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.
The feeling that someone is looking down at you or disrespecting you is one of the coldest most morale damaging things that can happen in a group.
Has your facility ever considered a Pyxis or other med system? It would help with the counting and med errors (I would hope).
LPNs in my state cannot "assess" but they can "gather information and report to the RN." And as far as analgesics and other prns they can "evaluate effect."
I have no idea what your state laws are but good on you for speaking up for your coworkers.
But NEVER EVER sign as a witness if you didn't see it with your own eyes no matter WHO asks you to!!
snowglobe2006
3 Posts
In my state (OR) LPN can't give Narc's without an RN because they are not
able to assess the patient. That is not within their scope of practice. Therefore, they can't (supposedly) give Narc's without an RN saying it is
needed. They also can't assess if it is effective. That is why we have to
do this here-it probably is the same for you. Silly, but true. I once supervised an LPN with 15 years of ER and ICU experience to my 5yrs.
You just need to make sure they know how much you value them and it
usually works out.