Sorry that this is long, but this has really been bothering me, and I had to say something...
I am a new RN with less than 3 months experience. I work the overnight shift at a SNF. I am usually the only RN in house, and am ultimately responsible for all of our 90 residents.
I sometimes work with an LPN, who I've decided, after working with her last night, is grossly incompetent at her job. She has been an OR nurse for more than 30 years, and now nearly 70 years old, she is taking her first bedside nursing job. It has come to my attention that her basic nursing skills are long gone, and her common sense is highly questionable. Others on our nursing staff agree, even the CNA's. I honestly do not think that she even knows how to properly assess a patient.
Some of the dangerous things I have heard of, or seen her do includes nearly giving a resident extremely hot water when giving a G-Tube feeding, doing a dressing change on a Stage IV decubiti without personal protective equipment, and last night I personally witnessed her drawing up the wrong medication for a patient having an acute psychotic episode (She was drawing up Zofran, when she should have been drawing up Zyprexa).
In addition to these errors, last night around midnight she was told by our CNA's, who are very good mind you and who know our residents inside and out, that a patient was not right and appeared to be having difficulty breathing. This resident has cerebral palsy and is mostly non-verbal, and frequently makes grunting noises, but our girls new something wasn't right. It turns out she was found to have a massive MI, and is now in the ICU, not expecting to make it through the night.
I had no idea this nurse lacked these basic skills until last night, or else I would have made sure to be personally notified of any of her patient changes of status, so that I could make an assessment on my own. Granted I am a new RN, but I think that my assessment skills are good enough to determine whether or not someone's condition warrants need for further medical attention.
The LPN didn't even do a set of vital signs, the only thing charted was a high temp, which she treated with Tylenol. When someone tells us that one of our residents isn't acting right, it's basic nursing knowledge that you need to make a full assessment of the resident, including a full set of vital signs, and make an educated decision on whether or not the physician and/or emergency services need to be notified.
Even though I knew nothing of what was going on, and she was not one of the patients I provided direct care for; as the only RN in house, I am ultimately responsible for the care of this and every patient under our roof. I feel horrible for what this poor patient had to go through.
From then on, when working with this LPN, I tell all of our CNA's to alert me about anything at all that is going on with our residents, regardless of whether or not I am their charge nurse.
The proper interventions should have been taken, so that this patient could have had a better outcome. I really hope this resident pulls through, but from what I hear, it is highly unlikely.
I just wish I knew, so that I could have done something...
