On working with LPNs in the clinical setting

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Hello all. I recently obtained my ADN and just landed my first job. It seems that in my area of the U.S., newly graduated RNs must work in nursing homes/LTC in order to sharpen their 'prioritization and delegation' skills for around a year or so before being taken into consideration for the care of more acutely ill patients. Same for the home health care setting. Everywhere I have checked asks that RNs have one yr. of previous work experience before consideration. So, here I am, working at a nursing home in my area. I was planning on just taking this in stride, but for some reason, I seem to get a lot of gruff from LPNs where I work! Several of them don't want to take the time to count their narcotics drawers at shift change, they sign their name without paying attention to what they are doing, and just rush through their med passes. I try and explain that I am new to nursing and want to take the time with what I am doing, but many of them just roll their eyes and get in a huff. I don't have as much of a problem with other RNs, they seem to understand where I'm coming from with regards to these matters. Is there any advice someone can offer me to help me to deal more effectively with these LPNs? Not sure if they are saddened by their career choice or what the problem is, but I just need some advice on how to deal with working alongside them. Thanks so much...

Wow, I'm in love with this post! It really has so much information, as well as some attitudes and ideas I hadn't considered before. I'm about to start my first job as an LPN, and it is in LTC. I will be working with 25 patients after 3 days of orientation, all on my own. I did the math, and if I spent 20 minutes with each patient, that would be my complete 8 hour shift. I can only imagine how much I will need the help of the other nurses, both in time management and in policies.

This was a very interesting read, and I think I'll start my job with a much more open mind having read this. Thank you!

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Specializes in LTC,Hospice/palliative care,acute care.

[quote=They're all ****** off about being bought out by HCR or something QUOTE

Certain entities in LTC have very bad reputations. In this area HCR falls into that category. It's morale busting when that type of thing happens to a facility-give the staff a break, they are going through a really rough time. It's not fair (or professional) that they are taking it out on each other but that can happen,think bout what they are going through and suck it up. Stand up for yourself,follow appropriate policy and procedure and don't make it an LPN vs RN thing.It's likely just new, green , slow nurse against old ,experienced, fast nurse

Something else to consider-sometimes these companies restructure - some of these nurses will likely loose their jobs. It's a really difficult and uncertain time for them all. Chances are that some of them will loose their jobs and you'll be left in a charge nurse or unit manager position. With your lack of nursing experience in geriatrics you will want to foster good working relationships WITH the ones who are left standing.

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I know you don't mean to come off offensively..

But it seems like you just think lpn's don't do this, don't do that

As you know ltc is stressful. Everyone i work with is stressed out,

And to solve issues like this i try not to look at my coworkers as just an "lpn" or "rn" or "med tech"

I treat everyone as equal when speaking to them working with them, but when it comes to delegating tasks/responsibilities of different titles that is a whole other story

But that doesn't seem to be the issue here.

Treat your other nurses as equals.

An lpn may not have an rn license but l our experience is very very valuable.

I know plenty of rn's who do things that you say these lpn's aren't doing/are doing incorrectly, so please don't just think it is an "lpn thing"

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I know you don't mean to come off offensively..

But it seems like you just think lpn's don't do this, don't do that

As you know ltc is stressful. Everyone i work with is stressed out,

And to solve issues like this i try not to look at my coworkers as just an "lpn" or "rn" or "med tech"

I treat everyone as equal when speaking to them working with them, but when it comes to delegating tasks/responsibilities of different titles that is a whole other story

But that doesn't seem to be the issue here.

Treat your other nurses as equals.

An lpn may not have an rn license but l our experience is very very valuable.

I know plenty of rn's who do things that you say these lpn's aren't doing/are doing incorrectly, so please don't just think it is an "lpn thing"

I didn't think less of them going into this job... like I said, I was a STNA for several yrs. and in my case it was just easier/better to go the ADN route. Then, by the way they were treating me, I started to think 'Wow. LPNs sure have a chip on their shoulder!' Really, they probably have the biggest chip on their shoulders at this facility bc they have been bought out by HCR. They in particular have less options to transfer out of this place than the RNs and know it. This is my 1st job as a nurse, and now that I've read all of your posts, I know what's going on at my place of work is deeper than LPNs not liking RNs. Wish I didn't have to find out the hard way... wished that I took another job offer besides this one. Yeah, the morale is down in the crapper and it's mostly bc they don't wanna be going from a good company to a bad one that gives low pay and doesn't value its employees.

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Specializes in LTC, Education, Management, QAPI.

Holy batman, Nola009! You have an awesome attitude!! PLEASE stay with Long Term care, we need you and your attitude!! The fact that you can come in and reinstate so effortlessly your appreciation for other's opinions.

I do agree with Brandon in some ways- LTC is fast paced. You also need to be sure that you aren't basing your opinion of LTC on just a few examples.

Your generalizations are just that- generalizations, so remember that. Get to the real reason why things are the way they are. I respect that you haven't had the experience to know certain things but are willing to appreciate and thing about other reactions.

As a former LPN (still tattooed on my leg in huge letters and picture, I will always be an LPN) then RN and then DON, I feel quite sure that your feelings are valid. I find myself often wondering why it's so difficult to sign out those freakin' narcs!!! Then I remember how hard it was to keep up on the floor. I guarantee it's rushing. You have the ability to fix that! Slow them down.

I might have reacted the same way as Brandon did to your OP, but your response made me happy. That is the right attitude!!!!!!

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i'm not offended or insulted - just giving my advice

watch a good war movie and try not to act like the butter bar (just kidding)

seriously, perhaps you could view it as a problem with co workers

rather than a LPN/RN issue

get a good perspective of what time constraints your co workers

are dealing with

understand that you may take all the time with what you're

doing when it's your time you're talking about, but when you're

on someone else's time, you may have to respect their time as well

I do hope that at least some of your co workers will also be

flexible and understanding or at least remember when they

first started

Sorry, but I have no idea what this means. I don't watch war movies and the only 'butter bars' around here are the ones in my fridge... that I use to cook with.

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Thanks, NurseGuyBri. It's a rough world and um, there's still a lot to learn. As a new grad who passed the NCLEX only a few months ago, I admit that I (and my classmates, I'm not the only one, lol) thought I had 'arrived' a little bit [i mean, hello?!! Do ppl not realize how hard nursing school is?!] Now it's like 'yeah, it's only beginning'. And it is. Waking up from my dream right about now....

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