Stuck in LPN mode?

MKFaizi · Aug 23, 2005

I am a LPN and I loathe working in nursing homes because all you do is pass meds and deal with families and change dressings. As a RN, I would loathe management.

Forgive me if I am offending you with my personal feelings about nursing homes. But I consider them to be deadening.

Would you ever consider working elsewhere? I think Hospice would be more interesting and get you out of the LPN mode. You would be making more decisions. What about a hospital ER?

Again, this is my personal prejudice because I loathe floor nursing of any kind. I like nursing where people come in and people go out.

Certainly, getting out of a nursing home would get you into more interesting areas of nursing. Also, in my experience, nursing homes pay LPNS well but they do not offer RNs much more. You are doing the same job. They do not want to pay you a lot more for doing the job that a LPN can do.

If you truly love your job at the nursing home -- and I know some nurses do -- then, you will probably have to go into managment and supervision or stay in LPN mode.

If I were you, I would gleefully get out.

I work on the urgent care side of a family practice. Rural practice. Next best thing to a ER. But doctors are not about to pay RN wages when they can use a LPN.

This brings me to another sore subject. Why do we have to have these divisions in nursing? Why can't a nurse be a nurse? I have respect for education. I work directly with a nurse practitioner who is more knowledgeable and as knowledgeable as any doctor with whom I have ever worked. A lot of doctors. A nurse midwife delivered my daughter. She was better than a doctor, by far.

But, below that level of education, I cannot help but see nurses as all pretty equal -- depending on experience. I have worked with LPNs who were dazzling with their knowledge and expertise and I have worked with RNs who were just as good.

How can the divisions be eradicated?

MKFaizi · Aug 23, 2005

As for your manager, well, in my opinion, she is disgusting to say that to you after you took the time and money to become a RN.

I think you should gleefully get out.

I knew a LPN who became a RN. Her ambition was to work ICU. She graduated and got an ICU job. She lasted one day. One whole day -- because she did not like the way they did things.

To my thinking, she stayed in LPN mode. She returned to nursing home nursing as an administrator. I honestly think I would rather die than come back as a nursing home administrator. It's a Beetlejuice thing.

James Huffman · Aug 23, 2005

I think this is one of the problems with staying in the same work location after school and graduation. It's very hard to get out of the "mode" you were in before. And it's not just the new graduate who has a problem with it: colleagues, families, everyone is likely to treat you in the same way.

I would encourage a couple of things. First, get a new job. Pronto. Secondly, I'd encourage spending at least one year in an acute care, med-surg unit. It gets you used to doing a lot of different things, and it's a custom in nursing that has a lot to say for it. (I think it often functions as our equivalent of an internship). It's not perfect, but I think you should do it. Med-surg also gives you the chance to see aspects of a lot of areas of nursing, and you might find an area you would enjoy exploring. Or you might enjoy med-surg, and want to stay there. You also might want to go back to LTC. But regardless, I think you should get out for a while.

It's comfortable, in a funny way, staying where you are. But I don't think it's best for you, and I suspect you know that as well. If I were you, I would start applying to hospitals in your area.

MKFaizi · Aug 23, 2005

James is probably right. I have worked med-surg and I hate it but that is me. Did you never have such experience?

Regardless, I agree with him that you need to find another job.

fla orange · Aug 23, 2005

Ms.Nitengale I've got to agree with everyone else. You should spead your wings and fly to other areas of nursing. Med-surg wouldn't be a bad choice, you'll see a variety of illness and diseases. If you absolutely know med-surg isn't your cup of tea try a sub-acute center or a rehab hospital.

MIA-RN1, RN · Aug 23, 2005

After 15 years as an LPN, I went back to school and gained my RN degree. At work, my job did not change in the least. I still work the floor in a nursing home, and I still pass meds. My manager says that I am "stuck in LPN mode". How can I step up to RN mode if I am still doing the same job? I am willing to take on the responsibilities, but there are very few opportunities available, with no current openings on the nursing management team. How can I step up my game and be a team player if I can't get on the team to show 'em I can play? Any suggestions on how to point this out to my manager without being considered rude? Thanks for any suggestions!

Maybe you can strike a happy medium and find yourself an RN job somewhere totally different but maybe stay on per-diem where you are now? You will then be able to experience all that your degree allows in RN nursing but also you will have a comfortable place to return to now and then. You may find yourself gracefully outgrowing the nursing home at some point, but it may be easier than a swift break.

Tonight in class we discussed LTC and it seems to be that, at least here, it is mostly LPN's and CNA's performing the bulk of the patient care with one RN who may oversee several floors. For me, I would get bored quickly but if you love it, maybe just continue what you are doing once a week or so while you spread your wings at the same time and try what's out there in the RN world! :)

nitengail_2001 · Aug 23, 2005

Thanks to all for the input....but what if changing jobs is not an option for me at this point? I am simply trying to make the best of my current situation. Please don't judge me too harshly, but my license is on probation that carried over from my LPN license, and I am obviously limited in my job choices. Even though my probation is only for writing a telephone without the proper authority, it still carries a very negative stereotype, and most employers do not want to learn what the specifics might be. I have had to deal with many episodes of prejudice, and I have been passed over many times for advancement due to being on probation. I am stuck in LTC hell, so to speak. However, I refuse to be a victim, and I am looking for suggestions on how to make a bad situation into a good one.

nurseinmo · Aug 23, 2005

Even with the probabtionary thing to deal with I would still be looking for another job. It doesn't hurt to try! I know from experience as well that it is hard to transition while staying in the same setting. I have been an LPN for a year now, and had to stay in the same place I was before for many reasons. Most people still don't see me as a nurse, though things are starting to get better. I am now in RN school and will continue to work at this facility until I graduate and then I am soooo out of there! Is there anyone else to pass the meds? Were your duties supposed to change and just haven't due to staffing, there are still some questions to be understood before proper advice can be given I think. I guess my best advice is to try to make people start to see you as an RN and the more experienced and better rounded nurse that you are. I know that doesn't help much, but best of luck untill you can/want to find new work!

MKFaizi · Aug 24, 2005

I agree with LPN181 and Coopergirl.

I think you should still try for a better job. How long will your license be on probation? My guess is that you would be hired. Even you call it LTC Hell and that is the way I always saw it, too. The only thing I could stomach were two sixteen shifts on the weekends. I did that for four years until I knew that I was making a positive job switch. I would hate to go back to that kind of work, especially if I had invested time and money into becoming a RN. I still also think your supervisor was insulting to you.

Coopergirl has a good idea. Try for other jobs and WHEN you get hired, keep your foot in the door there for a while, in case you decide you want to go back.

Here in my corner of LPN land, we had a guy nearly code in the office today. Just not something we want to happen. Our equipment is old and ridiculous. Guy did not seem to be in a lot of pain. Thought he had indigestion. Took forever to fill out his paperwork. I asked him if he was okay. He said he was okay.

Finally, I took him to a room and checked his pulse. Felt like some kind of atrial fib. I did the EKG immediately. Looked weird. I gave it directly to my NP. She said, "Call 911."

I had begged the guy to let me call 911 before he even set foot in the office. He refused and said he would just go back to work.

I said, "You can't do that. You are having chest pain and you have to see someone."

So, fool that I am, I let him come into the office. I told him that if his EKG was not right, we would have to send him out by ambulance anyway.

Should I have let him go back to work and die? As it turned out, he could have died in our office. Fortunately, when we called for an ambulance, they actually came quickly. Not always the case. We got him out but he coded as soon as he came through the ER door -- forty minutes away.

Next chest pain, I am not offering a choice. I will call 911. End of the news.

A rural family practice is not the place to have a massive heart attack.

That happened to me ten years ago. Elderly man came into the office and the son said he thought his sugar was out of control. Sweating like you know what. This was a very rural practice. The doctor was not scheduled to arrive for fifteen more minutes. Just one LPN and a receptionist and no defribrillator.

I went to check his pulse and he suddenly clutched his chest and essentially died. Just like that. I was putting him on the floor as I saw the doctor coming into the parking lot so I was starting CPR when the doctor came through the door.

Fruitless effort, needless to say.

I don't want that to happen again. In my mind; my imagination; I have put a big orange-red X on my office door -- NO CHEST PAIN!! CHEST PAIN, GET THEE BEHIND ME!!

Want a job in rural practice? There are lots of rural hospitals that need RNs.

RN34TX · Aug 24, 2005

When I got my RN I stayed on the same Med/Surg floor I'd worked on as an LPN and felt the same way, no difference and no "higher level of functioning" that people always told me that I'd experience once I was an RN but could not conceptualize as an LPN.

In fact in my mind it put all of the rumors and controversy to rest. I finally had real proof for myself that the RN's were full of it and indeed I was doing the same job as them even though many insisted that they performed at such a higher level but it wasn't any different.

My co-workers were great and thrilled that I got my RN but....to comment about a previous post about your co-workers not getting over you being an LPN:

Like I said, it didn't happen when I got my RN as they were all cool about it but back when I got my LPN I stayed at the same nursing home I'd worked at as a CNA. Big mistake.

The CNA's who trained me as a brand new green CNA resented that I was now an LPN even though they had far more experience than I did and thought that it wasn't right that I was "moving up" while they stayed CNA's even though they knew me back when I didn't know how to use a hoyer lift.

The LPN's and RN's often criticized and went behind me to see what I'd missed or done incorrectly basically because they could not get over the fact that I was a CNA at one time but was now an LPN and they couldn't accept it. I'd always be a CNA in their minds.

Maybe you need to find a new facility that will see you as you are and not as you once were.

NYOKA59 · Aug 24, 2005

After 15 years as an LPN, I went back to school and gained my RN degree. At work, my job did not change in the least. I still work the floor in a nursing home, and I still pass meds. My manager says that I am "stuck in LPN mode". How can I step up to RN mode if I am still doing the same job? I am willing to take on the responsibilities, but there are very few opportunities available, with no current openings on the nursing management team. How can I step up my game and be a team player if I can't get on the team to show 'em I can play? Any suggestions on how to point this out to my manager without being considered rude? Thanks for any suggestions!

A nurse is a nurse whether you are an LPN/LVN or RN. Granted RN's have more skills than an LPN, but after 15 years as an LPN you should be able to conduct yourself as an RN even though you still pass meds and do treatments. That is what a NURSE does. Have you forgotten why you became a nurse? I think if you can answer this question, being stuck in the LPN mode will soon disappear. You can make your duties more meaningful by thinking as an RN in everything you do. I know of alot of LPNs who are more knowledgeable and have better bedside manners than some RNs. I know that it may seem less meaningful being in a long term care facility but only you can make it enjoyable for yourself and those that you serve. If you have been in a nursing care home setting for 15 years, I can imagine the wealth of knowledge that you've gain about this particular area and from those that you care for. Don't give up, hold your head up, do your duty with pride and I know your management team will take notice.