LPNs at my facility feel they are being direspected

[Sapphy, BSN, RN]

I have recently run into a situation at work that I am unsure how to handle. I work with a lot of wonderfully experienced and knowledgable LPNs. I, as you can see from my sig am a fairly new grad. Recently, TPTB have started forcing these seasoned nurses to defer to me and other RN's just because of the letters behind my name. As a general rule, I will defer to the LPN with 20+ years experience in nursing. Yet, now I am being forced to cosign their narcs?? This makes no sense to me. The way we are set up I, as the RN, spend the majority of my day doing assessments. The LPN's are responsible for med passes. We are supposed to be working as a team with me as the RN Team Leader. If there are tx that need done, like dressing changes for example, generally, I do them while doing my assessment. But last week the RN's were called to a meeting so they could tell us not to let the LPN's walk all over us. We have me and an LPN responsible for 20 patients. With 20 patients these poor LPN's are lucky if 9 am meds are given by 1 PM! And now they have to hunt one of us RN's up everytime they give a pain pill???

The LPNs are understandably bitter about this and while they say that they do not blame me as the RN, you can tell that they are very resentful when they have to page me to sign a narc slip when 6 weeks ago they were qualified enough to give their own meds.

I find myself apologizing to these co workers daily and reassuring them that while TPTB may not feel they are competent, I do.

Needless to say, work has become a little stressful for me and I am unsure how to handle it.

[lvn2004]

It is NOT your fault! These companies now are really getting in over their heads. They say there is a nursing shortage but I truly don't beleive there is. Most of the nurses out there are either burned out completely due to the nonsense of caring for 9-10 patients a peice and have pursued other careers or they are working different areas, such a nurse consulting. I really believe if LVN's were able to do more and the hospitals weren't so adamant about wanting RN's only then there wouldn't be such a shortage. I am sorry you are having to go through this. I wish you the best of luck and hope things will get better for you.

[TheCommuter, BSN, RN]

These LPNs have a nursing license issued by the state; therefore, they should be able to sign for their own narcotics. I think having an RN to co-sign all narcs is quite dehumanizing to the LPNs.

[Sapphy, BSN, RN]

I agree 100% I do have to say that we all have to have our narcs cosigned... but the fact that only an RN can cosign is the real issue.... How did I, with my 6 months experience as an RN, become more qualified than the LPN with 20 years?? I feel guilty for being an RN most days!!

[grandee3]

Thank you for standing up for us LPN's. The narc thing blows my mind. A Staff nurse should not have to have another nurse sign with them unless it is a waste. How time consuming.

[SharonH, RN]

What brought this on? You say you do not feel this is necessary but did you bring this up to the people making the change? You have a right to question this policy, you may not be effective in getting it changed but at least you can voice your objection. After all, you are being inconvenienced also by having to do this. As for how to deal with the stress of it, here's my advice: stop apologizing and taking responsibility for something that is not your fault.

[lovingtheunloved, ASN, RN]

I'd pay money to see the chaos that would result from something like this where i work, considering several days a week all the floor nurses are LPNs and the only RN in the building is the ADON. Sure. Go ahead and hunt her down.

[following_faith]

I'd pay money to see the chaos that would result from something like this where i work, considering several days a week all the floor nurses are LPNs and the only RN in the building is the ADON. Sure. Go ahead and hunt her down.

:rotfl: I am sure that would hold true in many places! When are these people who make these decisions going to GET IT!

[meownsmile, BSN, RN]

No reason an LPN should have to have a narc co-signed unless they are wasting. Even then,, another LPN should be able to sign that waste. I routinely have an LPN sign as witness to my wasted med if i only give a portion of a narc. Rediculous to think they are making a RN co-sign. That doesnt even make sense.

[jimthorp]

Some corporate bean counters convince the corporate decision makers that "this" will affect the bottom line by either improving it or prevent litigation, i.e. save money. No matter how small the straw they grasp at is, the execs fall for it.

They would have you believe it is all about patient care but the bottom line is; it's the bottom line.

[Sapphy, BSN, RN]

The Co-signing of the narcs is really not the issue here. That was just an example. In this facility, until a year ago, the LPN's were taking a team, doing their own assessments and basically doing total patient care. Now the LPNs are no longer allowed to do the assessments, admissions have to be cosigned by an RN. From their perspective they have become med nurses. That is all they have time for. They are given 20 patients to give meds to and I am given 20 assessments to do. The co-signing of the narcs came about because of a stack of med errors last month. It started out, we just had to have our narcs double checked by the charge nurse. Some people refused to comply so we were told narcs had to be co-signed by the charge nurse. In reality, our charge nurse is not always available. When we asked what to do when this happened, then we were told that an RN had to cosign. Now I don't see why an LPN cannot co-sign a narc for me. Her eyes are no worse than mine are as an RN. But the cosigning is not the whole issue. LPN's are being disrespected as a whole. I cannot even say they are trying to phase out the LPNs there because they keep hiring them. I just feel I am in this position of being the object of resentment for these season LPNs who have more knowledge in their little finger than I have in my whole body. I learn something new from one of them every day and I HATE that they might resent me for being an RN. So daily I apologize and try to tell them that TPTB might think one way but I certainly don't.

[Dorito, ASN, RN]

I was an LPN for 15 years before I went back to school and our facility was always changing our responsibilities. Sometimes we could hang IV's, then they would change it. We used to do assessments and then they would say only an RN could do it. The driving force for me to go back to school was a new grad announcing to a patient that she had to do the assessment because "she's only an LPN".....after hearing that a few times it got me motivated enough to get back to school and I'm glad I did but I still respect those that cant or don't. I speak for all of us that are or were LPN's and thank you for the respect due.