I had my first shift last night on a Med-Surg Oncology floor. I was shocked to find out that I was being oriented to the unit by a LVN. Now I realize that we do a lot of the same tasks as RNs but there are other things that I would be doing that they don't...
Has any RN out there been trained by a LVN? I am a new graduate, and I know I have A LOT TO LEARN but this particular LVN was engaging in unsafe behavior consistently--she seriously only used gloves twice the entire shift.
I was thinking about meeting with the nurse manager because I told the charge nurse and she didn't seem too concerned. Everyone seems very lax on this floor and I did have a great time but I know that is not what is important. Do you think it would be too ballsy for a new grad RN employee to meet with the nurse manager this soon?? The LVN was extremely nice and was trying to be helpful but she gave me incorrect information multiple occasions as well.
That is the biggest load of crock I've read in a long time. Nursing is lifelong learning, not about learning only during buddy shifts. So assuming there's an alleged lawsuit, the defense lawyer is gonna question *every single person* the nurse ever learned a thing or two from? Garbage!
And what if the OP makes a huge error while being trained by an LVN? Would the court still hold them legally accountable?
I suppose I should have been more clear in my post. I didn't really care that much who with what license I was being trained by, but was more concerned with the fact that this particular person was constantly teaching incorrect practice.
I didn't go to the nurse manager, but I went to someone in staff education, and explained to the Nurse Educator on our floor that some additional education would be needed on certain topics.
Hopefully, I won't get too much heat for it, but it really is about patient safety, whether I am new or not.
Let me just give a few brief examples of what I was seeing...
1. Tubing never labeled because "I don't like to."
2. No cleansing of sites before an injection.
3. Not changing caps on Infusaports during dressing changes AND thinking they should be changed every 10 days when it is every 7 days.
4. Not using MARs in the patient's room to do your triple checks before administering meds. Or hanging an antibiotic, leaving the room, then say, "Man, I am not sure if I hung the right one, let me go back and check."
5. Thinking IV tubing is good to use for 7 days.
6. Telling a patient a PICC line doesn't go anywhere near the heart, "so that is why it is safer."
So, I hope you all will agree that these are important things not to overlook and I couldn't just stand by and see these mistakes repeated. I am using this opportunity to help. I obviously know I don't know everything and my preceptor, I am positive, KNOWS A TON! I would hope that if anyone saw me doing something incorrect, that someone would have the guts to tell me. I really like her and get along with everyone so I am just going to show her the institution's policies on a few things so she'll know for sure in the future.
I think it is all about how you approach the situation.
Thanks to everyone again for all the great responses!:redbeathe:nurse:
i suppose i should have been more clear in my post. i didn't really care that much who with what license i was being trained by, but was more concerned with the fact that this particular person was constantly teaching incorrect practice.
i didn't go to the nurse manager, but i went to someone in staff education, and explained to the nurse educator on our floor that some additional education would be needed on certain topics.
hopefully, i won't get too much heat for it, but it really is about patient safety, whether i am new or not.
let me just give a few brief examples of what i was seeing...
1. tubing never labeled because "i don't like to."
2. no cleansing of sites before an injection.
3. not changing caps on infusaports during dressing changes and thinking they should be changed every 10 days when it is every 7 days.
4. not using mars in the patient's room to do your triple checks before administering meds. or hanging an antibiotic, leaving the room, then say, "man, i am not sure if i hung the right one, let me go back and check."
5. thinking iv tubing is good to use for 7 days.
6. telling a patient a picc line doesn't go anywhere near the heart, "so that is why it is safer."
so, i hope you all will agree that these are important things not to overlook and i couldn't just stand by and see these mistakes repeated. i am using this opportunity to help. i obviously know i don't know everything and my preceptor, i am positive, knows a ton! i would hope that if anyone saw me doing something incorrect, that someone would have the guts to tell me. i really like her and get along with everyone so i am just going to show her the institution's policies on a few things so she'll know for sure in the future.
i think it is all about how you approach the situation.
thanks to everyone again for all the great responses!:redbeathe:nurse:
wow that nurse is not the sharpest knife in the drawer and is lazy.
Specializes in acute care med/surg, LTC, orthopedics.
yeah i agree.
in ltc, lpns and rns do essentially the same thing so no problem with experienced lpn training new rn.
some people are so caught up with titles.
angel, rn
not just in ltc, at least not where i'm from, in an acute care setting as well. lpns don't do picc lines, iv pca's or ivp, otherwise same skill set. in fact, upon observation, one would never be able to tell who's an rn and who's an lpn - without looking at their name tags.
LVNs and RNs training each other. RN's training LVNs is understandable and LVNs training RNs depends on where and the situation. I have worked in a General Surgeon's office for 6 years with four different surgeons. The last one I actually helped start his practice and opened the doors with him 2 years ago. I gave my notice and an RN was taking my place....the first hour went well until I had to hear all about what LVNs do wrong while being told and I quote "No offense to you". I was trying to make this transition as easy as possible giving her sample sheets on tests he ordered for certain chief complaints and why he ordered them, all the while, trying to keep patient load to a reasonable level while showing her how clinic flow went and the workings in an office. When you work closely with someone five days a week you tend to learn exactly what they need or are requesting. She was a charge nurse on a surgical floor. Working in a surgeon's office I have dealt with wounds, wounds vacs, JP drains etc., etc., what floored me was the fact that she didn't want me to show her how to do the wound vac and dressing change (even though I have been doing these 3 days a week on differnet occasions on different patients) she wanted to watch a video on the internet instead..Needless to say this left me very despondent after about the third day of all of this...especially when my hand would be knocked out of the way when I would try and show her something and having to listen to these little comments. I have worked side by side on a hospital floor with RNs and LVNs some I would work with any day of the week and twice on Sunday, others I wish not to be associated with because all they did was bark orders from behind the desk. You have to know your capabilities and scope of practice, and yes the real working world is nothing like nursing school and yes even as an LVN you eventually think like a lawyer because this is a sue happy nation. Coming from an LVN this may all be a waste of my time saying, but just because LVN is after a name doesn't mean that common sense and good judgement doesn't follow. This was a bad experience where the whole hang up RN to LVN happened. I wish you luck in your career.
sounds like you're your preceptor's preceptor! hope it all works out for you!
dead right lol! but there is a vast difference between "orientation"-as to a department's layout and routine-and "precepting" or "mentoring"; only an rn can instruct a new rn graduate on the work done solely by an rn. no lpn, lvn, staff nurse or enrolled nurse-whatever the title is in your particular country-can operate within an rn's scope of practice! however, given the fact that rn training is college based instead of hospital based, the lpns et al the other titles, frequently have a better grasp of the practical side of running the unit. as i said, none of us should turn our noses up at knowledge and experience, regardless of the source, and i for one have encountered, and in fact work with, quite a few platinum standard staff nurses/ens. but while they can help teach a new grad, they can never mentor her-not in the official sense.
wow that nurse is not the sharpest knife in the drawer and is lazy.
perhaps a bit harsh a judgement, but she definitely needs watching, and perhaps a bit of in-service training herself.
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
Dead right LoL! But there is a vast difference between "orientation"-as to a department's layout and routine-and "precepting" or "mentoring"; only an RN can instruct a new RN graduate on the work done solely by an RN. No LPN, LVN, Staff Nurse or Enrolled Nurse-whatever the title is in your particular country-can operate within an RN's scope of practice! However, given the fact that RN training is college based instead of hospital based, the LPNs et al the other titles, frequently have a better grasp of the practical side of running the unit. As I said, none of us should turn our noses up at knowledge and experience, regardless of the source, and I for one have encountered, and in fact work with, quite a few platinum standard staff nurses/ENs. But while they can help teach a new grad, they can never mentor her-not in the official sense.
Perhaps a bit harsh a judgement, but she definitely needs watching, and perhaps a bit of in-service training herself.
It's actually what goes IN the record officially. There are a lot of sensitive egos abound here who is arguing logic. You can't argue logic.
Obviously, OP, I would certainly change preceptors from the information you've shared with us.
But when it comes to legalities, it's not appropriate for an LPN to train an RN as part of the orientation record.
OP, this isn't about titles--it is a legal document and your scope of practice differs. PERIOD. There is no two ways about it no matter how nicey-nice we want to be--this is the USA...where lawyers live in every corner. You earned your license, don't give it away so you can be "nice."
Specializes in Care Coordination, MDS, med-surg, Peds.
I agree there is no reason an LPN can't orient someone to the basic workings of a unit. An RN would need to show the RN-y tyoe things that an LPN can't do. As far as learning from the LPN, heck yeah!! Of course, from this one, OP, you may learn all the things NOT to do. This is not to say that you RN preceptor can't be just as wonky. I have said many times as an RN that I would rather have have ONE good, experienced LPN to work with than THREE book smart, floor stupid know-it-all RNs. BTW---I am an RN, 15yrs hospital, + 4 years as an LPN (hospital) and 10 years CNA/CMT. As a hospital LPN, I trained many an RN.. IN general duties only, the RN charge taught the RN-y stuff. Just my 2 Cents.
Specializes in Tele, Med/Surg, Case Mgmt, Ins. Rev.
You are truly in a difficult situation. I agree that Standards of Care should be universal, and I find this LVN's appalling. I was an LPN for many years before becoming an RN. I took every CE opp that presented itself, knew all of the Unit and Facility Policy and Procedures by heart. I was the Unit Preceptor for the Med/Surg/Tele unit I worked on and precepted both RN's and LPN's.
New grads require experience in caring for a full assignment of patients including assesment, med admin, reviewing tests, calling physicians, assisting physicians at bedside, and receiving/giving report on this assignment. A little different from school where most students are not given this experience. Once they were proficient in these skills, they would then transition to their own assignment. Once they were proficient in their skills and multi-tasking, they would then add the skills that were RN specific such as Blood Product Infusion and signing off assesments with another RN.
Experienced nurses would typically only be with me for a few shifts to learn the process at our unit, location of items, etc. The nurses that could not look past my license, were quickly educated by the Nurse Manager that Quality and Competent Nursing is not based on amount of time spent in a classroom.
Everyone that you meet, Unit Secretary, Monitor Tech, CNA, LPN, RN, MD, etc all have something to teach us. Use common sense to weed out the information or practice which is substandard.
If you feel that the Nurse you are precepting with is risking patient care, perhaps go to the Charge Nurse with your concerns prior to going to the Nurse Manager. I wish you many happy and successful years of nursing!
:redbeathe:nurse:
Scrubby
1,313 Posts
And what if the OP makes a huge error while being trained by an LVN? Would the court still hold them legally accountable?