Sick of the negativity on my unit!!!!!

[pink2blue1]

:angryfire

I am an LVN in California. I work on a very busy and fast paced Med-Surg unit. Our specialty is post surgical patients. So we get everything from lap appy to total joints to bowel resections....anything where the patient is stable enough to come to the floor. Our ration is 5:1. Well since I am an LVN I cannot Assess, I cannot hang IV piggy backs and I cannot do IV push. I understand that in other states LVN/LPN scope of practice differs. Since I am IV certified, I can hang blood and blood products. That being said.....

Every shift I work I have to have an RN cover me for piggy backs. Usually it's the charge nurse. Also the night shift makes out the schedule for day shift, and they TRY to give the LVN's the least amount of piggy backs. However, lately it seems like every shift I work, there are 2 lvn's. It's been hard. LAst Friday and Saturday, 2 LVN's and NO CHARGE nurse. Well the RN's are getting pissed that they have to cover, or hang piggy backs. Myself, I feel awful that I am imposing more work on them on this already busy floor. I always offer to do a PO in place of my piggy backs or anything I can to help them. Problem is that the other LVN on the floor (Been there 3 years!) is "lazy" according to some of the other nurses and NO ONE wants to cover her, also according to the RN's. I feel bad. I also feel like I am getting a negative stigma placed on me because I am an LVN too. Since starting I have come into my own pace and rhythm and people now trust me more than the other LVN. But again yesterday, on a busy day, I had 5 patients, and somehow I ended up with Piggy backs on 4 of them! It was A LOT. One of the RN's made a comment about how she hadn't seen the Charge nurse and I told her I had. Then she snapped and said "OH with all of YOUR patients, you know, I don't know why they do this to us, becuase when this happens WE HAVE NO CHARGE NURSE!" Omg, I was mortified. I quickly told her that NO it was not only MY patients. She had also bee starting IV's on other peoples patients. We started the day with 29 patients on the floor and ONE cna to do vitals and help the nurses.

I am not sorry I went this route, but I am getting VERY frustrated and the negativity toward LVN's. I am tired of people acting as though I am less competent, not because I am a NEW nurse, but because I am an LVN.

For the record, I worked on this very same floor as a CNA for 4 years before I graduated and passed boards. I worked with these same nurses. Now I just feel like crap and I dread going in when certain ones are working the same shift as me.

Any other LVN's feel this same way???

[pagandeva2000, LPN]

I would remind them that you are operating under the scope of practice as illustrated by the board of nursing in your state as well as the protocol of the facility that you work for in any manner that it takes for them to get off of your back. One of the things I have observed is that nurses that went straight to becoming an RN have not been advised or oriented to the scope of practice of the LPN in their respective programs and therefore, they may view this as they see a licensed NURSE who is needed to perform a BASIC skill and not knowing any better this may frustrate a busy RN that has more advanced issues to deal with.

I have a similar issue going on in the clinic I work with. LPNs are unable to administer a flu or pneumococcal vaccination without screening or assessment by an RN, even with a physician's order. Interesting enough, I work for an agency as a vaccination nurse, and this has NOT been an issue working at flu clinics, with two LPNs and no RN supervision. But, the protocol at my facility does not allow this. Now, this is insane to me, because I equate these vaccinations to administering medications such as (these are examples) vancomycin, digitalis or HTN medications. Now, no nurse I know of can administer any medications without a physician's order. If any of us see these medications I mentioned, any nurse with basic knowledge is aware that we have to assess for certain parameters such as is the patient experiencing tinnitus or dizziness, taking an apical pulse or if the blood pressure is above or below certain parameters, we hold the meds until the physician (not even an RN) further assesses them and makes a decision. The same to me applies to the flu and pneumonia vaccine. If the patient is allergic to eggs or such, we hold the vaccine and tell the physician. We would have epinepherine on hand for anayphylaxs, right? Well, they have allowed the clinic to back up to the point that patients are waiting for over three hours for a simple pneumonia vaccination. The RNs that I work with think very highly of me, because they say that I work hard and am very observant. But, that doesn't stop them from being highly annoyed because they have to be interrupted for something silly. I do not take it personal, though; and the rare blue moon that one has gotten a bit snippy, I have reminded them that this facility has not allowed me to do this (I got sort of nasty as well), and from then, they have not gotten rude with me. And, I know that they were not mad at me, per se; it is that again, they see a capable nurse that can perform this basic skill and yet, they cannot utilize me in that manner.

I would speak to these nurses by saying to them that it is clearly not YOU that is causing this, but this is also your license that has to be protected in the same way that theirs has to be and you have to work within your scope of practice. If they still get a bit funky, ask management to come and speak to you all as a group to reiterate this fact. Bottom line is that there is nothing that they can do about this...period. Hate to say it, but that is what they get the bigger bucks for. And, if this continues to frustrate you, this may give you the incentive to decided to go for further education yourself if that is what you wish. Good luck, and try not to take it too personal.

[pink2blue1]

Thanks pagandeva! In most cases the RN's are awesome and they do say "It's not your fault and I am not mad at you" but they object to covering because it puts them "out of ratio" But this one RN I was talking about DID direct it at me and she was mad. I spoke back as best I could. Thanks for your post.

I am already starting on my RN program, so I do not plan on staying and LVN for much longer! But still, while I am here I would like it to be a pleasant experience.

[bellasage]

I think I love it when negative people say "I don't know why they do this to us..." I hear it all the time too.

I just want to say HEY you don't likey??? You leavey!!! I just can't take it as well! I hear more complaining than people working! Yeah there are some new rules and policies that just make work harder but hey you know what its probably going to cover your ass at the end.

I remember this one nurse spent more time bitching about this new form than the time it actually took to finish the form!

Silly....

But you also have to put yourself in the hospital admin. place. You are the one responsible for everyones life, and you want to make sure your nurses are responsible, doctors are responsible and so on... So to make sure that certain things/steps are done I think they come out with these forms to be filled. So you can't say you didn't know...

[Ginger's Mom, MSN, RN]

When I worked Medical Surgical floor, I was often the only RN. What saved me was the awesome nurses. It was really helpful to have the main line running, having an alcohol wipe available and supplies available. If I was caring for a patient it would be helpful if the nurse stayed with my patient while I tended to theirs. I can understand the frustation level. But you being organized, a list of medications that need to be adminstered, the drugs available, and good IV line you have done your job well, the issue is with the RN. I know how it can be demeaning when someone puts you down, when they would float me to the ICU the nurses always gave me a cool reception since I could not take care of the more difficult patients, but do the best you can do.

[azor]

What i'll say is try and be your best in all and anywhere you see yourself cos i know for sure that its good to be good and it pays to be good .Dont mind those of the negative attitudes trying to put you down.You have to overcome them.Dont be like them! Allow them be like you.keep it real! this is you,you cant be them! Some pple can do something and go scot-free but if you want to change YOU because of them,you might get caught on the act so be the best of yourself no matter what but if you think you cant condone it any more,change to another department where your skills will be appreciated.Goodluck.

Azor

[Pertlvn03]

The only way you can please these nurses is to have everything ready for them save them time to do the work. When I have a patient who needs IV push. I have everything ready for them to do the pushing, syringe, meds, alcohol, needles or whatevery safe thing you do at your facility. I print the order for them to verify. It will only take 5 min. of Rn's time.

I worked with some LPN's that, because they are not allowed to do it just don't care and would only tell the Nurse that so and so needs IV push. To get respected at your job you have to make that extra efforts to get noticed. Like wise they need you. Hanging blood for example It needs two licensed to verify the blood, so they need you if it's there patient.

[TheCommuter, BSN, RN]

Any other LVN's feel this same way???

Thank goodness that I'm an LVN in Texas, as we are permitted to assess, hang IV piggy back, and do IV pushes as long as we have the proper certification in IV therapy. Basically, the LVN scope of practice is very wide in Texas, and the only things we cannot do are pronounce death and spike blood. I work in the rehab unit of a nursing home, and we deal with post CABGs, TKAs, THRs, post CVAs, post MIs, BKAs, AKAs, and other postsurgical cases. I am fortunate to say that the tensions between LVNs and RNs are nonexistent at my workplace, because I rarely need to call upon them to do something for me. Once in a blue moon, a patient will be prescribed an IV med that LVNs cannot administer, such as Procalamine or Vitamin K. This is the point when I will ask the RN to give it. Typically, the RN supervisor is available to give these drugs when they are ordered.

[pink2blue1]

The only way you can please these nurses is to have everything ready for them save them time to do the work. When I have a patient who needs IV push. I have everything ready for them to do the pushing, syringe, meds, alcohol, needles or whatevery safe thing you do at your facility. I print the order for them to verify. It will only take 5 min. of Rn's time.

I worked with some LPN's that, because they are not allowed to do it just don't care and would only tell the Nurse that so and so needs IV push. To get respected at your job you have to make that extra efforts to get noticed. Like wise they need you. Hanging blood for example It needs two licensed to verify the blood, so they need you if it's there patient.

I do ALL of that and even offer to do PO/IM for them in place of my IVP/IVPB! Still I get grief from some of the RN's.

Thanks though, I will keep doing what I am doing and prove myself yet!

[pink2blue1]

Thank goodness that I'm an LVN in Texas, as we are permitted to assess, hang IV piggy back, and do IV pushes as long as we have the proper certification in IV therapy. Basically, the LVN scope of practice is very wide in Texas, and the only things we cannot do are pronounce death and spike blood. I work in the rehab unit of a nursing home, and we deal with post CABGs, TKAs, THRs, post CVAs, post MIs, BKAs, AKAs, and other postsurgical cases. I am fortunate to say that the tensions between LVNs and RNs are nonexistent at my workplace, because I rarely need to call upon them to do something for me. Once in a blue moon, a patient will be prescribed an IV med that LVNs cannot administer, such as Procalamine or Vitamin K. This is the point when I will ask the RN to give it. Typically, the RN supervisor is available to give these drugs when they are ordered.

Wow! maybe I oughtta move to Tx! LOL! Isn't it strange how we are the same type of nurse, took and passed the same NCLEX and yet your scope is so much broader than mine here in CA, but I CAN spike and hang blood. Hmmmm....

Thanks for the response

[pagandeva2000, LPN]

I do ALL of that and even offer to do PO/IM for them in place of my IVP/IVPB! Still I get grief from some of the RN's.

Thanks though, I will keep doing what I am doing and prove myself yet!

One thing I want to say, though...while I understand that you want to be a team player and help out, try not to go too overboard and 'prove yourself' to the point that you tire or frustrate yourself out. If you are doing your share and above, then, these nurses have issues. Bottom line is that certain things are not within your scope of practice...PERIOD. I know that this adds stress to them, however, the same way you have to deal with it as an LVN, they have to deal with your limitations as RNs...the higher skilled nurses.

They may never be happy, and some people are natural bullies who wish to take advantage of the fact that you are feeling guilty. Would they do it with an aide??? Probably not (or at least not the same) because medications does not fall into their scope of practice. Well, the same for you...certain medications or the way they are administered are not under the LPN scope of practice in your area.

Like I said before, what I think they see is a qualified, licensed nurse being unable to perform a basic skill and this frustrates them. It happens alot. But, life does suck occasionally.