RN working in LPN position

[love_ur_nurse]

I work in a LTC setting. For the last month, they have been scheduling an RN in an LPN position. Where I work, there is one RN and two LPNs on dayshift. The two LPNs divide the 120 residents while the RN only deals with the 7-10 "skilled" residents. When they schedule an RN in the LPN spot, it leaves the one LPN to care for the 120 residents alone while the two RNs sit and care for the skilled. In our facility, we have 2 trach, 2 peg, 34 diabetics, etc. that the LPN is responsible for. This leaves the LPN to handle all IV, UA, Peg, Trach, skin tears, labs draws, and whatever else comes up. My question is, how do I handle this in a way that will not offend anyone. The LPNs are drowning at work.

[Fiona59]

Whenever we had an RN scheduled to work in an LPN position, the RN was required to perform the LPN's duties. She didnt get to pick and choose what she wanted to do. She was there at RN wages to perform LPN duties. It was made clear to her when she accepted the shift.

Heck, I've worked in RN positions with the other RN's picking up my IV meds when staffing was unable to fill the RN position and had to bring in LPNs.

You need to talk to staffing office and see what their expectations of this filler nurse is!!!

And if your unionized speak to your steward.

[LPN1974, LPN]

I work in a LTC setting. For the last month, they have been scheduling an RN in an LPN position. Where I work, there is one RN and two LPNs on dayshift. The two LPNs divide the 120 residents while the RN only deals with the 7-10 "skilled" residents. When they schedule an RN in the LPN spot, it leaves the one LPN to care for the 120 residents alone while the two RNs sit and care for the skilled. In our facility, we have 2 trach, 2 peg, 34 diabetics, etc. that the LPN is responsible for. This leaves the LPN to handle all IV, UA, Peg, Trach, skin tears, labs draws, and whatever else comes up. My question is, how do I handle this in a way that will not offend anyone. The LPNs are drowning at work.

So, are you saying that instead of two LPN's and one RN, now they're scheduling 2 RN's and one LPN?

What did you mean when you said you "sit and care for the skilled"?

And the one LPN is getting all that dumped on her?

That's awful. I don't know who is at fault there, but as an LPN if I had to care for 120 residents....well I just wouldn't do it. I'd turn in my notice as of yesterday.

Then the 2 RN's could deal with it.

If you are one of the RN's in this situation I would like to enocurage you to step up to the plate and do something about this.

That's an incident or medication error big time waiting to happen.

Does the LPN give meds, also to all those people???

[love_ur_nurse]

Whenever we had an RN scheduled to work in an LPN position, the RN was required to perform the LPN's duties. She didnt get to pick and choose what she wanted to do. She was there at RN wages to perform LPN duties. It was made clear to her when she accepted the shift.

Heck, I've worked in RN positions with the other RN's picking up my IV meds when staffing was unable to fill the RN position and had to bring in LPNs.

You need to talk to staffing office and see what their expectations of this filler nurse is!!!

And if your unionized speak to your steward.

Thank you for your response. I work at a "family owned facility" (not union). I just feel like I can't provide the proper patient care I need to d/t time constraints.

Thinking of going to work somewhere else.

:o

[LPN1974, LPN]

Another comment...for crying out loud, don't worry about offending someone! That's unsafe staffing!!!

You're killing the LPN. I cannot believe 2 RN's would care for 7 to 10 residents when one was doing the job and dump the rest of that on the LPN.

That makes me so angry.

[meownsmile, BSN, RN]

I agree if you are scheduled to work for the day instead of a LPN, you should be doing the other LPN's duties. As a LPN i would be fighting mad if they called in a Rn to work rather than a LPN and she and another RN only cared for 7 skilled patients. Give me a break. Sounds like people around there should get a clue. What would happen if they didnt have any LPN's in the facility, would 3 RN's care for the 7 skilled patients only? Think about it, someone is shirking their duties.

If there is a problem about who is working LPN duties, get yourself a notebook, list everyone and put in dates of last working LPN duty and take your turn.

If this kind of stuff keeps up, you wont have LPN's to work anyway, id be the first one out the door if i saw 2 RN's sitting and only caring for 7 patient while i had 120 to deal with. And as a former LPN and present RN, i wouldnt let it happen to a LPN i worked with.

I dont mean to sound so harsh but this is exactly how RN's get a bad rap.

[love_ur_nurse]

so, are you saying that instead of two lpn's and one rn, now they're scheduling 2 rn's and one lpn?

what did you mean when you said you "sit and care for the skilled"?

and the one lpn is getting all that dumped on her?

that's awful. i don't know who is at fault there, but as an lpn if i had to care for 120 residents....well i just wouldn't do it. i'd turn in my notice as of yesterday.

then the 2 rn's could deal with it.

if you are one of the rn's in this situation i would like to enocurage you to step up to the plate and do something about this.

that's an incident or medication error big time waiting to happen.

does the lpn give meds, also to all those people???

i am an lpn in rn school. the lpns at the facility are responsible for adm the narcotics, ivpb, all insulin and finger sticks, peg meds, etc. we have recently been added the job of central line flush. by "sitting and careing for the skilled" they get vs 1x on their 12 hour shift and only chart 1x. the lpn gives their meds., peg flushe, nebs, etc. i have only been at this facility about 6 months but am getting very tired of the abuse.

[meownsmile, BSN, RN]

You've got to be KIDDING!!! Get the H*** out of there quick. That home doesnt deserve to have you. And on the way out the door write down the abuse hotline number and CALL IT QUICK. Not only are they abusing you, but they are abusing the residents too. Putting them in harms way BIG TIME.

[love_ur_nurse]

You've got to be KIDDING!!! Get the H*** out of there quick. That home doesnt deserve to have you. And on the way out the door write down the abuse hotline number and CALL IT QUICK.

Thank you all for the support. I know the RN has more education and deserves respect for what they know, but I also feel like the LPN and patients deserve better. I will be going to the DON and possibly another facility.

[meownsmile, BSN, RN]

Uhmm, exactly why the RNs need to be out there doing the work too. She does have more education.

I guess you can chalk this up to a learning experience if you are in school. After you graduate and get your license dont ever do to others what has been done to you. You'll be much happier.

[love_ur_nurse]

Thank you all for the support. I know the RN has more education and deserves respect for what they know, but I also feel like the LPN and patients deserve better. I will be going to the DON and possibly another facility.

Here's another tad bit of information. The RN makes 22/hr while the LPN makes 13/hr. Go figure.

[LPN1974, LPN]

I dont mean to sound so harsh but this is exactly how RN's get a bad rap.

You are so right...I agree with that. I KNOW that not every RN on the face of this earth would do that, but I HAVE seen it happen many times. If some {and I'm trying to choose my words carefully here so as not to offend} know that they can get away with it they will.

Where I work I saw this. Let me give you the setting, ok.

We work in a facility, at the time had about 130 Developmentally/disabled people, with about 15-20 living in 8 different homes.

It's in the middle of summer time Ok?

3 RN's sat at a table in the clinic and made the unit clerk go out to pick up one resident at a time in the campus vehicle that we have to drive, simliar to a little golf cart, only this one was enclosed, not open to the air.

Remember, it's hot weather.

Ok, she had to do this all day long.....go pick up a resident and bring them to the clinic, remove their shoes and socks, then the 3 RN's did a physical assessment, the clerk had to put shoes/socks back on, transport that person back to the home and pick someone else up. Same thing all day.

Those 3 RN's could have gotten off their lazy a$$e$ and went to the homes and did the assessments.

I did not work the dayshift, I came in at 2:00 PM, but I was told by the clerk and other staff that this happened.

And yes, I believe it happened, because I know those 3 RN's very well.

And yes, thisis the reason RN's get a bad rap. For heanven sakes, RN's roll up your sleeves and go to work! There's alot to do, and one LPN or one person here or there can't do it all.