LPNs as Unit Managers?

[westieluv]

I began working in a LTC/subacute rehab facility back in December. All of the units in this facility have LPNs as unit managers. Is this the norm in LTC? I'm not discounting the value of LPNs as nurses, please don't get me wrong. I have worked with many, many excellent LPNs over the years who gave great bedside care and had more nursing knowledge than some RNs. However, as an RN of just over 20 years, I admit that I have a problem being talked down to and taking orders from a unit manager who has been and LPN for two years and has almost no experience in nursing, much less in management. IMHO, nurse managers should, at the least, have their BSN. I don't have my BSN, I am a diploma nurse from a hospital-based nursing school. I wouldn't expect to get hired as a unit manager because I don't have my BSN, and it blows my mind that the unit managers where I work aren't even RNs. Again, nothing against LPNs, but if someone wants to be in management, it seems to me that they should be a "step up" from the rest of us. I figure that it's a cost saving maneuver, but it really bugs me, especially when my LPN unit manager comes walking down the hall giving out orders and correcting what we do when we are buried in work and can't even take a break. Any manager should have some empathy towards their staff, but IMHO they should also have proven that they were willing to take on the extra education to be in a management position. I realize that it's not the LPNs' fault if they were allowed to be managers by the facility, but what kind of a facility would allow this?

[FLArn]

I have seen the practice of using LPNs as unit managers in LTC here in Florida also. However, here in Floria they must be working towards their RN; not sure if there is a completion deadline. I feel the more important distinction is that they are managing the flow of the unit and the implementation of policy for the administration; they do NOT manage/supervise the RN's practice. In other words, they manage the unit but they are not my "boss". That would be the DON. As an aside, I also have nothing against LPNs, in fact I married one and at the start of my career he could nurse rings around me!

[NotFlo]

I think the problem is more these particular unit managers, not whether they are an LPN or RN. I am sure the obnoxious ones you mention would be just as bad if they had an RN or LPN.

However, as LPNs, they can't supervise your nursing practice, just supervise you administratively. For instance, my unit manager is an LPN, and she might speak or or write up an RN about tardiness but if she has a problem with that nurses' nursing practice (I don't know, poor technique hanging IVs or dressing changes or whatever) she would get the RN supervisor involved.

Our DON does not have a BSN, so I highly doubt they're going to require BSNs for the unit managers...

All our unit managers are LPNs, but the one I work for is excellent. She's been a nurse for 28 years, did over a decade in acute care, and is the facilities go-to expert on respiratory issues. There is so much to learn from her for both other LPNs and RNs. There isn't an RN (or LPN) in my facility who I can imagine doing a better job.

[alphabetsoup]

It has been my experience that LPNs are predominant in the LTC setting. This makes sense as there doesn't seem to be many LPN positions in the acute care setting. Therefore, you might expect to see more LPNs in management type situations. As your supervisor, you would expect for her to "supervise" you. I think overall though, it can sometimes makes for a weird dynamic, especially when you need a clinical resource on an issue and the issue is not within your boss's scope of practice.

Is it possible that even though she has only been an LPN for two years that she also has a degree in another area? For all we know, she has a BA in Business Administration and then she became an LPN. With this economy, anything is possible.

[NamasteNurse, BSN, RN]

For many LPN's in this economy nursing is a second career. I have a BA and was a manager for 15 years. I have much experience in the business world and also in the educational world as my BA is in education. Being a unit manager is a logical step after a few years experience as an LPN. LTC is full of LPN's. Since we don't have a lot of other options in the nursing world please don't take this away! Many LPN schools have more clinical hours than the RN programs.

For example my LPN program gave us 600 hours of clinical while the local community college gives it's RN candidates 50 hours. The knowledge of LPN's and RN's is different, not one better than another. Don't assume that more time in the classroom means a better nurse. Or that more letters after ones name means 'smarter'.

[taalyn_1, CNA]

I work in LTC as an aide and am working on my ASN and I see this a lot at my facility. I only know of a couple RNs at work. The rest of the nurses are LPNs (and excellent ones at that). The LPNs are in supervisory roles because that is what is available. IF LTC could get more RNs to work for them then this probably would change, but in order to do that LTC's rep. needs to change. It amazes me how many times I hear my fellow students say things like, "I will only work in LTC as a last resort" or "Why on earth would you want to work there, you'd make such a good nurse somewhere else".

It seems to me that LTC (in respect to RNs) has the rep of, this is where you go when: you are a bad nurse who cant cut it at the hospital; you are a bout to retire and want to take it easy; you are just plain lazy and want something to coast in. So many RNs think LTC is beneath them or is a slight to their rep as a nurse they do not even consider working there. Its sad. LTC is a great place to work, but until facilities start hiring more RNs and actually run the facility like it should be ran, LTC will continue being looked down on.

LPNs do wonderful work at my facility, but as others have stated, scope of practice should be somewhere in the thought process of administrators when hiring management/supervisors.

[DSkelton711]

I am am RN and really feel it is more about the person's experience and supervisory skills, rather than just education. The only thing that keeps me out of LTC is the thought of having 35-50 patients per day. That is crazy. Kudos to those that manage to do it.

[michiganmark_rn]

As a nurse, my one and only concern is that my unit manager be able to properly manage the unit, treat their staff fairly and get the job done. If they can do that with an lpn license, I'll happily accept their supervision. If they are not capable of doing that, I could care less if they have their lpn, rn, bsn, masters, doctorate or have been personally vouched for and blessed by the pope. Show me some professionalism and ability and concern for the welfare of the unit and I'll love ya forever.

[krissy_mack]

In my opinion, no one should talk down on you no matter what their education background is!! Doctor, RN, CNA etc.

[CapeCodMermaid, RN]

LPNs can not supervise RNs...plain and simple. They can manage a unit,they can coordinate a unit, but by law they can not supervise RNs. That said....I have an LPN as a unit manager and she's wonderful...she manages...she does not supervise the RNs working on that floor.

[cheleb61]

When I lived in New Jersey, every facility that I worked in required that the unit manager to be an RN. When I moved to Florida, I was shocked that LPNs could be unit managers and where I live it doesn't matter if they are going to school for their RN or not. That being said, I have 2 wonderful LPNs as the unit managers where I work. They are both extremely competent in their nursing skills and they both know how to manage their staff in a professional manner. When there is a problem with an RN, the ADON or DON gets involved. It sounds to me that the unit manager the original poster is describing has a big head and is really letting the title get to her. I don't think that she should be unit manager with only 2 years experience.

[marthyellen]

Both my unit managers are LVNs. One became a unit manager with only 2 years experience as an LVN. She had leadership skills from a previous job experience in another industry (she did not become a nurse until she was in her 50s) I would rather have an LVN with 2 years long term care experience than a RN with no experience in LTC.