it to them. I do not think that is right but, it may be one reason for her actions as well as some other reasons We could all come up with.

oh fergus, I am not trying to label anyone just pointing out it is not that good of an idea to feel you know or can do it all especially at her stage of the game. I think that is a bad and dangerous attitude even for a seasoned and experienced nurse.

[Brownms46]

Originally posted by fergus51

Heather,

I just think we're putting words in Mito's mouth unfairly. Everyone seems to agree the RPN was being ridiculous, but then Mito gets painted like an arrogant know it all. Saying she could give care without the RPN doesn't sound unreasonable or horribly arrogant to me. We were expected to do our care without relying on the LPNs by 3rd year. And saying you don't need one manipulative hag's "help" doesn't mean that you don't value actual help from other nurses or think you know enough to test out of clinicals (not that this is even an option anywhere I know of).

It came across as arrogant to me! As it comes across as YOU are putting words into the RPN's mouth as well! How do you know exactly what the RPN was being "ridiculous" about??? And how did someone you have never met...all of a sudden become a 'manipulative hag"?? Why is the RPN ridiculous..just because they didn't think the pt should have waited all day to get bathed!

What makes me feel better when I'm sick is to get bathed. Helps me feel immediately better! I for one, wouldn't want to have my breakfast, without being able to brush my teeth, and wash my face and hands. All these thing could have easily been done while doing assessment, VS, meds etc! In fact I couldn't even imagine having to wait all morning to be able to do or have at least the mininum of those things done!

And maybe the RPN didn't address their concerns to the "student" because of the student's attitude!

Milto in the past has made his attitude toward RPN/LPNs known on this board...and it's no secret that he feels "above" them, and I for one feel he may have projected the same attitude on in person, that he has here! And maybe the pt. themselves expressed to the RPN as it being a problem with not having their care earlier. I mean it's not too far out of the realm of possiblity! I know I would have!!! I also have a problem with him stating that it was fine with their instructor ...as long as they finished up with everything before leaving in the pm! But maybe it wasn't fine with the pt!!!

I wasn't going to get into this...but I can't hold my peace any longer!

[mark_LD_RN]

good point brownms46.. i feel the same way.am care is important. and Mito does come across as such.