I knew it wasn't right while I was doing it...

Nurses General Nursing

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glen

6 Posts

In my state, LPN can take doctor's orders in LTC. However, in the hospital an LPN is not supposed to take verbal or written orders.

LPN1974, LPN

879 Posts

RN's can screw up orders, too, don't tell me they can't. Just because you got RN behind your name doesn't make you perfect.

My DON took an order from a doctor, for Cipro 500mg, actually wrote it on a piece of paper and then handed it to me and told me, "Write this up."

Well I did write it up because she's the boss and she told me to.

After I wrote it I faxed it to the pharmacy, and then when she came back around I said, "Here , review this and sign it, please."

She THEN says, "You didn't put X 10 days on there. Didn't I tell you X 10 days?"

I said, "No, you didn't."

She then looks for and finds the piece of paper she wrote it on, and NO, IT DID NOT HAVE X 10 DAYS ON IT.

I wrote it exactly as she had given it to me.

She couldn't blame anyone but herself because the X 10 days didn't get faxed to the pharmacy.

The pharmacist asked me how many we wanted it for, and I told him the doctor didn't say, which the order I received did NOT say.

So he says, he would send 5 days.

So it got screwed up from the minute she gave it to me to write up for her.

If I had known it was going to be such a mess I would not have done it for her, and the only thing that covered my @$$ was that after I wrote it I made her review it and sign it.

So RNs can screw up even the simplest of orders ALSO.

Sometimes LPNs are no the only dum@$$E$ in the group.

mocaj

25 Posts

my thoughts exactly!!

:bow: :yelclap: :smiley_aa :yeahthat: :cheers:

Well You learn something everyday...I am an ACLPN I take orders everyday from all different kinds of doctors...Guess that is why I cant get into traveling then because I would have never guessed those stipulations were made in different states...but I would make it clear and loud to the physician that it is not allowed where you are.. Some places are more lax about LPNs and others arent yet I have Charged as LPN in LTC here in the backwoods...lol...so it does seem that places are different every where I Know at one Time California was the strict-dess on nursing....Dont put yourself in that position again try to handle it before it happens again unless you cant get the policy/ law changed...because if you were dying would you care if it was LPN or RN....dont answer that it may incriminate you....lol

jenrninmi, MSN, RN

1,975 Posts

Specializes in L&D.
RN's can screw up orders, too, don't tell me they can't. Just because you got RN behind your name doesn't make you perfect.

My DON took an order from a doctor, for Cipro 500mg, actually wrote it on a piece of paper and then handed it to me and told me, "Write this up."

Well I did write it up because she's the boss and she told me to.

After I wrote it I faxed it to the pharmacy, and then when she came back around I said, "Here , review this and sign it, please."

She THEN says, "You didn't put X 10 days on there. Didn't I tell you X 10 days?"

I said, "No, you didn't."

She then looks for and finds the piece of paper she wrote it on, and NO, IT DID NOT HAVE X 10 DAYS ON IT.

I wrote it exactly as she had given it to me.

She couldn't blame anyone but herself because the X 10 days didn't get faxed to the pharmacy.

The pharmacist asked me how many we wanted it for, and I told him the doctor didn't say, which the order I received did NOT say.

So he says, he would send 5 days.

So it got screwed up from the minute she gave it to me to write up for her.

If I had known it was going to be such a mess I would not have done it for her, and the only thing that covered my @$$ was that after I wrote it I made her review it and sign it.

So RNs can screw up even the simplest of orders ALSO.

Sometimes LPNs are no the only dum@$$E$ in the group.

I'm sorry, I must have missed the post that said LPN's are dumb___.

Sodie, BSN, RN

41 Posts

Honestly critical thinking is something a person just has...I don't believe you can be taught it to an effective manor. HOWEVER, you must have a full understanding of the knowledge you are critically thinking. Honestly there is where the difference lies between most LPN's and RN's...the A&P required for RN's is much more indepth (from my experience)....than what it is for LPN's...it is that knowledge base that provides the tools for an RN to critically think differently. Supervision is also taught at a greater level.

I disagree that critical thinking is something a person just has. When I look back over my career, I know that I have developed critical thinking as I have moved forward. I know the difference in me now as compared to where I was 16 years ago. I see it everyday in new graduates. They remind me of myself so many years ago. And I tell the new grads, I see myself in you. It has nothing to do with LPN vs. RN. I work closely with new graduates and trying to help them develop their skills. It is so wonderful to see them grow and develop the critical thinking skills. I think traditional thinking can be sporadic and uncontrolled, critical thinking is controlled and gives the person ability to plan and organize. We all think traditionally, but we learn to think critically. I believe you can guide someone to thinking critically by asking questions and letting them discover the answer instead of telling them. It takes time and practice, but we have all been there-- LPN's, ADN's and BSN's.

LPN1974, LPN

879 Posts

I'm sorry, I must have missed the post that said LPN's are dumb___.

Well, I sure didn't miss the posts where the LPNs are

gettting "dumbed down" on here.

underwatergirl

120 Posts

I enjoyed your response, very thought out and great of you to be that way with new nurses. Now here is a thought to consider....this is kind of how I see it, I have met a few nurses who were braniacs....Aced every test, can ramble things off to you like no one's buisness. Very intelligent...but were disasters(sp?)(sorry I am tired) on the floor. Couldn't manage a patients care for nothing...but had over 20years of experience the one that sticks out mainly in my head...she was sent to critically thinking/organization/task managing classes...she just couldn't organize or critically think. Think of the person you know how is always disorganized, do you think you could retrain them in theory to be more organized? Anything is possible but from my experience, either you got it or you don't. Yes over times, our criticall thinkings skills are fined tuned, with knowledge gained and lessons learned. Now I am not saying that a person who is disorganized can't be a nurse or for that matter one who can't critically think...but their shifts will be much harder and more chaotic than others who can. Honestly I remember when I was first out of nursing school...I have always been a "thinker", very organized but my problem existed in knowing the most efficient way for me to organize and critically think...that is all I had to learn, is what works best for me. But if you don't have the fundamental ability to critically think or organize...than how can you learn to fine tune that?

So I stand by my opinion, it is very individually based and not every nurse can learn how to critically think...they struggle with it. Some are still great nurses but most of them are in a field that allows such occurances to be that way. I really enjoyed your opinion, made me think, I always did like that...I love the way you present yourself to new nurses. I bet you give them the confidence they need to continue in nursing!!! That my friend is AWESOME!!! I will remember that.....

Annette

I disagree that critical thinking is something a person just has. When I look back over my career, I know that I have developed critical thinking as I have moved forward. I know the difference in me now as compared to where I was 16 years ago. I see it everyday in new graduates. They remind me of myself so many years ago. And I tell the new grads, I see myself in you. It has nothing to do with LPN vs. RN. I work closely with new graduates and trying to help them develop their skills. It is so wonderful to see them grow and develop the critical thinking skills. I think traditional thinking can be sporadic and uncontrolled, critical thinking is controlled and gives the person ability to plan and organize. We all think traditionally, but we learn to think critically. I believe you can guide someone to thinking critically by asking questions and letting them discover the answer instead of telling them. It takes time and practice, but we have all been there-- LPN's, ADN's and BSN's.

Kireri

19 Posts

I agree, you take the order, YOU write the order.

Where I work (Kansas) I do not have a lot of interaction with LPNs. We have none in my area.

However, if it is NOT in their scope of practicce, then the LPN should not be taking orders, etc. Stay within your scope of practice, RN and LPN, and you will not have a problem/

MMARN, BSN, RN

914 Posts

Specializes in Cardiac/Telemetry.
I answered the question regarding what LPNs are allowed to do in my state, but due to a comp glitch, it is gone. It was a long post that I don't feel like retyping, so I'll just make a list of what LPN's on my acute surgical unit cannot do. I hope this help clarify things.

Lpns cannot:

Take verbal or telephone orders

push IV meds

set up or chage settings on PCAs

hang blood or blood products

access heparin locked PICCs, ports or central lines, or flush them

hang TPN

These are they tasks that I run into on a daily basis. I'm not sure if there are others under the law.

Lpns can assess pts in my state. On my unit, the LPNs take their own assignments equal in number and acuity to the RN's. They do not have a specific RN assigned to work with them. They ask whomever is available to do the tasks they cannot.

I'm not a nurse, yet, but the hospital in which I do my clinicals, the LPNs can do everything you said they couldn't do in your facility. This confuses me b/c LPNs might as well be called RNs or vice versa. I saw her take telephone orders and order blood for a patient and then tell the doc that he needed to order it. I don't get it. I'm not very clear on what's who's job or not.

icugirl33

107 Posts

So are you saying LPNs cannot take TOs? That is strange. I have worked in 5 different states and LPNs can do almost everything RNs can do with few exceptions. As a matter of fact, the facility I work at, our charge nurse is an LPN and has RNs working under her supervision.

I don' tthink so!!!An RN night be working there but not under the supervision of an LPN. What's next, an RN will be supervising the MD!!

Ashera, LPN

179 Posts

In my facility (hospital) LVN's take vo's and to's - but NO nurse takes an order and then asks someone else to write it for her. If you take the order - you write the order. You write....

D/C Levaquin, advance to reg diet, benadryl capsule 25 mg Q6hours for itching---------------------------------------------------------------RS

TORB Dr. XYZ/RS,LVN 1725 3/32/06

---------------------------------------------------------------------

Noted RS, LVN, 1728 3/31/06

This is then handed to unit secretary who puts in the computer, writes on the MAR, alerts other depts. she signs off that she has done so. Another nurse RN or LVN notes the order -

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