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 I won't get into the specifics, but it had to do with an outdated practice.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?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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 I won't get into the specifics, but it had to do with an outdated practice.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!
First, you're being very disrespectful of the LPN. LPNs are nurses, too, and they're our colleagues. "New BSN vs. Veteran LPN" shouldn't be an issue. You're on the same team.
Second, there's usually more than one way to do anything, and what you've learned in school, "EBP or not", isn't always the best way to do it. Without knowing exactly what the "evidence based" practice was, we cannot know who was doing it correctly. Given that you are new, however, I'd be willing to believe that you may have inadvertently skipped a step and the LPN was genuinely trying to help you or protect the patient.
Third, did the LPN really "chew you out" in front of the patient? Did she raise her voice, call you names or behave in an unprofessional manner? Or was she merely trying to get you to stop what you were doing before it got to the patient? Because if she's experienced and you're new, she might very well have had a good point and it doesn't sound as if you were listening -- or that you were very respectful of her.
Fourth, if you do go talk to her tomorrow, please apologize to her for being disrespectful of her. Then you two can look over the policy and procedure manuals and decide who was doing it correctly. You both may learn something.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
Perhaps the LPN was unprofessional for criticizing a brand new BSN in front of a patient -- and perhaps she was merely trying to get the OP to stop doing whatever she was doing before she harmed a patient. We don't really know. We have only the OP's word for it that she was right in her practice and the LPN was wrong. I remember trying once to tell a brand new intern and a brand new GN (didn't even have a license yet) that giving 20 mEq of KCl IV push into a 22 g. hand IV for a K+ of 3.9 was a bad idea. They didn't listen to me in the nurse's station, they didn't listen to me in the med room, they didn't listen to me in the hallway -- but they DID listen to the Pharmacist who went into the patient's room and actually raised his voice to shout "STOP!" Was the pharmacist wrong to "yell at" a brand new MD and a brand new GN to protect the patient?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
Without knowing what the "evidence based" practice was or what the OP was about to do to her patient, we don't know that the LPN was being unprofessional. It could be that "chewing her out" was the only way to get the OP to listen before she harmed a patient. I wouldn't be so quick to judge the LPN without knowing the whole story.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
Great way to ensure that the OP never fits in to her workplace. "Education" of an experienced nurse by a newbie never seems to have a desirable result (for the newbie). And about this jealousy business . . . I cannot believe that anyone over the age of 11 actually believes this.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
The fact that the new BSN felt like she was being inappropriately "chewed out" in front of a patient does not really mean that the LPN actually chewed her out. If the LPN actually DID chew her out, the fact that the BSN felt the LPN was in the wrong doesn't mean that the LPN was actually in the wrong. It's entirely possible that the experienced nurse was correct, the new nurse was wrong and there was only one way to stop the new nurse from harming the patient. If that were the case -- and we don't know whether it was or was not, since the OP didn't discuss the practice involved -- then stopping the new nurse from harming the patient took precedence over the new nurse's feelings and the "lack of professionalism" involved in making sure she stopped what she was doing wrong. In otherwords, we don't know that the OP was not grossly negligent or incorrect.
I would say something like "Well, I certainly don't know 'everything', but my teachers told me that so-and-so should be done when you're doing such-and-such".
I would say something like "Well, I certainly don't know 'everything', but my teachers told me that so-and-so should be done when you're doing such-and-such".
Oh for goodness sake do you honestly think that will be accepted warmly? Not everything learned in school is the right way or the most supported by evidence. Just because your "teacher told you" doesn't make it right. If you want to know why someone is doing something differently just ask them to explain the procedure as they do it. Any precepter intent on doing a good job will explain how AND why. That way you'll get your answer without sounding like a complete tool and you can do your own research to guide YOUR practice.
Or you can do what you suggested which sounds like a challenge and wait to see what happens. Spoiler...it won't end well.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
OP: The smart and wise "new RN" do well to respect the experience of the "old" LPN and listen more and talk less. The lack of respect is glaring and I bet dollars to donuts, she can feel it coming off you like heat off a radiator. She is not jealous; she is disgusted.
When I was a new RN there was an LPN who had been on the unit more than 40 years. You bet your bippy I respected her and listened when she spoke up. She probably forgot more than I ever knew about nursing and my specialty. I always respected her and learned so much in the process of listening.
Respect is a two way street; if you want it you have to give it. Just because you are an RN (BSN!) does not mean much when you are inexperienced. You have a lot to learn. Don't spout off about EBP and what your instructors said all the time; try hearingwhat she has to say, at least, first. Maybe with less arrogance and the air of superiority coming from you, the LPN will lighten up. And in the process, maybe you will learn a thing or two and realize you really don't know it all.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
First, you're being very disrespectful of the LPN. LPNs are nurses, too, and they're our colleagues. "New BSN vs. Veteran LPN" shouldn't be an issue. You're on the same team.
if you do go talk to her tomorrow, please apologize to her for being disrespectful of her. Then you two can look over the policy and procedure manuals and decide who was doing it correctly. You both may learn something.
Without knowing what the "evidence based" practice was or what the OP was about to do to her patient, we don't know that the LPN was being unprofessional. It could be that "chewing her out" was the only way to get the OP to listen before she harmed a patient.
Right...it doesn't sound like the OP is extremely open to learning from her, so could have been appropriately escalating
Based on the title of this post and how you set yourself as the "new" nurse compared to the "old" LPN, I am going on the hunch that the other nurse may not be the problem here. Do not discount the years of experience this nurse has and discounting them due to being an LPN. The ego coming off this post really sets the tone here. The way you have it set up as BSN vs LPN clearly indicates you think you are better than this other nurse. Remember you are a bloody team and are not competing with one another.
Since you're new I'm assuming she was in the process of helping train you. I'm an LPN and when I worked in LTC I was part of a training team and where I work now I've been the sole trainer for every new nurse that comes into the facility for years. It doesn't matter if they're an LPN or RN, they all shadow me. Policies and procedures vary from facility to facility and even person to person, often things are done differently in the real world vs school. When training if someone does something wrong, I'll usually point it out and then step in and show them the way we do things and then try to give a rationale why we do things that way. It seems like that's what the nurse was doing although she could've been more tactful when explaining things. I would check with your facility on policies and procedures.
Your resentment over being corrected by an LPN (or an old nurse) is pretty apparent though, that attitude isn't going to help you in this career especially if you're working somewhere where LPNs and RNs work alongside each other.
Ruby Vee, BSN
17 Articles; 14,051 Posts
Second, there's usually more than one way to do anything, and what you've learned in school, "EBP or not", isn't always the best way to do it. Without knowing exactly what the "evidence based" practice was, we cannot know who was doing it correctly. Given that you are new, however, I'd be willing to believe that you may have inadvertently skipped a step and the LPN was genuinely trying to help you or protect the patient.
Third, did the LPN really "chew you out" in front of the patient? Did she raise her voice, call you names or behave in an unprofessional manner? Or was she merely trying to get you to stop what you were doing before it got to the patient? Because if she's experienced and you're new, she might very well have had a good point and it doesn't sound as if you were listening -- or that you were very respectful of her.
Fourth, if you do go talk to her tomorrow, please apologize to her for being disrespectful of her. Then you two can look over the policy and procedure manuals and decide who was doing it correctly. You both may learn something.