RN Graduate Establishes Dominance

[nicmdavi]

Hello fellow Nurses!

I am in need of some advice and alternate opinions. I am experiencing difficulty making a decision on what to do. The situation is as follows:

I am an LPN working for a General Surgeon and Nurse Practitioner. I am the only clinical employee in the office; so, needless to say, the work load is WAY too much. They recently hired a medical assistant for me to help. I was so excited to have a partner/coworker; and, even more excited to have a Graduate Nurse from an RN associates program. She graduated six years ago; however, she is not licensed. She failed the NCLEX five times and decided she was done trying. This was the reason she gave in the interview for not becoming licensed, "Family is more important to me and I didn't want to work RN hours." At first, I was perplexed but thought that maybe life handed her some higher priorities. Now I know she lied about it. I wouldn't have thought any different of her had she told me the truth. I guess I am rambling so I will get straight to the point. She has made multiple comments to me, the providers and the my other coworkers about her superiority compared to my LPN status. She has tried to tell me how to do my job ( mind you it is only her second week working ). She will cut me off mid-sentence when trying to teach her how to do something in order to let me know she is already aware of how to do it; however, she does it incorrectly. There are so many other things this person has done that disappoint me greatly. I would never ever disrespect a fellow RN or LPN and I have never been treated as a lesser equal by those RN's I have worked for. It is quite the contrary: They have asked me for help/advice in areas I was more knowledgeable in and vice-versa. Friends are telling me I need to assert my authority right away but I am a very passive person. Plus, I really wanted my assistant and I to have a great working relationship. Like police partners...sharing the load and having each others backs. I guess I am hesitant to assert my authority because I do respect her for graduating from RN school (even though she is not an RN, Not even a certified medical assistant) I know it is drilled into LPN's during school to always report to their RN;so, maybe that is why I am lacking in putting my foot down. Maybe in my mind she has some authority over me??? I am a bit surprised in the lack of her basic nursing knowledge for a graduate nurse, for example: not knowing what warfarin was, or knowing that Mycin antibiotics are not Penicillins. ( Maybe those are just some things she forgot right? I mean....I don't remember everything ) I feel so indecisive and confused. I guess what I really want to know is this:

Would I be in the wrong for treating her like a medical assistant and not a graduate nurse?

I gave her my trust and the privileges of a graduate nurse but now I am thinking the better of it. She doesn't respect me at all and has made that quite clear. I am so bummed out. Any suggestions, reassurance, advice or opinions would be MUCH APPRECIATED!

-Nic

[Sour Lemon]

I have no advice, but she sounds like a complete nightmare. I can't imagine why your employer would want to hire someone who failed NCLEX five times ...into any position. Have you discussed these issues with your employer(s)? You'll need to have their support if you hope to keep her in line, but it might be better to just show her the door.

[Cat365]

She is not an RN. You are an LPN. You took the test and passed it. She did not. She is an unlicensed assistive personnel. Perhaps a highly educated one, but still no license.

You know your job and she is your assistant correct? You have the seniority.

Anyway you you break it down you should be the senior one of this working relationship. You need to assert yourself. If that doesn't work you need to take your issues to a higher authority. If she can't adjust her behavior she needs to be replaced.

For one thing if she starts acting in the role of an RN without a license it can be dangerous for the patients and open the practice up to potential lawsuits. It is not just a matter of senority. It is a matter of safety and legality. If she proves uncooperative she needs to be fired for the safety of all concerned. You need to form your objections in this way. Not that you can't work with her, but that this is dangerous.

Assert yourself YOU are the nurse, not her. It is your responsibility to delegate and be an advocate for your patients. A diploma doesn't matter if you can't pass the NCLEX. Also I just looked recently and the dang thing has about an 80% pass rate for first time takers. She couldn't pass after 5 attempts? What does THAT say about her?

[evastone, BSN, RN]

When I was in college, a professor once told me that respect is earned, not given freely. You have earned respect from your colleagues through your years of dedicated service. She has not.

Intervene if this person puts patients at risk but otherwise let nature take its course. If she continues to disrespect her coworkers and diregards their advice she'll soon be lacking a job.

[kidsmom002]

Graduating from nursing school does not make someone a nurse. Someone can only claim to be a nurse if they pass the NCLEX. After 6 years and 5 failed attempts to pass NCLEX there is no reason to treat her as a nurse much less be afraid to exert authority over her. You are licensed and she is not. Do not allow anyone to convince you otherwise.

[vanilla bean]

Would I be in the wrong for treating her like a medical assistant and not a graduate nurse?

Absolutely not. It's the job she signed on for. The reality of the situation is that she's *not* a nurse and *you are*.

[Rocknurse, MSN, APRN, NP]

Sounds like she's incredibly insecure and trying to make up for the fact she's a failure. Tact is a very important component here. You must be quietly, discreetly tactful and assert yourself with dignity in a non-demeaning way. But assert yourself you must. Remind her that you have the license and that she is therefore bound to do what you delegate to her. Just state "I simply can't have you make those kind of decisions because you are not a licensed professional". Keep at it and don't be bullied.

[Libby1987]

It doesn't matter what education she's had or even what licensed she might hold, the issue between the two of you stems from personality and self worth.

I'd treat her like any other new employee and write her up as appropriate and work towards letting her go earlier sooner than later if she comtinues to behave inappropriately. But don't set her up through your own insecurity. There is a culture in your office that seems to be positive, comtinue to live it, teach it and accept nothing less from her.

[JustBeachyNurse, LPN]

GN status is dissolved after your first nclex attempt. Either you pass and you are an RN or you fail and you are a general citizen until you pass the nclex. She's unlicensed assistive personnel. If she acts like anything more she is out of line. She is not a nurse.

[Been there,done that, ASN, RN]

Who is evaluating her performance? If it's you. get her canned.

If it's not you, report her performance, and get her canned. You need somebody in there that will learn the ropes and work WITH you.

[BostonFNP, APRN]

What a nightmare for the office, why did the practice manager even consider it. Ugh.

She is not a graduate nurse. She is not any type of nurse.

Like other have said, drop a comment about how unlicensed personnel don't make those decisions.

[Extra Pickles]

I'm surprised that she was hired if her line for not having a license is that her family is more important than working RN hours. Anyone who has a license should know that is BS. People do decide to not work as RNs after they are licensed, but I've yet to meet anyone who could pass the NCLEX who chose not to take it. She told your employers that she chose not to take it instead of telling them she failed it five times. I have no idea how it is they believed that load of horsepucky but hey it takes all kinds.

like others have said she is not a graduate nurse and if she tells people that she is intentionally misleading your patients. She lost her GN status the first time she failed the NCLEX. What she is is a person with an associate degree but no qualification to use the degree as she couldn't pass a minimal competency test.

You have to stop being the patsy here. This is no time to resort to being passive or she will march all the heck over you, happily. When she steps out of line, look at her and say I know you said you learned this in school, but you aren't authorized to do/say/whatever that here.

Do your bosses respect your opinion? Do they trust your judgment? if they do now is the time to pipe up and tell them that she is acting beyond her scope, inviting trouble for the practice, and that you hope their insurance premiums are paid up because she's going to do something harmful to someone before long.