LPN Supervisor Over RNs.???

[zimsaint]

I was recently offered a job where as an RN, I will have to report to an LPN. She will be my supervisor, but they are expecting me to sign off on documents that she can't because of her position. I find this very strange and I am not feeling comfortable enough to accept the position. It seems this company is having a LOT of trouble retaining an RN in the position. A few staff members have hinted to me that the LPN likes to gloat and brag that she is the SUPERVISOR, and RNs work under her. In addition she is paid more money; howbeit she has been with the company almost 20 years. I have not committed to accepting the position, I told them that I will let them know by Friday. They tried to pressure me to accept by telling me that they would continue to interview " qualified candidates" and I really needed to let them know ASAP. The HR person confided that they had no other candidates as most RNs refuse immediately when they find out that an LPN would be their supervisor. What do you all think of this situation? Would you be willing to work as an RN under these circumstances. I'm leaning towards rejecting the offer, but I think that would be a "proud" spirit, which is not good. I'm confused, any advice would be appreciated.

[leslie :-D]

yrs ago, my facility hired an lpn as a nm.

the bedside nurses were all rn's.

a few times, the nm intervened on a family member's behalf, telling me/us to administer certain meds/amts after she got the order from the md.

i and we, refused.

i/we explained to the md, our concerns and he dc'd all orders...

the nm hadn't told him the entire scenario...

only the family's concerns.

we (rn's) ended up going to our med'l director, sharing our concerns.

she ended up being fired and no further lpn's were hired.

it has nothing to do w/one being superior to the other.

but it does have to do w/knowledge base and a comprehensive understanding of pathophys...which rn's are supposed to be educated on.

who knows?

some day, maybe adn nurses will have to answer to bsn nurses.:)

leslie

[FireStarterRN, BSN, RN]

The actual reality of the situation is that in some settings you have LPNs who are vastly more experienced than the RNs they work with, who might be fairly fresh out of school.

The legalities don't recognise this fact. But, an experienced LPN can be qualified, in a practical sense, to supervise an RN.

However, legal realities might make you think twice about taking the job since you don't know this particular LPN, you haven't worked with her, and the set up sounds in opposition to what the law requires, therefore it makes the whole organisation suspect.

[zimsaint]

Thanks for all the advice that you guys gave me. I too don't think this is about superiority or bruised ego; it is definitely not an LPN vs RN intelligence or capability debate. I think given the fact that I am being asked to "sign" documents certifying the competency of her work it would be best for me to refuse this position.

In addition, I don't need to deal with a person who compensates for their own perceived inadequacies by gloating over the fact that she has a position in which she is given more responsibility than nurses who hold superior ranks. I respect that fact that this person has been with the company almost 20 years, but management need to wake up and smell the coffee. There is a reason that the retention for nurses is so bad for this facility. When I spoke to my peers and colleagues about this situation, I would guess that 90% had heard of this person and NO ONE had anything good to say. I will keep working per diem and agencies as I keep looking. Thanks again for the replies.

[TheCommuter, BSN, RN]

I am in Texas, where the LPN/LVN scope of practice is very wide.

Every nurse manager I've ever had was/is an LPN/LVN. They all had RNs working under them as floor nurses.

In my state of residence, an LPN/LVN can supervise an RN administratively, but not clinically. In other words, the LPN nurse manager can hire, discipline, or fire an RN for administrative issues such as attendance, insubordination, dress code violations, misappropriation, etc. However, the LPN nurse manager cannot give directives to the RN regarding clinical aspects of the job, such as assessment, medication administration, and overall patient care.

[IndySkies]

I worked once in a Nursing Home with an ADON that was an LPN. For the most part in routine day to day operations their was not a problem.

However every once in a while a situation would come up that is would be obvious that she did not have the background, education, and/or expertise she needed to be effective in her role. Occasionally when I would be in conference with the DON, (an RN), she would interupt with comments that made this type of short coming apparent.

It was less than a year when I left the facility, even though I liked the residents, and the CNA staff was usually competent. It was obvious that an LPN, however good and experienced, just did not have the necessary expertise necessary for the job. ( I was an LPN for years prior to becoming an RN).

This on top of the personality of the above LPN manager would make it a position I would not accept.

[Tweety, BSN, RN]

The red flag to me is that they are having trouble retaining RNs in this position. All else aside, that would be the dealbreaker for me.

[bubblymom373]

Yep something does not sound right about this. Save yourself the headache and stomach problems. Would you really want risk your license like that??

[pagandeva2000, LPN]

I can see how a waky facility can somehow create a situation of an LPN being the manager over all other aspects outside of the RNs actual nursing practice, I would be clearly uncomfortable being in such a situation. To me, this is yet, another way of stretching a vague scope of practice that LPNs already experience in order to fill in the gaps where necessary.

If RNs are leaving by the droves, and this is all they had left, that is a danger sign. Traditionally, the LPN works under the auspice of the RN, physician, physician's assistant and dentist. Doing otherwise, for ANY reason upsurps the licensing of the RN and I would be insulted as well.

Of course, there are many situations where the LPN may be considered as a senior nurse in terms of years of nursing service and experience, however, it is just unnatural for me to have to supervise an RN under any capacity. It shows me that this facility has other skeletons in their closet that need to be avoided at all costs.

[DaveMac]

I am an LPN and would feel uncomfortable supervising an RN. It is one thing to show or review a task, however, to actually supervise-no way. To me, this is not an LPN to RN war...it is just common sense. If I wanted to supervise and take on all of that responsibility, then, I would have become an RN in the first place. I would have told them to take that job and shove it as an LPN...as an RN, I would not even grace them with my presence. Something is fishy in Denmark...

You are so right. As I stated in an earlier statement, I was assigned as an LPN supervisor over several RNs. I felt uncomfortable in this role, and left that job within a few weeks. As was said by someone else, it is the state boards nurse practice act which controls this.

Some of the best nurses that I have learned from have been the LPNs. Many know more than some of the RNs that I have worked with. Here RNs push meds, hang blood, and mix meds here our state will not let the LPNs do this. Some of my friends here here are LPNs and work in another state like I do, can do more there than here. It makes it hard for them when they bounce back and forth.

As far am myself, there no RN vs LPN war. We work as a team and make sure all the patients are taken care of. And don't leave the aids out of the team, it takes a village to care for the patients. :dancgrp:

[pagandeva2000, LPN]

You are so right. As I stated in an earlier statement, I was assigned as an LPN supervisor over several RNs. I felt uncomfortable in this role, and left that job within a few weeks. As was said by someone else, it is the state boards nurse practice act which controls this.

Some of the best nurses that I have learned from have been the LPNs. Many know more than some of the RNs that I have worked with. Here RNs push meds, hang blood, and mix meds here our state will not let the LPNs do this. Some of my friends here here are LPNs and work in another state like I do, can do more there than here. It makes it hard for them when they bounce back and forth.

As far am myself, there no RN vs LPN war. We work as a team and make sure all the patients are taken care of. And don't leave the aids out of the team, it takes a village to care for the patients. :dancgrp:

Now, a question for you; this has haunted me since I joined this forum; I am hearing that some states are not allowing LPNs to administer medications. Is this true for you or your friends? If not, what did you learn in your LPN program and what was the length of this program? I guess I am perplexed because I was always exposed to LPNs administering medications; maybe not certain ones, but enough of them to know it was better to be licensed.

Thanks!:typing

[tnrose]

Hi, I'm new to this site and I wanted to reply to Leslie's comment saying that someday maybe adn nurses might supervise bsn nurses. I work on a med surg floor and our supervisor is an associate degree nurse, we have many bsn nurses on our floor. So far so good, and nobody seems to have a problem with it. I'm an LPN in school to obtain my RN, and I'm not trying to feed into the LPN/RN/ADN/BSN argument, I just wanted to put my two little pennies in. I agree with some of the other comments that an LPN could be in a position to supervise RN's, as long as it's in the area of management and not medication administration, etc. I can only speak for the hospital I work in, but we do a pretty good job of working together and not getting caught up in who has what title, although we do understand that there are limitations as far as who has what qualifications, and respect is shown where it is due.

[pepperann35]

I can see how a waky facility can somehow create a situation of an LPN being the manager over all other aspects outside of the RNs actual nursing practice, I would be clearly uncomfortable being in such a situation. To me, this is yet, another way of stretching a vague scope of practice that LPNs already experience in order to fill in the gaps where necessary.

If RNs are leaving by the droves, and this is all they had left, that is a danger sign. Traditionally, the LPN works under the auspice of the RN, physician, physician's assistant and dentist. Doing otherwise, for ANY reason upsurps the licensing of the RN and I would be insulted as well.

Of course, there are many situations where the LPN may be considered as a senior nurse in terms of years of nursing service and experience, however, it is just unnatural for me to have to supervise an RN under any capacity. It shows me that this facility has other skeletons in their closet that need to be avoided at all costs.

In general, it is hard to keep Rn's in LTC...they have so many other opportunities that LPN's don't. Therefore you may have an LPN with a vast amount of experience that can make an excellent supervisor. I don't see anything suspicious about that at all.