should a RN be a med tec for a LPN

Specialties LTC Directors

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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.

Specializes in LTC, Hospice, Case Management.
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.

Maybe you should just go demand to speak the the DON of the facility and demand to know why this is happening. (Uhhh..just kidding)

Really this is not your battle. Not sure if it doesn't bother her why it would bother you so much. I was an LPN supervisor in LTC for years and a few of the RN's out right scared me...then there was also a few that came in as the "almighty" RN that had no clue regarding LTC regs and just plain did things wrong. (Of course there are some really scary LPN's too).

Just let it go -

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Specializes in ER, Med/Surg, LTC.

When it come to LTC facilities, it is a completely different entity. I worked at one for 3mths and the fact is, most RN's do not stay long, you will find that as LPN/LVN jobs diminish, most find themselves working at LTC, and most are put in floor supervisory positions.

Think of it as a learning experience, because most LPN/LVN's are very knowledgeable.

I would not take it personal I am sure your wife as an RN is only there for a short time, probably until she gains enough experience and can get into a hospital setting..........

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

You keep using the term "works as a med tec". That is not accurate - unless as you stated before - your wife does not give insulin. A med tech passes meds with restrictions. A nurse does not. They are not the same thing and shouldn't be used interchangeably.

Your state BON is the only authority you can tap into (as you did) - the other 49 states have their own written regulations. In a real life situation involving co-workers sometimes an LPN questions or "supervises" - if you will, especially if the LPN has more experience in that particular area. I've oriented LPNs and RNs to home care cases, for example. I've never seen anyone get bent out of shape because it happened to be an LPN providing the teaching for that area and if you focus on that too much it will be very hard to work as a cohesive team. I'm glad you found the information you sought, though!

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Capecod said it...the LPN cannot supervise the clinical practice of the RN but...she can ask questions.

Lets say that I as an RN works as a CNA...if the nurse on duty who happens to be an LPN asks me a question about care..."Did you put the barrier cream on Mr Jones or is Mary's splint on?......is she just asking about her residents, supervising me or just making sure that care was done?

In the OPs sitiation..its hard to know exactly what went on..was that nurse just finding out what care was done or trying to "boss" the RN around?

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Ok I understand what everyone is saying about the lpn asking questions, maybe I should have asked who should be the med tec the RN or the LPN. If it's the LPN then she is supervising the RN. I mean that is how I see it. Maybe Im reading more into the BON than I should, but if you have a RN and a LPN the LPN should be doing the job that med tecs do and the RN doing the nurses job. By NCBON a LPN can not make certain assessments so it only makes sense to me to use your RN to the highest level of care and as the care goes down let the other staff do them. Its hard to post on a BB cause you can not always come across the way you want to. And if I am being narrow minded I'm sorry. I as a RN am trying to understand why managment would ever have a higher degree employee doing what a lower degree employee could do and have that same lower degree person doing what the higher person should be. I work in a hospital and no they do not hire lpn and the ones that are there are used as cna 2, not a nurse. I just dont understand it, even if I was not a RN and I was in management I'd have my RNs taking patients and lpns doing the float/ medtec if needed. No insults were meant just trying to satisfy my mind.

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I am reading this with my chin hanging down at the responses you are getting and asking myself ?? Where is CapeCod Mermaid to set the record straight? Oh a sigh of relief when I see the appropraite response.

I too have been in this arena for a long long time....33 years to be exact....CNA, med tech, LPN, RN and on the story goes....There is a heiracy and a reason for it. Thankfully, there are regulations and you can guarantee if something went wrong and someone had to answer to it...it would be the RN. She/He is the responsible party on the shift. I was an LPN for 10 years and a Charge Nurse in SNF at that time. I remember being upset that in my Practical Nursing program I was not taught lung sounds. I had to get that later during employment. I later returned to get my Nursing Degree and I asked why they had not included that in my PN program and was told...It is not in the scope of practice for an LPN to do assessments but it is the role of the RN. Why, of course!

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Specializes in Geriatrics.

I knew of a RN that only wanted to pass medications as she only worked every other weekend which left the LPN in charge. This was a mutual agreement and the facility knew this. Something went horribly wrong one weekend which involved the state health department. When everything was finished the DOH turned the RN into the BON not the LPN, despite the fact the RN was "just passing medications".

It has been said here before- it is not in the LPN scope of practice to perform assessments- notice that is missing in the ADPIE equation they learn. The LPN can not supervise a RN's clinical skill when it's not in their scope of practice.

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Common sense tells you that the LPN should be the med tech and the RN should be the area nurse in those cases. We had a nursing supervisor who took a CNA assignment one time instead of putting the LVN in the CNA assignment. She thought she was garnering favor with the nursing personnel but all everyone did was to talk about how she could not handle the nurses' job, much less the CNA's job.

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I guess I could sort of see this scenario happen if your wife was in orientation with the LPN to learn the med pass part of the job. I have oriented new RNs on the med carts in the past. Then they move on to other phases of learning the job.

The other scenario is if your wife was one of those unfortunate RNs who cannot find work and was hired into a facility to work as a med tech until something else opens up.

Other than that I don't understand the situation.

As an aside, when I was in school for my LPN, we spent an entire clinical rotation on a med/surg floor doing nothing but assessments. Then we had to continue on with the rest of the dPIE in order to pass that rotation. So although we cannot do them as working LPNs (except in LTCs where there is an RN signing off, which is a whole different can of worms) we do learn how to do them, or at least, I did.

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I've bumped myself down to a CNA or LPN duties when needed. I've worked with other nurses that might not have been able to do the LPN work or CNA work. I was still accountable for the staff and residents at the RN.

Yes...it makes sence to have to delegate downward? Or that the LPN should maybe fill in as the the CNA or med tech but it doesn't always have to be.

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Specializes in Gerontology, Med surg, Home Health.

I'm not sure I'm getting the bumping yourself down to LPN duties. Don't you all pass meds and take care of patients?

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Specializes in geriatrics, management, home care nurse.
I'm not sure I'm getting the bumping yourself down to LPN duties. Don't you all pass meds and take care of patients?

Thank you CapeCod,

When I began my nursing career in 1990, actually when I started working as an rn in a ltc facility in 1992, our ADON was a LPN. She was in charge of all of the staff, and sometimes I felt belittled by her due to being a fairly new nurse, and her familiarity of the facility as she was there 9 years, however she left in 1992 and I was promoted to ADON. As ADON and a RN there were tons of times that I worked as a CNA when they were short staffed etc... In a long term care facility sometimes there arent any other options whos going to do this or that. You have to work with what youve got and do the best you can. Sounds to me like this lpn you are talking about may have some insecurities about her own prof. status or may be jealous of your wife for having her RN. (Women working with other women sometimes can get ugly.) Unprofessional but true. What I'm trying to say is that it isn't uncommom for lpns or rn's or adon's or dons and sometimes even administrators to work as a cna, med aid, etc...Actually I believe that a good boss should work in all nursing depts so she/ he understands what the cnas have to do and what they have to go through when theyre short of staff etc...I was a cna for 5 years after graduating form high school and i remember having nurses or management walking over the entire nursing home to tell me a res. needed to go to the bathroom or was soiled. I had an admin. point to a kleenex on the floor as we both walked by it, she was closer to it and say, " pick that up". I felt like a peon, slave when in actuality cnas are the reason our homes survive. Also, it is up to the charge nurse whether that be an rn or lpn working with an rn to schedule the staff to what they will be doing during the shift. Its kind of hard to give you the correct answer to your question as only your wife knows if the lpn is out of line in what she is asking your wife. Who ever is acting as charge nurse is who the cnas and med aids need to answer to. And yes, if the charge nurse is the lpn then yes, the nurse acting as a med aid should answer to the lpn. This is according to my state however where i was working as rn.

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