Our new hire, new grad charge nurse

txgal34 · Dec 28, 2010

not all LVN's/LPN's are "jealous" of the RN. I graduated with a 4.0 from an LVN program. I CHOSE the LVN route. I will in some point in the future probably pursue my RN, however I am quite content in the LVN role. TX is very liberal state "we work under the supervision of an RN" so if facility policy permits and we have been properly facility trained, there are not restrictions. I am lucky that I have worked with excellent RN's, sometimes new grads. I know coming out of school I had a lot more clinical experience and would glady help when they needed help with a procedure (cathing, etc.) that they were not proficient at. However, their knowledge is much greater due to the classroom education that I did not get and are able to easily explain a question I may have because RN's have had that in-depth classroom education I have not. Maybe the concern of the OP is not having an RN in charge of the LPN's, but more of a concern if/when an emergency happens, will the RN be able to know what to do? I am very competent, however when I have any doubt on a pt, will get my RN to take a look at the pt to verify or ease my concern.

SE_BSN_RN, BSN · Dec 28, 2010

Oh my lord this is driving me crazy! The question that is screaming from my mind is how many RN's are actually working on this floor? She made no mention of how many RN's there are, just that there are "mostly" LPN's.
Where I come from every new grad RN I know that was hired as a charge nurse was in a LTC facility, which a lot of experienced nurses have no desire to do. I've heard some of them say that they had to go to the facility to do something in the middle of the night (on call) because there wasn't even an RN in the building.
It's all scary to have a new inexperienced nurse in charge, no matter where you are.
If there isn't a more qualified RN to do the job (or if there isn't another RN period), then she's stuck with it. She might not like it either, I would think she PROBABLY doesn't like it. She might only have taken that job because the market is so horrible for new grads that she couldn't find another job and couldn't feed herself or worse yet her family. Maybe she took that job only until she finds one more suited to her experience level.
An LPN can't be in charge here in this situation. Doesn't have anything to do with the experience level, or how much of a wealth of knowledge she may be, it's simply a matter of logistics. In theory and in practice, by law, an LPN works under the supervision of an RN. An LPN can not supervise an RN. Period.
To answer another previous poster would I feel differently if the majority of the nurses on the floor were RN's? Yeah, absolutely. Unless they were all new grads. There was never a mention of there being more qualified, experienced RN's eligible for this position. The way it comes across to me is that this RN was made the charge because she was THE RN.
How many RNs work this floor?

In some states, yes, an LVN/PN can supervise an RN. Just not clinically.

ougreene · Dec 28, 2010

Well, as LPN for 10 years, and fairly new RN/BSN, I was hired at a long term care facility as a charge nurse.

There is a lot to think about in this issue:

Most New employees dont cost as must as employees who have been on the payroll for some time, including insurance for the employee.

An experience RN, may not be in the means of the facility budget.

Depending on how many LPNs vs RN ratio, the facility may need an RN and their own RNs may not meet the leadership qualification the facility needs.

IF there was an opening for a charge nurse, and it was posted...then those that applied should know why they were not hired.

While an LPN/LVN is not a degree, the RN and beyond has forefilled the educational requirements which includeds courses on deligation - leadership etc...

While the LPN/LVN may have exceptional nursing skills, a new grad RN has the education and degree.

I am very neutral on this and see both sides! As I said I am an fairly new RN/BSN with 10 years of experience as an LPN in office nursing. Everything is so individualized and there are many unknown about your new grad. Any leadership role in their past may have been the key and then of course the education degree.

Gail RN BSN CCRC AE-C

SE_BSN_RN, BSN · Dec 28, 2010

Yes, and it is tough, no matter what your degree. The letters behind your name don't tell your experience, either. It's hard for the employees as well as the new person coming on until everyone gets comfortable with each other and they know each other's strengths and weaknesses.

Gerry1888RN · Dec 29, 2010

Livelaughlove09 - you're right -- I responded to the issue speaking in a general sense. I've never seen an LPN as a charge nurse in acute care hospitals either. I've read some posts from people here who were newly hired RNs in an LTC with a LPN as their immediate supervisor. These issues will probably continue due to the new grad RNs not finding work in the specialty they envisioned themselves in while in school.
This is too bad as there were no winners in this situation. Kudos to you and your co-workers for trying to help her succeed.

Interesting to know that it's not uncommon to have an LPN in charge of RN's in LTC. I work in a sub-acute LTC facility as a new grad, and one of my charge nurses/house supervisor is an LPN. She's a great nurse, a good person, been with the facility for a long time, and has years of experience, but I didn't think LPN's were allowed to supervise and delegate to RN's. She is also in charge of experienced RN's which makes even less sense.

SE_BSN_RN, BSN · Dec 29, 2010

Interesting to know that it's not uncommon to have an LPN in charge of RN's in LTC. I work in a sub-acute LTC facility as a new grad, and one of my charge nurses/house supervisor is an LPN. She's a great nurse, a good person, been with the facility for a long time, and has years of experience, but I didn't think LPN's were allowed to supervise and delegate to RN's. She is also in charge of experienced RN's which makes even less sense.

No, it doesn't make sense, but this is where nurses should know their scope of practice and what their facility guidelines are. Some states the BON allows LPN's as supervisors but not clinically, so they can not delegate....and it will say on the website. I worked as SDC which does not, in my facility, have to be a nurse at all. Our MDS coordinator is an LPN, also. Both positions, along with the ADON can be LPN's, according to our corporate policy, as long as the administrator allows it. Which begs the question, then why are these spots filled with LPN's when only an RN and above can delegate? Don't know. I do know, at my facility, the new hires were RN's and they didn't interview for the positions because they didn't want them, and they couldn't get hired on at the hospital because they had no experience, which, in LTC does not vary all that greatly between RN's and LPN's. However, the facility won't just kick the LPN out of the position to give to the RN because they "finally have an RN." I was offered the position of MDS assistant and I am going to take it......not because I can supervise an RN, but because learning MDS is a good skill to have....and I want to learn that, too, not just floor nursing and SDC work. LTC has a lot of options, too, if people are willing to look into what is offered. However, it won't be my career. I want to deliver babies.......crazy me, huh??

r.oxymoron · Dec 31, 2010

Try looking at it from the new grad's point of view. I was hired as charge right out of nursing school, and I flat-out told my supervisor, "You're kidding me, right?" I was HORRIFIED, but I needed the job. I was lucky to be surrounded by outstanding fellow nurses whose experience I could tap into. It's difficult however, to ask what their assessment would be without putting the final decision in their hands; my license was the one on the line.

I agree with you, the slot of charge should be given to those with more experience. I muddled through because I work with a great team. Others aren't so fortunate.

SummerGarden, BSN, MSN, RN · Jan 1, 2011

what could possibly be the upside to having the 'co-workers take a big bite"??? this must be the 'nurses eating their young' syndrome i've heard about. maybe, instead, some encouragement, maybe even getting to know her & what knowledge/experience she does have that allowed her to gain this position. i can't understand the anger toward her at all. i hope she does well & wish her (and all her co-workers) the very best. this profession is difficult enough without having us at each others' throats!

i am not angry with her... i think she was a fool to accept the position. i do not think that nurses should take a bite out of her, i just know that they will and so will the environment. there is no way a new grad should be a charge nurse as his/her first job.

i know of some new grads with bsns who landed such positions out of school. to no experienced nurses' surprise (i see a lot of lay people and new grads posting otherwise on this thread), new grad bsns left the positions willingly. the new grads feared a loss of licensure and rightly so. those new nurses had no idea what they were doing or how to do it because they had absolutely no expereicne to draw on, no time management skills, and no critical thinking skills. you cannot rely on education and subordinates alone to be a good nurse leader... experience enhanced by education teaches you what you need to know.

SummerGarden, BSN, MSN, RN · Jan 1, 2011

well the new charge nurse quit the other night. we all helped and encouraged her. i guess it was just too much responsibility for her.

it is sad given the job market, but i know of others placed in similar situations who also quit. this is why i am not surprised. management should have never ever placed that nurse in that position. instead, that nurse should have been allowed to be a new grad and properly orient as a bedside nurse.

OCNRN63, RN · Jan 1, 2011

Well the new charge nurse quit the other night. We all helped and encouraged her. I guess it was just too much responsibility for her.

No, it was that she needed the opportunity to gain experience and skills, as any new graduate should. Sheesh.

I'm not surprised at all she quit. She was destined to fail in this situation. I hope she finds a job where she's able to learn and grow into her own.