momnurse6

Thank you so much!

LTCAngel, I have been a nurse for over 20 years and I agree with you that lumping LPNs under one umbrella is unfair. As I stated I am NOT bashing LPNs. I have worked with and trained LPNs as a instructor. I have also mentored RN grads. Many of the LPNs that I am currently working with are great! However, I have encountered many that have raised my concerns for residents. I have spoken with adminstrators and DONs and many times nothing is done. Some of the LPNs describes these LPNs as a warm body; similar to how some agency nurses where called when I worked the night shift in the ER. I understand I work with a variety of people some excellent, some not so great, some irresponsible, however my concern remains with the residents. My intention was not to insult any one or profession but to get suggestions for help.

I am a new NP and have been working in LTC for a little over 6 months. I am having a very difficult time adjusting to this type of environment. I have worked with LPNs, however, my experience with LTC LPNs has not been positive. Just like in the hospital, we have great nurses and then we have nurse who are not so great. In LTCs I have encountered too many not so great nurses. I worry that although I speak slowly and I think clearly and spell lots of what I am ordering the order is transcribed wrong and sometimes not at all. One great example while on call this weekend, I got a call from a facility telling me about a resident who's BS was over 500 on the 7-3 shift, I got the call at 7pm. The nurse told me the pt did NOT have a hx of diabetes and the patient was given insulin without an order for insulin. I asked why was the BS checked, the nurse could not tell me. So I asked many questions, ordered a work up for diabetes including fluids and to call me back with BS at HS (no call back). I tried to call back and no answer at the facility. Only after I spoke with nurse practitoiner for this facility that I found out that this patient was diabetic and did have orders for management of diabetes....Oh my goodness. I am not bashing LPNs, I would just like some suggestions. I have spoken with DONs and I have spoken with administrators to no avail. If anyone has any suggestions I am completely open.

I am a new NP and I am working in Long Term Care with residents who have end-stage illness. As a RN I loved my job, as an NP not so much; I question and worry about every order or decision I make. I worked in an ER but it was 2 hours away, I worried about my decisions but not as much as I worry now. One of the doctors I work with told me it would take about a year or so for me to be comfortable with my new role. My question is for noviced and experienced NPs; will this pass or is it my setting? I have been working in this setting for 6 months.