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.
I guess because ive walked both sides of the fence i see the grass is not greener on the other side. I used to work DD also as a LPN. Thats a different world.
Hmm, wonder if those RN's ever thought if they split it up and all went out and did them at the homes they could have been done 6 hours earlier and went home or shopping for the afternoon. LOL guess they didnt think that far. Suckers!!! i would have.
I guess because ive walked both sides of the fence i see the grass is not greener on the other side. I used to work DD also as a LPN. Thats a different world.
Hmm, wonder if those RN's ever thought if they split it up and all went out and did them at the homes they could have been done 6 hours earlier and went home or shopping for the afternoon. LOL guess they didnt think that far. Suckers!!! i would have.
Obviously they didn't think that far.
I'm not grouping all RN's into one group, but several I've worked with have that attitude, and if they can get away with it, they will. I do know a few who won't do it, but a just a few.
I also have come across very few RN's who will give meds.
Where I work they'll call every LPN who is off no matter what shift she works to get someone to come in, if someone called in sick. VERY few times have they actually come in there themselves and went to work.
It sounds like the LPNs do much of the RN duties. I mean, what did the RNs go to school for if all theyr'e going to do is vital signs every 12 hours on a handful of patients, and chart once on these handful of patients while the LPNs are doing pretty much ALL of the technical skills that the RNs should be doing? How backwards is that?
Specializes in Gerontology, Med surg, Home Health.
I'm not sure I get it. There are RN jobs and LPN jobs??? At my facility there really is no distinction in who does what. About the only thing the LPN's can't do is sign off an MDS, but as far as patient care, everyone does everything. Some of our managers are LPNs. I have a feeling if we pulled that stuff everyone would quit. We carry a Medicare/Managed skilled census of about 28-33...the LPN's work on the skilled patients as well as the long term care patients. I'm glad to say that the nurse's assignment is usually based on what they know as opposed to the initials after their name.
I am so sad to hear that any nurse regardless of level of education would feel it was fair to the patients and/or her co-workers to divide patient care that way.......this is one of the many reasons there is a nursing sortage...if we as nurses can not learn to take care of each other,how can we expect others too??? As an LPn I personally would not accept an assignment of 120 pts EVER..and I would not accept it with 2 other nurses present not willing to divide them,I would find another job asap and not subject myself to the pending lawsuits that are sure to occur with that kind of nurse-pt ratio......
It's the same way at my facility. With a few excepts, the RN will not work, period. Sit and watch, take breaks, talk, ect. Work? NO.
They have scheduled a few RNs into LPN postions. I have to follow both RNs and LPNs. The unit is divided into teams by room numbers, so the split is usually equal. Following the RN, can be a real pain. They don't seem to be able to finish their work, keep their cart clean or stocked, or put away anything. I start at 10:30, on the RN side, I have to finish the 8pm meds, give a back lash of PRN meds, figure out what is wrong with the new admits, because the RN can't seem to remember what their dx, and beg for information that should have been given in report. Oh, whats this a new pt, and you 'forgot' to mention him? ect. I'm not saying every LPN is easy to follow, but never as hard as the RNs I follow.
I used to work at a hospital, at night, just me and an RN. The RN got to divide up the pts. You would never queese who got all the alzehimers and violent pts. Or who would get pts who would need 1000 cc tap water enemas until clear? Not the RN.
I am studying for my RN, will be a while before I get there. There is a couple of really good RN's who I use as my examples. But, at my facility the attitudes and inabilities of a lot of the RNs make it a joke to emulate. I would be going backward instead of forward in my career if I were to follow their example.
I think it is a matter of pride and personal respect a lot of people are missing. It's like they take a lot of time to comb their hair and put on makeup, but forget their attitudes spoil the finished product. It's like putting a gold ring in a pigs snout. I really hope I don't sprout an attitude when my training is donek as I have lived on the other side for so long.
Specializes in Education, Acute, Med/Surg, Tele, etc.
We have RN's and LPN's responsible for all 160 patients in my facility no matter their title really, the only difference being the RN does all the delegation/assignment during their shift as well as the 160 residents (so the RN's have more work actually, we have 11 caregivers who do all direct care and oral meds, and ONE LN (licensed so RN or LPN) do all injections, PR, and all treatments.
Luckily we do not accept patients with tubes (with the exception of a foley or two)...so that relieves us a bit with 160 patients and ONE LN per shift!!!!
I feel for that LPN so very much...add tubes to my 160 and I would run out the door screaming!!!! I felt like we were abused and overworked...my GOD! Those LPN's are sure dedicated...I sure as heck wouldn't put up with it, I thought our facility was borderlining the patient safety issue...yours IS without a doubt!!!!
Is is "Assisted Living"? For some reason they get away with so much in the grey areas! Especially when it comes to patient ratios! I work in one and I have asked questions of my State Board about staffing and ratios and they WILL NOT answer me or even send me a e-mail saying they won't answer me or don't know..UHGGGG! Makes it hard to know the rules and to enforce them...which I believe RN's are mandated by THE STATE itself to do...OH CALGON TAKE ME AWAY! LOL!
Good luck to you...I would keep actively searching for another job!
meownsmile, BSN, RN
2,532 Posts
I guess because ive walked both sides of the fence i see the grass is not greener on the other side. I used to work DD also as a LPN. Thats a different world.
Hmm, wonder if those RN's ever thought if they split it up and all went out and did them at the homes they could have been done 6 hours earlier and went home or shopping for the afternoon. LOL guess they didnt think that far. Suckers!!! i would have.