New Grad butting heads with LPN

[PedsRN32]

So, I'm a new grad peds RN (graduated in May 2020). I work on a small unit where we have an LPN who works 3p-11p M-F. She has 42 years of experience and I look to her a lot when I have questions or want to learn something. But there are times where she does things that I don't agree with and sometimes it's like if she knows my stance on a subject, she'll do the opposite. For example, she's thrown a fit about me giving a diabetic patient a Sierra Mist that wasn't sugar free (he wasn't even on any insulin and I gave him 1 a day just to appease him). But the time I tell a patient no to jello with sugar in it because he glucose was >500, she went and gave it to her. Well, last night I had a 7 year old patient who was refusing to take her oral antibiotic that she needed to take in order to be sent home. The other option was to hook her back up to the IV for antibiotics and she'd have to stay all weekend. We told the resident that three of us had tried and failed and he asked me to try again. So, I got the pill and started heading in there. Well, the LPN stopped me and told me that I was not to go in there and that I had other patients that needed to be seen (none of my patients had anything that I needed to do right then--and for future reference, none of my meds or anything were late) and I was to go tell the resident no and to put the orders in for IV antibiotics. I told her no that I was going to go try one more time like the resident requested and she made it obvious that she was not please. Well, 15 minutes later and the child was going home because I got her to take it. It was just frustrating having her talk to me like that because she'd never do that to the other nurses.

 

ps. would also appreciate any tips you have for how to get a kid to take po medicine. Because this child was difficult and that's putting it mildly. We tried so many different things and she just wasn't having it. I think a lot of it was behavioral because the parents stated she took meds okay at home and you could tell they were getting frustrated when she was refusing. They offered her so much stuff and she still wasn't doing it.

[RuralMOSchoolRN, ADN, RN]

She's testing you--she probably feels she has the upper hand because she has been there so long--even though your license gives you the ability to do more.  To the extent you can ignore her bad behavior.

However, on the jello-500 glucose I would have told my floor supervisor and written it somewhere-if not in the patient record then written the situation and had your nurse supervisor sign that you told her the issue.  That is jeopardizing the health of a patient over--what--spite? 

PO meds and kids.  "hiding" them in things if possible works if you can get it as a powder or unflavored (pudding works well).  Around 2nd grade level explaining that you know it tastes bad but it will help xyz and get her to xyz activity faster sometimes can help.  Also having a favorite drink or snack ready as a chaser helps.  Again age dependent--but sometimes they will do okay just taking a pill--I know a lot of meds are liquid but I've had kids figure out how to swallow an amoxicillin pill over taking 15 ml of a liquid that they hate.  Lastly--sometimes its better not to have parents in the room or to make a big deal out of it--if you approach it as a "time to do x" instead of making a production out of it they will do better--at least the ones that are refusing as an attention getting mechanism. 

Good luck!