New BSN vs veteran LPN

[kiyoshi kazuya]

Hello,

I am a new BSN grad, fresh out of nursing school, with no previous experience other than my rotations. I have encountered an issue with an old LPN on the unit. I won't get into the specifics, but it had to do with an outdated practice. I was using what was emphasized as "evidenced based" by my preceptors and nursing school instructors. However, when the LPN saw me do that, she chewed me out in front of the patient and basically said what I was doing was completely wrong. She then stepped in and did my work for me. This was not my first, or tenth time doing the technique, and when the LPN stepped in, she was doing something quite different.

What should I do now? Should I go talk to her tomorrow? If so, what should I talk about/how should I approach her about this subject?

Thank you!

[TheCommuter, BSN, RN]

Answering your question without knowing more specifics is quite challenging right now. You have left a very important detail out of the scenario: what was the outdated procedure?

The LPN was unprofessional for criticizing you in front of a patient, but we really need to know what the outdated procedure is.

[Lunah, MSN, RN]

Please be careful about describing your coworker as "old." Better terms may be "seasoned" or "experienced." Did she compromise patient safety with her methods? I agree with The Commuter that the way she handled things was unprofessional and definitely needs to be addressed.

[caliotter3]

Address her lack of professionalism in a written counseling. Stress that her behavior was detrimental to the emotional well-being of the patient. Get straight on the policy with your supervisor.

[Horseshoe, BSN, RN]

Address her lack of professionalism in a written counseling. Stress that her behavior was detrimental to the emotional well-being of the patient. Get straight on the policy with your supervisor.

THIS!! Your policy will dictate your next steps.

[Penelope_Pitstop, BSN, RN]

Get straight on the policy with your supervisor.

Yes, exactly. Just because something is based on EBP does *not* mean that all facilities are up to date. The facility's "best practice" might be outdated, or could have been updated without adequate staff inservice. This is really a learning opportunity more than anything.

[Purple_roses]

I can understand your frustration. One thing to remember, however, is that the adjective "old" that you stamped on the LPN has nothing to do with this situation. She is a person, a nurse, and your coworker. Old has nothing to do with it. Do you know how often practices change? Pretty often. One day your practices will be viewed as outdated too.

The LPN 100% should not have yelled at you, especially in front of others.

One thing my manager told me is this: there are lots of ways to do things. Do things the way your preceptor tells you to do them. If another nurse tells you to do it a different way, explain that you were taught to do it differently, and then use your resources to back yourself up. Call an interdisciplinary team member, use Google, or use information found at your hospital to show the other nurse why you need to do things a certain way. Remember--old nurse or new nurse--it's impossible to remember everything we learned in school. Just because a nurse is doing something differently doesn't mean she or he is a bad nurse. It simply means that we all forget things from time to time and that we all could use refreshers every once in a while. (Still, the yelling absolutely was unjustified.)

[OneDayAtATime93]

Hello,

I can relate with your situation. While in my facility we don't have LPNs, we do have CNAs. I have been a CNA for 5 yrs, and I have worked at the facility where I am currently a RN. I graduated a month or so ago, and I am 23, so the older CNAs look at me and think I don't know what I'm doing. They have never attacked me in front of a patient like in the situation you mentioned, but if they did, I would take them into a private area and discuss it with them. I feel that you cannot let this behavior continue. Educate her on EBP, and look at your hospital's policies to ensure they are up to date. This may be a policy issue and should be brought up to your manager or unit educator. But with regards to the LPN, she should be spoken to. I would let her know that it isn't appropriate to address you in such a way, and in front of a patient. Being honest, jealousy is probably in issue here. You're this new RN and she's an LPN. I find that with the CNAs, this is the cause of a lot of conflict too.

Best of luck.

[Penelope_Pitstop, BSN, RN]

Hello,

I can relate with your situation. While in my facility we don't have LPNs, we do have CNAs. I have been a CNA for 5 yrs, and I have worked at the facility where I am currently a RN. I graduated a month or so ago, and I am 23, so the older CNAs look at me and think I don't know what I'm doing. They have never attacked me in front of a patient like in the situation you mentioned, but if they did, I would take them into a private area and discuss it with them. I feel that you cannot let this behavior continue. Educate her on EBP, and look at your hospital's policies to ensure they are up to date. This may be a policy issue and should be brought up to your manager or unit educator. But with regards to the LPN, she should be spoken to. I would let her know that it isn't appropriate to address you in such a way, and in front of a patient. Being honest, jealousy is probably in issue here. You're this new RN and she's an LPN. I find that with the CNAs, this is the cause of a lot of conflict too.

Best of luck.

The BIG difference here is that an LPN is a NURSE and a CNA is not. An LPN also passed boards and has a license. LPNs typically have their own assigned patients and do not act as a nursing *assistant* would.

[Wuzzie]

Hello,

I can relate with your situation. While in my facility we don't have LPNs, we do have CNAs. I have been a CNA for 5 yrs, and I have worked at the facility where I am currently a RN. I graduated a month or so ago, and I am 23, so the older CNAs look at me and think I don't know what I'm doing. They have never attacked me in front of a patient like in the situation you mentioned, but if they did, I would take them into a private area and discuss it with them. I feel that you cannot let this behavior continue. Educate her on EBP, and look at your hospital's policies to ensure they are up to date. This may be a policy issue and should be brought up to your manager or unit educator. But with regards to the LPN, she should be spoken to. I would let her know that it isn't appropriate to address you in such a way, and in front of a patient. Being honest, jealousy is probably in issue here. You're this new RN and she's an LPN. I find that with the CNAs, this is the cause of a lot of conflict too.Best of luck.

Bad, bad advice!!! Pretty sure "educating" an experienced nurse isn't going to have the desired effect. Unless the desired effect is to have a giant target placed on her back. On the other hand I'm sure the manager will be super appreciative of the new person letting her know that the policies aren't up to her standards. Not!

Jealous of the new grad?!!! Wow, that is particularly laughable and hugely insulting at the same time.

[OneDayAtATime93]

You are 100% correct. But it is still not appropriate for anyone, whether MD, RN, LPN, or CNA, to try and make someone look incompetent in front of a patient. Because now when the RN is back in their room, the pt may question their competence because of what the LPN did. Unless it is something grossly negligent or obviously incorrect, there is a way of assisting staff members when in front of a pt. Clearly the LPN went about this incorrectly as the OP stated she "chewed" them out.

[OneDayAtATime93]

So it is acceptable for someone to attack a new staff member in front of a patient? And if the LPN is using an outdated technique, then yes, they should be "educated".