Tips! Help for LVN / LPN to RN students

[vintagemother, BSN, CNA, LVN, RN]

I've been wanting to write a tip post for awhile. Because I've been facing some challenges in my LVN-RN bridge program and I don't want others to go through what I experienced.

There are lots of tips on here for new nursing students, but we LVNs/LPNs are different.

We're different because we have real world work experience. We know how it really is out there.

My program isn't a "true" LVN - RN program. Rather, we're thrown into the 3rd of 4 terms with other traditional RN students who have never worked as a nurse.

One challenge: professors who assume that LVNs take direction from RNs and don't have to use "critical thinking" because as LVNs, they believe we can "pass the buck" to the RN. My instructors keep saying this to me, us. It's not true, I was charge nurse and there was no RN in the facility when I worked the vast majority of the time.

There was certainly no RN on the floor with me.

Anyhow, this post is supposed to be helpful. So I'll stop complaining and get to the lessons I've learned.

Clinical paperwork will take a lot of your time. As a working nurse, I never had to write up 10 pages per day on my patients. At school, we work for 8 hrs then go home to write papers.

The clinical paperwork must be completely filled out with direct book references. It's not enough to know that lisinopril is an ace inhibitor that is used for HTN and should be held if the pt has low BP or low HR. Instead they literally want you to copy from the lab book the exact mechanism of action, know which labs should be drawn on the person taking lisinopril (hello! None in real life) and the side effects-not just dry cough and low BP, but random side effects that aren't common but are listed in the drug book.

Most of my instructors have been great, but some want to feel "smart" and therefore don't like the confident demeanor of LVNs. For example, I have classmates who are in the traditional program that make statements such as, "what is an anticoagulant used for?" Then they are told and they still ask "why is my pt prescribed Coumadin after his valve replacement?" Teachers love these students.

On the contrary, one LVN who works with IV pumps all day at her job told the instructor, "oh, I understand that pump. I just have to press this and that to program it, right?" The instructor immediately bristled because, I guess, we're supposed to be "dumb" and seek the professor for knowledge.

Not all of our instructors are like this. Not even the majority. But my experience with 1 teacher like this has really affected my confidence.

My other tip is to work hard to study for exams. Be prepared to put in lots of hours. I've seen so many LVNs fail out of RN school over testing. Know that the exams are hard. Even though we already know a lot, as LVNs/ LPNs, we aren't used to "school". I was in school just 18 months ago, but still I have to really study to pass my exams. I highly recommend using NCLEX RN questions to augment your "studying". They are working for me.

I would love it if other lvn/LPN-RN students added their tips. I'll add more as I think of them.

PS I love LVNs/LPNs!!!!!!!!!!!!!!!

I hope this post doesn't come across as bitter!

[Jules A, MSN]

Its been a while but I joined the last two semesters of an established ADN group for my bridge. My classmates initially looked at me with a critical eye so I went out of my way to be super friendly to them which was well received. With regard to the instructors I just flew under the radar. I felt like they were eyeballing me up for bad habits and thats cool but I wasn't about painting a target on my butt by trying to be a super star. I actually enjoyed the fact that the material wasn't all brand new but was more in depth. To me it wasn't offensive to dumb it down, I just wanted to get through it.

[vintagemother, BSN, CNA, LVN, RN]

I agree with what you wrote, Jules! Yes, we should fly under the radar!

As for me, personally, I wasn't trying to show off. But i think a meek demeanor is helpful when working with the instructor. The nurses loved me so much they truly allowed me to take charge of pt care-meds, charting, etc. this was indeed our assignment. I found out, the hard way, that even if my pts and nurses think I did a good job, that my clinical instructor will rip into me over clinical paperwork.

Evidently, I should do what other students do: hide from

The teacher and do clinical paperwork at the hospital.

I suppose I'm sounding bitter. It's just hard.

To the Mods....I posted in the wrong forum. I think this should be in the LVN/LPN to RN forum.

[Scottishtape]

Following :)

[Jules A, MSN]

I agree with what you wrote, Jules! Yes, we should fly under the radar!

As for me, personally, I wasn't trying to show off. But i think a meek demeanor is helpful when working with the instructor. The nurses loved me so much they truly allowed me to take charge of pt care-meds, charting, etc. this was indeed our assignment. I found out, the hard way, that even if my pts and nurses think I did a good job, that my clinical instructor will rip into me over clinical paperwork.

Evidently, I should do what other students do: hide from

The teacher and do clinical paperwork at the hospital.

I suppose I'm sounding bitter. It's just hard.

To the Mods....I posted in the wrong forum. I think this should be in the LVN/LPN to RN forum.

Definitely ask your classmates the specifics of the paperwork because in my class they had many of the same instructors the year before and were aware of who wanted what which was very helpful for me. Care plans, if you are still having to do those awful things, are a huge pita but don't re-invent the wheel just get it done they way they want. I saved them so I could copy and paste references and any of the redundant stuff from patient to patient.

[vintagemother, BSN, CNA, LVN, RN]

Thanks for the tip, Jules! I have been reaching out to other classmates. Especially those with experience completing the paperwork. That has been helpful!

I should have added that to my tip list: As Jules said, don't reinvent the wheel when completing clinical paperwork. Copy and paste redundant information. I've also added sticky tabs to my drug book.

And, as Jules said, Don't be too proud to reach out to other students for help. Even those you may not know well. This has really helped me to see examples of the phrases instructors were looking for.

If your paperwork isn't up to par, schedule a meeting with your professor, just like you would if you failed an exam. This was very helpful and I wish I'd done it sooner.

One more paperwork tip, if your paperwork requires any information on "protocols" at the facility, go ahead and get copies on day 1. Keep them with you in your binder so that you can always reference them. In my school, you have to rewrite the policy or highlight the pertinent areas of policies with every single clinical packet. (I mistakenly thought I could paraphrase common sense!)

[Jules A, MSN]

Once my fellow students realized I didn't think I was hot stuff because I was a LPN they were more than generous with pointers of working the system which I really appreciated as someone joining their group late. It was invaluable to me.

[lillady04]

Thx so much for posting this! I Just got accepted into a Lpn to rn bridge and wanted to know what to expect.

[jmuhammad10]

I'm curious - how many of you are in a LPN/LVN to RN program that is online? I would love to hear about your programs. Or if you are looking for an online program. Email me at [email protected].

[vintagemother, BSN, CNA, LVN, RN]

Adding on:

I was not aware that LVN to RN students are subject to so many prejudices when going to complete the RN program. While this issue has been touched upon above, I want to add more specific detail. The reason I want to do this is to help other LVN to RN students.

My lecture and clinical instructors repeatedly make statements that LVNs don't use critical thinking, can't do pt teaching, and do not do assessments. They have stated multiple times that the LVN gets to "pass the buck" to the RN in challenging situations.

Furthermore, the other students assume we are there to show them up because of our experience providing pt care.

My positive suggestion is to be very humble. To steer clear from doing things that could cause you to be looked at as being a "know it all".

Another suggestion: try to make allies/friends with some of the other traditional RN students. Both the really "smart ones" as well as the really "kind, compassionate, caring ones".

The other thing I really want to emphasize is how important it is to learn exactly what your school prioritizes r/t learning objectives. As for me, I'm an excellent test taker, so that wasn't my problem.

The reason why I'm a good test taker is partly due to the fact that I am a "school" person and test well, naturally; but also is due to the fact that I sought out tips from prior LVN to RN students.

The people I talked to were smart, competent LVNs, but I was told that the bridge programs were super hard, even for them!

Because of friends advice, I decided to do NCLEX prep questions for each exam, in addition to regular studying. This has helped me immensely!

Regarding clinicals, based on my experience, and the things my instructors have told me, LVN to RN students tend to focus on pt care, rather than the completion of clinical objectives. My instructors and peers have reminded me multiple times that I'm not a part of the paid staff; therefore my responsibility is to complete clinical objectives, rather than do staff work.

And please believe me, the nurses on staff will be more than happy to let a competent LVN perform all duties, but this is not your role.

Another tip: contact your clinical instructor often, even if you don't think you need her. It's good for your grade and good for your learning the schools priorities (which, I repeat, are NOT the same as the priorities for when you worked as a staff nurse).

Be extraordinarily detailed in your clinical paperwork! It's more detailed than the work you do as a staff nurse. But I had to come to the realization that, while in school, my role is to show the instructors what I know by writing every single detail down... Even stuff you think is obvious.

I hope these tips help other LVNs to be successful in their RN programs!

[vintagemother, BSN, CNA, LVN, RN]

The semester has ended, and I did pass, by the grace of God. He both kept my spirit intact and also showed me how to apply my knowledge.

I learned that clinical paperwork, at my school, requires detailed write ups. This is best done by copying and pasting from reputable online sources, which you must cite, to avoid plagiarism.

Therefore, don't simply write that your pt has DM and you are watching for s/sx of hypo/hyperglycemia; rather, go to the NIH website and copy their verbiage.

Literally copy and paste. Then, add the numbers associated with the dx. For ex: if you're writing about DM, include the hgba1c limits, include the limits for no insulin as well as abnormally high gucose: eg 70-110 is normal. If you're writing up synthroid, you better mention appropriate TSH levels.

Further, I learned (the hard way) that it's better to get really good exam grades than to just slide by passing and then have to hope your miscellaneous points don't allow you to pass.

In other words, don't strive to simply pass, instead build yourself a cushion so that you have room for a few lost points.

One last point. As a working nurse, we LVNs know how important it is to give a good "report" to the incoming nurse. When I worked, I made sure the report sheet was filled out for the next nurse by the time s/he arrived. This gave me 7.5 hours. When I worked, the report sheet was different from my own working "brain" sheet I used to organize my work tasks. In RN school, things are different.

You are expected (by your clinical instructor) to have your "report/brain sheet" completed within a few hours of being on the unit.

During "report", Be prepared for your clinical teacher to ask you about random extra information r/t your pts. For example, the pts K is low. Are replacement Ks added? Why or why not? What is the mag level? If the MD didn't order a mag level, why didn't he? Did you ask for a mag level? Or, I know you can't give the diuretic because the BPs are low, but if you did have to give them, which would you give 1st, and why?

What I am saying is that, ideally, you will be prepared to answer any and all questions r/t your pts. Even random questions that you may not think apply to you.

If your pt has an INR lab, know their current Coumadin dose, even if you don't give it on your shift. And don't give multiple anticoagulants like heparin and coumadin s a rational explanation for your instructor, even if the RN and MD are aware, you need to be able to explain the rationale to your teacher.

One more tip: print out all of the hospital protocols r/t your pts! At my school, it's not sufficient to provide a basic explanation of nursing actions to prevent this or that complication.,rather, we are expected to attach a copy of the hospitals protocols r/t falls, IV assessment, potassium needs, chemo nursing interventions, etc.

Basically, I'm saying to be very detailed in your clinical paperwork.

One more thing: try to develop a humble poker face full of humility when in clinicals. I'm working on this.but what I'm saying is that it's best to say "okay. I understand" when being corrected.

[kfactor]

I love this thread - I am sorry I do not have any "tips" as I myself and debating going back late in the game (I am 45). I withdrew from my RN program and obtained an LPN on the way out (since I was in the second year). I knew I would have failed if I didn't. My BA is in economics and I went to a good school but I was wildly unprepared for nursing school! The attitudes and out right cruelty of the instructors was a real challenge for me and I learned too late to fly as far under the radar as possible. Hearing your experience is very illuminating. The idea that LPNs do not need to think critically is bewildering! Anyway I am 45 now and work for a hospice but get very little respect due to having an LPN and I cannot help but consider going back (usually when I feel the grumbling of resentment about the power dynamics). Your post did bring me right back to nursing school however - and does make me wonder if I could endure it!!I see you have an RN now - and it makes me smile. Kudos!!