knotizer12

Hey, I know I am very late to the party, but can I ask a few questions about the LPN-BSN program? 1) How hard, on a scale of 1-10 (har), were the classes? 2) How much did the program, in total, cost? 3) Was it difficult to juggle school, work, and life? I'll probably think of more late.

I'm a bit late to this party. I work at a hospital in WA state in an ambulatory surgery clinic. I was hired at the beginning of 2018 as a temporary employee and have since moved on to permanent status. I was told upon being hired that my clinic was not part of the union; I found out recently that we were not even part of the collective bargaining agreement but I'll get there in one second. A few of my coworkers were (and still are) very smug that "we get all the benefits of the union but don't have to pay union dues". When I was offered my permanent position in June, I met with HR to renegotiate pay; in WA state, LPNs pay range is from 19-27 dollars an hour and I was making 19.70. In contrast, medical assistants range from 14-19 dollars an hour and my hospital pays them starting 18.84 an hour. I was not happy and thought that I should be paid more because, in the job contract, LPNs are expected to do more "owing to the increased scope of practice." I was told (politely) to go F myself. But that isn't the reason I will be joining the union. We get our benefits from Sound Health and Wellness; just last week, we were all told that Sound Health and Wellness really only provides insurance and coverage to members who are covered by a collective bargaining agreement. So, our clinic is now to be included in the collective bargaining agreement between the hospital and UFCW local 21. I had no idea we were not covered at all. We have until the end of January 2019 to decide if we want to become union members or not. I believe this is a choice we are making as individuals and not as a clinic. I know I will be becoming a union member because I do not trust the hospital administration and especially not our HR department to make any changes or do anything for MY benefit.

I agree. I just mean in terms of asking "do you have any other questions?" and being able to tell the doctor to go back and speak to them or give them a call later. Not just sign as a witness and forget about it.

I think one of the reasons this issue is so "near and dear" to me is because, for the most part, the clinics do not hire many nurses. At wound care and primary care, you have a handful of RNs to do the actual wound care and phone triage but at my clinic there are only two LPNs. When I was hired, I was pretty much an MA in what I was expected to do; which is fair to an extend because they really needed someone to room for our PA. Maybe I'm being prideful, but I'm not an MA. I'm an LPN, albeit a new one. The clinic is finally to the point in staffing where I am actually start doing more "nurse" duties instead of MA duties. To me, signing your name under the "witness" line and writing "to sig only" is something an MA would do whereas a nurse would follow up to make sure the patient actually understood what they were signing and did not have any additional questions. Maybe I'm too prideful.

I guess it's facility vs facility. Actually this is a very good question. Why do we need witnesses at my facility? I can ask around.

I'll tell a little bit about my clinic. So we are a specialty surgery center connected to a hospital. We actually mainly provide colonoscopy consults and colonoscopies. Before anyone asks, the risks and benefits of colonoscopy are explained to the patient during the consult and the actual consent is signed just before the procedure itself which can be as much as 3 months after the consult. There are no RNs in the actual clinic. We have an endoscopy suite attached but those RNs do not oversee myself or the MAs. We are in charge of rooming patients for the providers (taking vitals and reviewing allergies/medications/family history, ect). I have been told many times by first the MAs and then my second LPN that writing "to sig only" on the consent literally means I am attesting to the fact that the patient signed the form but it does NOT mean I am attesting to the fact that the patient understands anything. Apparently they figured out this system with our hospital legal person. I just feel odd signing a consent as a witness when I either was not physically present to see the signatures OR unable to follow up with the patient. Maybe I'm looking too much into this but I think there's a misunderstanding happening between the MAs and LPNs at my clinic regarding consents and I am trying to put my finger on it.

I live in a rural area of Washington State. ADNs and BSNs hired for acute care at our hospital. I think they (of course) prefer BSNs but they take what they can get.

I'm asking questions because I do NOT want to assume anything. And you're accusing me of "speaking for you" or "assuming" things yet you're doing the exact same thing to me. Where did I say that I am blaming "society's or men's fault" for discrimination against me? I agree with you; it is the fault of the individual AND the organization. What I'm suggesting is that "harmless banter" whether anti-male or anti-female can quickly turn into an issue if someone feels personally attacked by the banter. And there are plenty of men who might take stuff the wrong way and file a complaint with an HR department. I'm so happy your experience has been positive. What I'm simply suggesting is that preforming extra duties for the sole reason you're a man (which you seem to be implying but PLEASE correct me if I am wrong) does nothing to further gender relations. I feel like we actually agree on pretty much everything but somehow are having a miscommunication. EDIT: I have to apologize here; I think I inferred from your first post that your were doing all the heavy lifting/dealing with agitated patients in your ER when that wasn't what you were talking about. So I guess ignore that part in my response and let's focus on the "banter" section. I mean, unless you don't want to talk anymore.

So what extra duties are my female coworkers doing for me? Why am I going above and beyond for them? If you're doing the "heavy lifting for them" then of course they appreciate you but are you getting paid extra? If not, and they are not repaying you in some other way, why are you doing it? Not trying to be hostile at all. Just very curious. Because suddenly if one gender is doing more work than the other, it paints the picture that one gender is better at the job. EDIT: Yeah it's all workplace banter until someone (man or woman) gets offended and goes to HR and suddenly you have to attend sensitivity training or are moved around. It happened to me once. Based on everything I have seen (which is anecdotal, I admit) women are more often than not the ones believed when it comes down to "he said she said" cases.

Except I see so many people on this board, and in real life, going on and on about how increasing the number of men in nursing IS about increasing wages because "women get paid less for the same work". Why aren't we addressing the issue of lateral violence by offering assertiveness classes to ALL healthcare workers instead of "we need more men to stick up for the women".

I will let y'all know how the meeting goes and what conclusions we came to!

My point was: isn't the best way to assess if the patient understands the procedure, barring asking them, to be present in the room while the provider explains everything? I guess if you can't actually be in the room for the explanation, asking the patient if they had all their questions answered is the way to go. I really appreciate your advice, Folks. It has helped me a lot. We have a meeting between the clinical staff here (two LPNs including me, two MAs, and our manager) and I want to talk about consents to them: how have they been doing them, the legal aspects, how do they ensure the patient actually understands the procedure/surgery (if they actually do). Heck, maybe that's why they write "to sig only" underneath the witness line; because they are saying they witnessed the signature but did not follow up to ensure the patient understands the surgery/procedure. Again, thanks for the good advice and please keep it up!

Ok so here is how I handled this case: I called the patient and asked him if he felt he was provided adequate information regarding the procedure. He said he was and denied having any other questions and was able to describe it to me. I felt comfortable signing the consent form. I still would like my providers to have the patient sign in my presence but it worked out this time. I guess I can agree somewhat regarding MAs and consents but isn't that why you have the witness in the room when the patient and the physician sign? To actually witness that everything is explained?

Not sure as to the reason, but our surgery scheduler informed us that they cannot act as their own witness.

So I work at a surgeon's office as my main job. One of the duties we have (the LPNs and MAs) is signing the surgical consent forms as witnesses. After we room the patient, we fill out some basic stuff on the form and leave it for the provider. Usually the providers are good about holding off on signing the consent until they can track one of us down to witness. I don't know what the protocol was before I came to the office as I started at the beginning of this year, but I've had a surgeon not come get me when he and the patient signed the consent form. He just hands me the signed form and apparently expects me to sign it as a witness. I will not sign the consent form unless I have heard the provider going over the risks benefits and/or physically seen the patient sign the form. Every time I have brought this up with my MA coworkers, they seem to think writing "to sig only" after my name puts me in the clear. Would you guys sign a consent form that you physically did not witness being signed?