How to deal with nasty LPNs.

Jules A, MSN · Feb 1, 2009

I've had the same issues with LPN'S. I would contact your floor manager and make them aware of the situation. It does no good to complain about it amongst yourselves, bring it to someone who can fix it. Lack of teamwork is a performance issue that needs to be addressed with that employee. The LPN'S should have more patients than the RN. I would assume you are responsible for taking their orders off, ivp med, blood, plt's etc. Check the state guidelines and the hospital policies to see exactly what they can do. Your RN license is on the line when dealing with LPN's. Good Luck!

This isn't just about LPNs! As other people pointed out it could be any other team members that may not be pulling their weight. What exactly do you mean by "Your RN license is on the line when dealing with LPNs"?

To the OP I do hope that you are doing a fair share of pt. care and I'd also investigate the written LPN duties before complaining to managment.

BroadwayRN, ASN, RN · Feb 1, 2009

I understand your concern and would follow through with those actions.

I would also change the title of this thread to 'how to deal with a nasty co-worker' I don't see nastiness as LPN, CNA or RN specific?

SuesquatchRN, BSN, RN · Feb 1, 2009

Nursing though is the only field in which subordinates routinely challenge their assignments and get away with it while the supervisor is told to check her attitude.

I don't know how the assignments are divied up on the OP's floor. However, I DO know what it's like to be an LPN in the middle of HS med pass ask a CNA to put a resident (who was asleep in her wheelchair, and would periodically awaken and beg to be put to bed) to bed three times and be ignored, and then have her answer back, "You ain't charge."

What the heck?

When I wrote her up I was told that the aides thought I was too bossy.

What the heck?

tmesk · Feb 1, 2009

It sounds like these people are forgetting what is in the best interest of the patient. I feel that if you dont' want to give great care to pt's then go work somewhere else. It is ashame that your supervisor allows this to continue. I would keep writing the incidences down and before long, you'll have enough to fire the person.

SweetLemon · Feb 1, 2009

I recommend dealing with them just as you would anyone else (other nurses, docs, whoever). Start by dealing with the person directly clearly making it known that their behavior is not appropriate and will not be tolerated. Give them a chance to fix it on their own, this will also allow them not to be blindsided if you do need to write up a more fomal complaint. If they do not comply and are clearly out of line start going up the chain until you get someone who will make the bad behavior stop. The truth of the matter is we all have bad days in which doing our job is a little more challenging their is a clear difference between having a bad day and having an attitude that impairs you from successfuly working with other staff. In the end allowing this co-worker to behave so poorly does compromise patient care. You need to be able to work as a team and if the animosity is high this will not be condusive to open communication and good patient care. Everyone does not need to be best friends but good professional working relationships are nessesary. Good Luck, going through the motions of dealing with these situations is a pain but really in the end is important.

gentlegiver, ASN, LPN, RN · Feb 2, 2009

If that happens I always try to delegate those jobs to LPNs because they usually have alot of free time (I usually help out after I finished all my RN responsibilities).

When I took a second look at your post, it made me really start thinking. What do you mean by the above quote?

Is the LPN suppossed to do patient care:

A) after she finishes her LPN responsibilities?

B) while she is in the process of her LPN responsibilities?

C) before she begins her LPN responsibilities?

And you failed to state just exactly what the LPN responsibilities are (aside from Med Pass) . How many patients is the LPN responsible for during Med Pass? Does the LPN do wound care? To be honest I found it rather stuck up the way you stated "I usually help out after I finished all my RN responsibilities". It might just be my current mood, but, you make it sound like the LPN is there to do ALL the work you don't feel like doing, and LPN responsibilities are not worth worrying about. Who care if the LPN gets behind in her responsibilities doing the job of 2 people, as long as the RN is able to finish her responsibilities with out having to rush abit.

I usually don't attack a post like I did here. I usually try to see both sides of the subject. Maybe I'm just tired of "nasty RN's" who dump everything on thier subordinates and wonder why they get a bit of attitude.

Gr8Dane · Feb 2, 2009

Let's see, as an RN you make double then what the LPN makes. You have the higher education. At the same time, why should the LPN do more work then you?

barefootlady, ADN, RN · Feb 2, 2009

I remember when team nursing was so simple, I enjoyed those days. Too bad there are gone.

I am having problems with a couple of LPN's who seem to think by telling me some line of bull they are off the hook. If I am the only RN then we will deal with the problem, if there is a RN supervisor, then it's her job and you should report it to her. One LPN is playing the dumb game. No way it will work, she has been an LPN for over 10 years, she knows the drill, get VS, assess lungs, abdomen, skin color, skin touch, O2 sat and etc. This happened the other night and I was not amused. I told her to finish the assessment, call the supervisor, and I would check the patient while she was giving the supervisor the details. She tried to tell me it was my job, I told her no, I was working as a wing nurse, not the supervisor, so all decisions would be made between the two of them. Neither one wanted to step up so I called the doctor and the admin on call. Not going to be pretty when we all meet. I am tired of being the one with the experience, so I get the dumped on. If you collect pay for the job, do it, if you need help ask the right way do not dump on me while I have patients who are needy, and if you call yourself a supervisor, the supervise. Sorry about the rant, but it just gets deep sometimes.

Gr8Dane · Feb 2, 2009

They attempted team nursing briefly on our neurotele floor as they could not keep it staffed (extreme turnover).

1 RN, 1 LPN, 1 Tech for 12 patients.

RN did IV's, IV pushes, chart checks, ADT, Doctor calls

LPN did med pass, shift assessments

Tech does care

Needless to say it didnt work and often the LPN got 8 patients RN got 4.

Gr8Dane · Feb 2, 2009

Barefootlady if I read your post right you were the RN on duty thus the LPN is practicing under you and by that it IS your job and within your scope of practice to handle critical situations... Immediate supervisor is you techincally ;0 Hince why your the RN and their the LPN's.

arabella205 · Feb 2, 2009

Ok, usually when we have 8 patients and no CNA, we split the patient care (4 for me, 4 for LPN) and it works fine. In that scenario I do my own PO meds, patient care, IVs, assessment ect for my 4 patients, while LPN does the PO meds, patient care for her own patient. I cover her IVs and assessments as well as orders.

My only problem is there are some LPNs (who have been there for years) who only wanted to do PO meds for that 4 patients assigned to her and not patient care. They would complain to have no time to do it, play dumb, disappear or take their time giving PO meds where in fact those 4 patients are theirs to begin with. It feels like they want me to do patient care on their patients too (aint happening sister). Just want to clarify that part. I am just tired to dealing with these people. I really think that they are testing me, just because I am new and look young (people think I am 17).

RN BSN 2009 · Feb 2, 2009

Does your facility have written policy regarding what tasks should belong to whom when there is a missing team member?