How does one write up LVN ?

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I am a new RN and sometimes we have to work with LVN's and one of my working days last week, this LVN told me straight away " You do your own thing and I will do my own". She did not help me with any PO meds or dressing changes. I am a 6 mos old RN in this facility and she has been LVN here for 10 yrs now. This has happened many times that old LVN's do not want to take new RN orders. I am RN and it bothers me that because of her behaviour my License can be at stake too sometimes. Somebody advised me to write her up and give letter to manager. I hv not written anybody up in my life and I DO NOT KNOW HOW TO START. What kind of language I should use ?

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Specializes in M/S, ICU, ICP.

wow, i would be real sure that i am ready to deal with any ramifications or attitudes that may come your way. i watched a long term care facility use my daughter's newness to write up some of the cna's where she went to work. they used her documentation to eliminate some of their problem staff. sad part was that then the rest of the cna's would undermine her and made the job for her a nightmare afterwards.

she has learned the hard way in this new place to "pick her battles" and not allow older staff to use her this time. if you choose to write someone up then you would do so just as you document. you state the facts and the date and time and let the facts speak for themselves. i would not insert opinion (such as she treats me like i have leprosy) or fears (such as i worry a patient will be hurt and she will not be there to help me.)

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Hi, there. I hope your day is going well.

Have you ever heard of progressive discipline? It proceeds in this order: verbal written warning, write-ups, suspension, termination. You cannot jump the gun and write someone up for insubordination if the person has not been verbally warned about it previously. Also, the previous verbal warning would have had to have been documented or witnessed.

I was an LVN for four years before I earned my RN license. If some new RN barked orders in my face or gave me directives without any tact or decent interpersonal skills, I wouldn't have followed the directions either. Also, even though you are the RN with a higher level of nursing licensure, that LVN with ten years of experience possibly does have a more efficient way of doing things, which is why she may stubbornly have wanted to do things her way. Before you take action, ask yourself if you could have delivered your verbal message more effectively and professionally to the LVN. It's not about what you say...it's about how you say it.

Also, the LVN has accountability and licensure that can be put at stake, too. LVNs have their licenses revoked, suspended, placed on probation, or otherwise disciplined in the state where I reside all the time.

I would present a verbal and written report of all of the objective facts surrounding this incident to your manager. Be objective, not subjective, and leave all emotion and personal feelings out of it. I would let the manager decide on which course of action to take.

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I agree with the Commuter, check your own communication skills and attitude. However, if this LVN is just a bad apple. Keep a diary for yourself for a few weeks. Document what you specifically asked her to help with and document in quotations what she said. Make an appointment with your manager, tell her of your concerns. Hopefully your manager will listen and support you. The manager should ask you for some kind of documentation so she can discipline the LVN. Then you can show her what you have written down. It is a very difficult situation.

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I am not against LVN and I do not boss at all, infact I have many LVNs as my friends. I had 9 patients when she siad " you do your own thing " and we never talked how to plan our day '. On other occasion when I was trying to critically think how to call doc about sudden high BP in patient she took CNA with her and told me to get my pt's food tray myself when I needed to call doc to get order for some med for patient. There are many instances and these are some.

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New super nurse. You sound like a great nurse. We didn't mean to imply you were against LVN's, We just try to see both sides of the issue. Document and quote what the LVN says. I just hope your manager has some backbone, she should be the one to deal with her.

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The Commuter and brownbook , whatever you are advising I have already done that. the tune of progresssive discipline is very familiar to me , i know subjective and objective difference and I am the most likeable and lovable new RN on the floor. Infact my manager has given me card and best RN badge within my 6 mos. I have most high rate patient satisfaction scores and I get along with CNA's and other LVN's very well. DO NOT ASSOCIATE YOUR BAD EXPERIENCE WITH YOUR RN's towards this case.

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LVN is just marking her territory and testing you. Passing your own pills and doing your own dressings are just part of the job. Yes, some have problems with authority and always will. Document for yourself each instance for in the future when a clear pattern is shown. Grow a thick skin because you will run into this everywhere. Jealousy is a human trait that often appears in passive-agressive behaviors. Pick your battles very carefully. I have two employees that are disrespectful and often talk back. I let it roll off my back because these two do their work, and they do it well.. You are the RN, you have the position to ignore things designed to tick you off. Never lose your cool because that will tell them they gott-cha!

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Specializes in Peds Homecare.

I'm just a little curious about what your job title is vs. what the LVN's job title is? Are you her supervisor? Is she supposed to do your meds or your dressing changes? Are you still on orientation? Maybe you could clarify the situation a bit for me?

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Specializes in ER OR LTC Code Blue Trauma Dog.

Rule # 1: You never write up anyone without completely exhausting all other means of attempted communication with that individual.

Rule # 2: This process is intended as the last and final resort.

Rule # 3: The process is NOT in any way intended as the first means of getting your point across.

Which part of this process don't you understand exactly?

Trust me, you won't look very good to your superiors if you get yourself involved in some sort of RN vs. RPN power struggle and that's exactly what it looks like to me ok?

If I was your Nursing Unit Director, ( I am not at all very far from this qualification) It would sound to me like you don't have enough experience, the acquired ability or the necessary know how to effectively deal and resolve such a problem on your own without involving outside intervention.

Such a complaint on my desk only reflects your lack of leadership and inexperience to effectively deal with such issues in my opinion.

Sorry, I know you have no absolutely no idea about my background, who I am, or even what I actually do for a living these days, (No, it isn't Nursing - it's actually Executive Management) but you wanted an honest answer, so I provided an honest opinion.

My Best.

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Well, pt care assistant, you may be in position of executive mgmt but you sound bossy yourself. At my facility open communication and problem discussions are encouraged AND how do you assume I do not have experience. Its not matter of power game, it matter of attitude and mutual respect for each other. I think this topic is beyond your comprehension

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Rule # 1: You never write up anyone without completely exhausting all other means of attempted communication with that individual.

Rule # 2: This process is intended as the last and final resort.

Rule # 3: The process is NOT in any way intended as the first means of getting your point across.

Which part of this process don't you understand exactly?

Trust me, you won't look very good to your superiors if you get yourself involved in some sort of RN vs. RPN power struggle and that's exactly what it looks like to me ok?

If I was your Nursing Unit Director, ( I am not at all very far from this qualification) It would sound to me like you don't have enough experience, the acquired ability or the necessary know how to effectively deal and resolve such a problem on your own without involving outside intervention.

Such a complaint on my desk only reflects your lack of leadership and inexperience to effectively deal with such issues in my opinion.

Sorry, I know you have no absolutely no idea about my background, who I am, or even what I actually do for a living these days, (No, it isn't Nursing - it's actually Executive Management) but you wanted an honest answer, so I provided an honest opinion.

My Best.

I WHOLEHEARTEDLY AGREE!

Leaders are not born they are made and trained. Everyone is not leadership material. She has demonstrated this clearly. May I suggest that you read EVERYTHING by John C Maxwell concerning leadership. Start with "The 21 irrefutable laws of leadership" that book will open your eyes.

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