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.
Sapphy, about 8-10 years ago I was working as an RPN/LPN when a similar situation occurred at the facility I worked at. Essentially what happened was it was decided by TPTB that skills RPN/LPNs had been performing for years they should no longer do, it required and RN. This occurred because of a hospital restructing situation within the community that resulted in the closure of 2 hospitals and the amalgamation of the the staff from the closed hospitals within the 2 hospitals remaining in the community. There was a lot of resentment towards the situation from the RPN/LPNs in regards to deskilling. There was a lot of resentment by all staff in regards to what was happening to health care within the community. There were RPN/LPNs that were resentful towards the RNs, despite that what happened was not of their choosing. Unfortunately they directed their resentment towards the wrong people, but they were not the majority.
As an RN, I would advise you not to apologize for the TPTB, nor feel guilty for the position they have now put you in. These were not decisions you or the other RNs had a say in. If they have a problem, they need to take it to TPTB. Continue to treat them with respect, in fact we should always be respectful towards one another. The RNs as a group if they have similar feelings you do about the situation, can also express them to TPTB in support of the LPNs. Instead of apologizing and feeling guilty, I would express my feelings about the matter to TPTB, I would feel more proactive in the situation this way than I would apologizing for things I had no part in.
Two months ago I could stage a decub then all the sudden we were told only RNs could. Fine with me less charting how ever my 3 month grad RN charge nurse almost looses her mind ever monday when she has to do all the measurements and for goodness sake dont let her be off on a monday because then even if Im the charge nurse I have to pull the RN from another hall and she has to do the ones on her hall as well as the ones on mine.By the way Ive been an LPN 15 years..Guess they think we (lpn) all lost our ability to stage at the same time .Sure its policy but they are really over working the RNs when they could really utilize us in better ways...
Specializes in Education, Acute, Med/Surg, Tele, etc.
Sad sad sad and commonplace...hurts me!
I am a big believer in teamwork, as many of my posts clearly state. I too had to co-sign for things that seemed silly! But that is facility policy and have to go with that...I just made that clear to whom I was working with.
Also, one day after a particulary vicious day at work...the LPN I was working with was in tears because of the utter disrepect she got from a patient!!!! (the patient use to be an LPN herself!!!!!). I had enough!!!!!!!!!
I snuck in some cute figurines I made from fimo clay (I work with this stuff...and made cute snowmen with nursing items on them for all my LPN's and most CNA's), and gave them to them for appreciation! No I wasn't trying to get bonus points..but my Goodness, someone needed to let them know they are invaluable to me and everyone there!!!!!!!!
It was the fact I hand made the items that pretty much assured them I wasn't just trying to make bonus points! I put thought, time and effort into it...and boy did they cry because someone thought of them and said how much they meant for once! Not to mention I portrayed the snowmen as nurses...because to me...that nice little N in their title does mean NURSE! Just a different scope of practice...(not much different as I see working with so many!).
I am not saying this would work for most, but it worked for me in a big way! Also being friendly and respectful at all times with them and my CNA's too! They are my team, I am part of their team...and we all have the very same goal :).
I am no longer at that facility...but in touch with all of them still...we found a friendship and closeness I am very privilaged to have in my life! I can now with all seriousness say...I have worked with some of the BEST LPN's and CNA's this earth has!
Two months ago I could stage a decub then all the sudden we were told only RNs could. Fine with me less charting how ever my 3 month grad RN charge nurse almost looses her mind ever monday when she has to do all the measurements and for goodness sake dont let her be off on a monday because then even if Im the charge nurse I have to pull the RN from another hall and she has to do the ones on her hall as well as the ones on mine.By the way Ive been an LPN 15 years..Guess they think we (lpn) all lost our ability to stage at the same time .Sure its policy but they are really over working the RNs when they could really utilize us in better ways...
Specializes in Education, Acute, Med/Surg, Tele, etc.
LOL, had that happen at my facility too! I just giggled and said "hey less for you to have to do!"...LOL we all laughed!
It isn't they can't, it is the good ol CYA that facilities live by...and fine..they want and RN only..okay their dime I guess...LOL!
We had one nurse complain that LPN's were doing too complex of dressing changes..and now she is really bumming out...we made her the skin care nurse for the entire facility...now she is so busy she can't think straight (and she made most of the skin protocols that are way beyond what is needed or necessary!!!). LOL!!!!!!! Now us RN's and LPN's say....oh well, if you are that good you do it then!
We have one particular LPN who is probably one of the wisest most knowledgeable nurses I have ever met. She has what calls inferiority complex days. Those are the days that I feel really horrible. I see her getting more and more frustrated as the day goes by and by the time 3:30 comes she is at her wits end. I try SO hard to do anything I can to help her. "Do you need anything?" "What can I do to help you?" No no let me get this person her pain pill. I have so much respect for this woman you cannot even imagine, yet she is the one who makes me feel the most guilty. Even though she assures me daily that it is not me she's just having an inferiority complex day. I find myself not even looking at anything I am cosigning for her, I could be signing away my first born for all I know lol. But I feel like if I actually do the double check, she will feel even worse!
At this facility, TPTB basically say like it or lump it whenever we bring up concerns. They have different answers for every person. When I complained that 20 patients was too much for any one nurse, the response I got was that I was just hearing from the nurses who had been there a long time and that it had always been that way. When one of the nurses who had been there a long time complained about 20 patients, she got "we're so sorry, we know how hard it is for you, we're trying." I am finding myself Thanking the Heavens that I am only committed to this facility for 2 years. I am seriously thinking that I will just learn what I can there and move on. I realize that you deal with situations such as this no matter where you work, but it really seems to consume this particular work environment.
I have so much respect for this woman you cannot even imagine, yet she is the one who makes me feel the most guilty. Even though she assures me daily that it is not me she's just having an inferiority complex day. I find myself not even looking at anything I am cosigning for her, I could be signing away my first born for all I know lol. But I feel like if I actually do the double check, she will feel even worse!
You are playing with fire. It's one thing to feel empathy for this person, it's another thing to put your license at risk by signing something without looking at it first. You are actually in violation of the nurse practice act in your state. Please step back and get some perspective: this woman's inferiority complex is not your problem. Please stop feeling guilty and apologizing!
" 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."
They REFUSED TO COMPLY? Anytime you do anything like that relating to narcs, you are sending a message. Falls into the same category as refusing a urine drug screen.....made TPTB leery and suspicious, evidently.....
"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 thought you said they (the LPNs) weren't blaming you?
"I could be signing away my first born for all I know lol. But I feel like if I actually do the double check, she will feel even worse!"
NEVER, EVER neglect to double check the narc you are SIGNING FOR! This situation sounds highly suspicious to me.
Are ALL the RNs there recent grads?
You said there had been med errors lately.....I am telling you you had better make SURE you check the narc you co-sign, or you could find yourself stripped of a nursing license.
You could find yourself in front of the board of nursing, explaining that you really didn't steal controlled substances but that "you didn't check the narc because you didn't want to hurt the LPN's feelings...........??!!"
HOW DO YOU THINK THAT WOULD SOUND TO A BOARD OF NURSING?
Does that sound believable to you?
Whooooaaaa, you had better STEP BACK and rethink what is going on in that facility.
Yes, most of the RN's are new grads... and no the LPN's SAY they don't blame me but it is an overall feeling that has happened. And as far as co signing her narcs are concerned, I can SEE what I am signing, I just don't make an issue of it. I was really just trying to give an overall sense of how things seem to me. I don't put my license on the line for ANYONE... took me too long to get it. In fact we have one nurse, who thankfully I don't work with often, who I WON'T put my name anywhere near lol.
As far as people refusing to comply with the double checking thing, it was nothing like what you are thinking. We give out SO MANY pany pills. I had one shift where I gave 17 Roxi's between 3 and 7:30. They were furious that we had ONE MORE thing to do that ate up time. We have no more time to give.
I know the feeling. At the last acute care facility I worked we were not permitted to give flu shots. Flu Shots which are being given by medical assitance and pharmacist in some cases. It was quite insulting.
Rules are rules...we either have to follow them, work toward changing them, or find something new. I don't like the idea of having to be co-signed either, but if that is what TPTB want, so be it. I do think it is insulting that something that someone is qualified to do independently and was once able to do independently now needs to be done with supervision, but life goes on.
Personally, I think that facilities should allow all of their employees practice up to their full scope...I will never understand why people's full potential is limited by someone else messing up, pride, arrogance, or unfounded lack of trust...
Just wanted to give an update on this situation. We have a new supervisor who is specifically assigned to our unit. Last week, I went to bat for the LPN's and RN's alike with her. I told her how some people were feling without mentioning names, I told her that there were some charge nurses who repeatedly treated us like children, I told her how I felt about the whole situation. It was very well received and hopefully things will get better.
DusktilDawn
1,119 Posts
Sapphy, about 8-10 years ago I was working as an RPN/LPN when a similar situation occurred at the facility I worked at. Essentially what happened was it was decided by TPTB that skills RPN/LPNs had been performing for years they should no longer do, it required and RN. This occurred because of a hospital restructing situation within the community that resulted in the closure of 2 hospitals and the amalgamation of the the staff from the closed hospitals within the 2 hospitals remaining in the community. There was a lot of resentment towards the situation from the RPN/LPNs in regards to deskilling. There was a lot of resentment by all staff in regards to what was happening to health care within the community. There were RPN/LPNs that were resentful towards the RNs, despite that what happened was not of their choosing. Unfortunately they directed their resentment towards the wrong people, but they were not the majority.
As an RN, I would advise you not to apologize for the TPTB, nor feel guilty for the position they have now put you in. These were not decisions you or the other RNs had a say in. If they have a problem, they need to take it to TPTB. Continue to treat them with respect, in fact we should always be respectful towards one another. The RNs as a group if they have similar feelings you do about the situation, can also express them to TPTB in support of the LPNs. Instead of apologizing and feeling guilty, I would express my feelings about the matter to TPTB, I would feel more proactive in the situation this way than I would apologizing for things I had no part in.