should a RN be a med tec for a LPN

[nowim clean]

My wife is a RN at a ltc facility and sometimes they will have her med tec when she does it is for a LPN, now I understand a LPN is never to be over or supervise a RN, so shouldn't the LPN be the med tec. My comes home and tells me how the lpn questions everything she does. I know as a RN even if you work as a med tec you are held to the level of RN, and where does the LPN come in to questioning the RN about treatment that was given? Thoughts please and I hope I hear from both LPN and RN.

[PediNrs05]

In all honesty I'm not sure how it works with the leadership duties. As an RN I've been assigned to CNA work quite frequently, and in some situations it was taking care of an LVNs and an RNs patients.

As a relatively new nurse I've found the title doesn't mean diddly about your experience, work ethic, and knowledge in a care setting. I have my bachelors personally. But I know several LVNs that can work rings around me, just as I know several BSNs that are downright scary with the way they practice.

What I'm trying to get at...if I was in charge of a patient and I had someone helping out, I would question things I felt were necessary because at the end of the day they're my patients. Doesn't matter what that persons title is, they're in my care.

Is she maybe being sensitive to working under someone with a lesser title?

Or, on the opposite side of the spectrum....I know a handful of LVNs that feel they have to be 10ft tall and bulletproof and show that to everyone all the time because they "only" went to school for a year. They may be the powetrip type which sucks.

[caroladybelle, BSN, RN]

What do you mean by "med tech"?As far as I know, one of the main and most important parts of a NURSE'S job is to give meds. Despite the fact that some states have permitted nonnurses to perform this task (an issue that many of us disagree with), this is one of the tasks that really deserves a certain degree of education to perform properly. A med NURSE, especially for LTC, really should be a well educated person and an RN is qualified. It requires skill, intelligence, organization and a continual flow of collaborative information between the med nurse and the care/treatment nurse to provide the most optimal care.While there may be nurses (LPN/RN) that "use" the opportunity to get over on someone, a certain amt of questioning is important and necessary.

[nowim clean]

Ok for some clarifacation, medtec where she works is someone who passes meds, but is not suppose to do insulin. In NC the BON says that no LPN should ever be over a RN. So there is a lpn who regardless of what wife does she questions her why did you do this, why did you do that? My opinion and only mine The RN should be the supervisor and the lpn the supervisee. I mean you delegate down not up correct? And no my wife does whatever she is told and does not rock the boat, I,m just saying I dont think it is right. Now if she was doing something unsafe, or causing harm YES say something, but she is not she is doing what she knows needs to be done. Such as hummmm her blood sugar is low think ill give them some OJ, why did you do that? Their diabetic did you....??????/

[NurseLoveJoy88, ASN, RN]

Us nurses really can't say rather the LPN is out of line or not because we are not there and don't know both sides to the story. In general, there are time when nurses will be assigned to pass meds or do "CNA duties" and there may be a charge nurse assigned to those patients, I'm speaking relatively about LTC. The med nurse and Charge nurse must me in constant communication as meds and treatments change regulary. The LPN may know something about the patient that the RN does not know and is just simply trying to convey that to her. Worse case scenario is that the LPN is just being a total know it all and trying to make your wife miserable. If that is the case your wife needs to professionally confront the LPN and if progress is not made go up the chain of command.

[nursel56]

Sounds more like an interpersonal issue. If your wife passed the meds and nobody said a word to her would the problem be solved?

Anyway, since you stated this was your opinion and yours alone it would be better if you let her post here and give us some more background information in order to better answer your concerns.

[nowim clean]

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aaq

can an lpn ever supervise an rn?

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a

an lpn may not supervise or monitor an rn. only the rnhas the authority to supervise, teach and evaluate nursingpersonnel. this component is the basis in regulation for the rn tohave accountability for the care delegated or assigned to others. it isimportant to note that this does not mean that the rn is responsiblefor the care provided by qualified individuals but rather that the rnis accountable for the decision to delegate the activities.the board advises the title "supervisor" not be used for a position

for which an lpn is assigned.

this was taken from the ncbon website so by the ncbon and the way i read it no a rn should not be the med tec reporting to the lpn i think that would fall under the monitor part of the bon's statement, it should be the other way around. if im reading it wrong then im sorry . i think i will contact bon and ask them.

[nowim clean]

I found my answer. This is from the ncbon websites and the rules for rn and lpn. It states it plainly. I copied it unaltered and posted it below.9/89 Revised: 1/91; 3-26-02; 4-2007; 1-2010 J:\PRACT\Handouts\Position Statements\DELEGATION AND ASSIGNMENT OF NURSING ACTIVITIES 1-2010.doc

Page 2 of 2 LPN Role in Assignment and Delegation:

• Assigns to other LPNs and delegates specific tasks to UAP following RN assessment and consistent with nursing care plan, provided:

o RN has validated competence of staff to whom activities are assigned or delegated,

o RN supervision is continuously available, on-site if necessary, as determined by client needs

o It is beyond LPN scope of practice to assign nursing activities to an RN.

• Maintains accountability for all assignments and delegations made to staff;

• Maintains ongoing observation of clients and their response to nursing action; and

• Supervision is limited to on-the-job assurance that tasks have been performed as assigned or delegated and according to standards of practice established in agency policies and procedures.

o It is beyond LPN scope of practice to supervise nursing activities of RN.

Bingo right there I knew it was written somewhere and i found it.

[caroladybelle, BSN, RN]

You are not getting it.Passing meds for a floor IS NOT WORKING BENEATH the LPN covering a group of pts. There is no subordination. Communication between the licensed nurse covering a group of patients and the nurse passing meds to provide optimal care to the pt is required. This frequently requires questioning between them. This also helps educate the other nurse about various issues. It has nothing to do with who is "senior".Has your wife never questioned an MD or NP regarding an order or meds prescribed. Is she violating BON policy by doing so? My question: Why are you posting this rather than your wife? It is not difficult for her to pose the question and provide more data. If she feels that this is a problem, she is be asking us.You can quote the BON all you want, but LPNs and RNs are both required to question and discuss between one another, to insure the safety of the pts. And the BONs primary job is to protect pts.If you truly have an issue and do not care for the answer, may I suggest calling the BON yourself, instead of arguing with an Internet BB.

[nowim clean]

Why are you posting this rather than your wife?

Because she does not even look at any forums, I too am a RN so it is so wrong for me to ask questions about something that I too may face one day? We are both RNs she does not complain about anything but when she talks to me it makes my wheels turn. I just read it as the lpn should be the med tec and the rn the nurse not the other way around, and who makes shift assignments? The lpn, just saying the way i read the bon statement that is not right.

[caroladybelle, BSN, RN]

Then call the BON.The designation of med nurse is not, in the majority of facilities, a subordinate position. And questioning, in and of itself, not insubordination. If it were, the majority of RNs across this nation would be in violation, for questioning various orders.Again, if you want a correct answer, call the BON, if you are not satisfied with our answers. They are the final judge of these issues.

[CapeCodMermaid, RN]

If there is a med nurse and a charge nurse, the LPN should pass meds and the RN should be in charge. The charge nurse usually is the supervisor of the unit and an LPN can not supervise the clinical practice of an RN.