StillNursin

On boy, I get so sad when I find out that what's happened to me - just isn't "unique." I think most LPNs ( including me!) would agree with Ratched Nurse in questioning whether a supervisor should be an LPN. It doesn't mean we're not highly qualified, or valuable to the nursing team- It's just not the way it works in Acute Care. ( SNF, LTC and VA- totally different stories!) It sounds like we've all seen our share of cruddy management , outright unsafe nursing practices and the downright perpetuation of "the good ol' boy system" in our careers. None of it is fun. Speaking up rarely makes you any friends- especially if you're new, and especially if you shed light on an issue that people at work have just ignored and accepted. I think you're awesome for doing what's right. Just don't forget about having that back up plan. ?‍⚕

I was deeply affected by this post, having experienced a very similar situation over the past year in the rural hospital where I worked up until this week when I was asked to vacate my position - for making the very mistakes "caliotter3" mentions, I started noticing unsafe practices with meds, antiquated/outdated policies, favoritism, nepotism, predatory nurse management practices, the allowance of CNAs to perform duties they were not qualified to do, etc. Unfortunately, being from another state (read: "you're not from around here, are you?" ) made me "an outsider," and no matter how correct I was to bring my objections, no matter how badly change was needed- I was the nurse who wound up being viewed as " difficult. " And, in the end, the nurse who LOST HER JOB FOR IT. I've been an LPN for 11 years, and had never experienced people in the professional arena so resistant to change as to put employee and patient safety at risk- reactive about everything instead of proactive. A patient falls? Let's see who we can blame. Patients complain that nurses aren't sanitizing their hands before and after care? No way could it be that the staff could use an inservice (what's that?) And sanitizer dispensers on the outside of the rooms in addition to inside.Perhaps it was the fact that I never cut corners with meds, charting, patient care, etc (and witnessed along the way a myriad of nursing no-no's that made my head spin) All the things we learned NEVER to do- HIPAA violations, (he's my mothers, brothers, cousins, neighbor and I heard he was here...) administering meds that dropped on the floor, sharps from am lab draws accidentally left in patients beds which on several occasions resulted in a needlestick, overriding the scan function at med pass, even sending doses of meds home with patients (hoping they'll take them later but documenting them as administered) the list goes on.... Maybe it was my poor assumption that the things above wouldn't happen-let alone be tolerated and perpetuated in a CMS-accredited hospital, or that I be treated fairly and talked to(along with my fellow nurses) instead of dictated to by a DON that excelled in the art of bullying her nurses into compliance with her scheduling and staffing needs... I can tell you from my own experience that it's a very thin line we have to walk as nurses at times- between what we know is right and ethical and the pressure to keep with the "status quo." This is even harder to do in small towns and small hospitals with staff who often equate any change to the "way we've always done it" as inherently bad or wrong. I can't express how much I sympathize with what you're experiencing, and think that a well timed resignation might be a good option- especially if you feel unsafe and you question the work of anyone. I made no friends by being outspoken about the issues at work and when I got nowhere with management, ensured that the care I gave was always above and beyond- documenting everything to the hilt, keeping a log of all narcs I pulled from Pyxis, refusing to cosign any med I didn't physically see compounded or the components, adding safety checks for fall risk patients ( because my CNA was "busy") and simply, doing a lot of work myself, to protect my license. For all the good I did, my refusal to simply "shut up and do my job" put a target on my back. I know however that I didn't compromise my ethics or sacrifice patient care. I may not have been a "team player" according to my supervisor, but when I think about it, that's not the sort of "team" I ever want to be a part of. No career is worth tossing your ethics out the window. I always thought "if you see something, say something -" but found that many people have the unfortunate mentality of, " if it ain't broke, don't fix it. " When it comes to caring for people, I think we, as nurses have an obligation to do things right- every time. But, if you find yourself in that impossible situation and you've tried all the appropriate remedies with management - and you still come up short, at least don't give them the satisfaction of firing you, too. It's no fun? Best of luck!

It looks like you've done your homework... Idaho is unfortunately (or fortunately, depending upon how you look at it) silent on a lot of scope questions for LPNs, but they are VERY specific in your responsibility when delegating - you are the license in the line. So, while you can delegate meds as you outlined above to a CNA which in Idaho is considered an UAP, they have to ALSO be a MA-C, which is a separate certification course of 80 hours and 40 hours of supervised practice. They also require CPR certification in Idaho. I've been an LPN for 11 years, and have not seen many CNA/Med Assistants-Certified, probably because Medical Assistants and LPNs have some scope overlap. You tend to have one or the other at a facility. My advice when delegating would be to ALWAYS check and double check, and remember that good, bad or indifferent - the responsibility rests on your shoulders. Good luck! http://www.legislature.idaho.gov/idstat/Title54/T54CH14SECT54- 1406A.htm