Professionalism as an LPN

[RoyalNurse]

Hi everyone,I just wanted to get some opinions from some LPNs on a topic.I recently worked with an LPN who was assigned to 6 "urgent-care" patients, I was the charge nurse. My duties included administering any IV medications that the LPN's patients needed, as well as mixing any antibiotics, and monitoring anyone who ended up on a cardiac monitor. One of her patients ended up needing insulin IV. I was not told about this order by the LPN, and I did not administer it. When the LPN gave report to the next LPN coming on duty, she said it was my fault that the insulin wasn't administered, as I was "in charge" of IV injections. I feel that the LPN is responsible for her patients as a nurse, and should have told me about this injection. I know that as an RN, I'm "supervising" this LPN, but she is the nurse assigned to these patients, and still ultimately responsible? What do you think?

[applewhitern, BSN, RN]

I am also confused as to how anyone would know a patient would need IV insulin "at the beginning of the shift." I have been an RN for 23 years, and I have never known at the beginning of the shift that IV insulin would be needed. Sub-q, yes, but not IV, especially when they aren't on an insulin drip, and we do not know what their blood sugar would be at that time.

[applewhitern, BSN, RN]

I work with three LPN's every day at my job. I perform the duties they aren't allowed to do. I also have my own group of patients, same number as the LPN's. I cannot, and will not, check all their charts for them. That would mean I would be checking about 18-21 LPN's charts, plus 6-8 of my own. I don't have time for that. Fortunately, our LPN's advocate for their patients and do not try to blame anyone else for errors of omission, regardless of the med omitted.

[Jrow]

Would it be right to say you are working with paper charts vs electronic? That there can be a problem. The LPN is responsible and the Charge RN is as well. She should've notified you and you should've been more aware of medication orders. She is beyond wrong to give report to an oncoming LPN that it was entirely you who was at fault for the Pt not receiving the ordered med. It may be a good idea for you and this nurse to talk about this incidence so that it does not occur again. In the end, it is the Patient who suffers for the lack of communication.