Why are LPNs allowed to supervise RNs in Long-Term Care?

BlueDevil,DNP, DNP, RN · Oct 20, 2012

I understand you don't respect her, that much is clear. I understand she voices inappropriate comments to/about residents. What I am failing to understand is how this is connected in any way to the fact that she holds a LPN (I'm sure that she would be equally obnoxious if she went back to school and completed the ASN degree) her role as charge nurse, other than the fact that you resent it? None of your examples demonstrate a patient safety risk, they simply demonstrate that you don't like her, lol.

Self reflect. It is clear to me that your real issue is that she gets to "tell the families" that she is the charge nurse. It is an ego issue. Just continue to take good care of your patients and let it go and you will be much happier. If you continue to let this bitterness eat at you, you are never going to be at peace with whomever they put in that charge role. Then one day, when they put you in it, you will be self satisfied, smug and arrogant and you will forget why you wanted it- to do better for those patients you are reportedly so worried about.

determined2banurse · Mar 31, 2015

I would just like to comment that more education does not equal better or smarter. I work with LPN's and RN's. In my experience the LPN's are just as knowledgeable about the disease process as the RN. In my facility the "less educated nurses "work the harder complex units because the the nurses who went to school longer can't handle it. My ADON is a LPN and she ROCKS. I myself am a LPN and the RN's in my building always bounce things off of me to get an opinion. So just remember education does not mean better you have to know how to apply the knowledge. Some people can memorize anything that does not mean they will know what to do with it.

allnurses Guide · Mar 31, 2015

I learned a long time ago when I started working in osych that being an RN meant nothing if I didn't know anything about psych. A psych tech just about saved my life my first week on the unit when she grabbed me by the back of my scrubs and pulled me away from a patient with a history of violence who I was approaching with all the "Theory" I had learned in RN school. I currently just started in LTC and there are two LPN's who are charge nurses on the unit, they actually don't officially supervise me but they have been a huge help in teaching me the ins and outs of LTC.. Not only have they done this longer but they know a hell of a lot more about the individuals that we serve than I do. I think that sometimes RN's can be a bit full of themselves when it comes to dealing with LPN's and even support staff such at CNAs and techs. Try being humble and learning from them sometime. Even a 1st semester student can teach you something if you listen.

JMHO

Hppy

withasmilelpn · Apr 1, 2015

Most of the facilities I worked at you were required to call the doctor when PT INRs obtained except for one Doc where we had standing Coumadin orders based on the range. Protocol for loose stools varied, sometimes it was just based on the hysteria of the nurse working at the time. (Have cared for MANY with cdiff - agree 24 hours seems reasonable but reason may not be applied always when it comes to loose stools. And btw in my history, it was always one particular nervous nelly RN that would always make me nuts with putting people on precautions. And she was ALWAYS wrong.) As to medicating for behaviors, I'm very conservative on that front and can't say I care for how she handled the situations you described. Sounds like this is a battle of personalities really, the "I make clinical decisions - not you" argument is a load of hooey though. And the fact that you said she gives LPNs a bad rep - more hooey too.

Gooselady, BSN, RN · Apr 1, 2015

Me too, this has very very little to do with her being and LPN and you being an RN having problems being supervised by an LPN. I hope that made sense . . .

Whatever the letters behind her name, she's a poor example of a professional nurse by your description, but it doesn't have anything to do with her capacity to supervise you, as an RN (however badly she's doing it).

An LPN with years more experience at the same job as a new RN *IS* the natural 'leader' and resident 'expert'. I have a BSN, and after nearly 24 years now, I have yet to see where my extra fancy BSN classes have somehow imbued me with knowledge or anything that puts me 'above' being supervised by an LPN or a CNA who's been on the job longer than I've been on it.

I've been doing private duty since January, and 99% of my fellow nurses are LPNs. They show me the ropes, period, end of story. I know what I know, but I don't know this patient the way they do, having worked with them for the past three years. That I took a leadership class or got more specialized training/education about 'disease process' means literally squat.

The only difference DETECTABLE between RN and LPNs in my current job is if a patient has a central line (none of them I work with do). As an RN, I am considered professionally capable of that competency, and an LPN is not -- but this varies by state, so clearly an LPN *is* capable, in theory.

If it just bugs a person to be supervised by a person with a more limited credential, that's an attitude that can get in the way of learning valuable things. A CNA showed me a diaper hack I've never forgotten, it works every time LOL. A CNA pointed out the urinary meatus in a female patient with odd anatomy, and I said 'nahhh, that's too high up!' and went back to jabbing the foley into her lady parts :sarcastic:

allnurses Guide · Apr 6, 2015

"It just annoys me that the Scope of Practice for RN and LPN in Michigan clearly states that an LPN cannot clinically supervise an RN, yet this is actually happening at my facility! What can I do about this?"

Here's my take on this - If it bothers you so much quit and find another job. The economy is improving but it still sucks and even good nursing jobs are hard to find right now. I'm in LTC right now as well for a reason - the schedule fits my family and School schedule and the pay is decent. I may not stay too long because some aspects of the job are not quite to my liking - but even if you try to raise a stink about this you will most likely not prevail and will then have the bad will of the whole department on you. The fact of the matter is that companies can do almost anything they want to employees unless you are part of a protected class due to ethnicity, religion, sexual orientation etc....

I just read an article today that said that most companies would rather terminate a squeaky wheel that is disrupting workplace cohesion than risk losing workers that work and play well with each other. In most state that have at will employment they can do this and you have very little grounds to stand on. If you are miserable being supervised in this way then go somewhere and be the supervisor. In my own position the LPN Charge Nurses are just a part of the multidisciplinary team and relieve me of a lot of administrative headaches.

I don't feel that being an ADN RN soon to be a BSN makes me any better than any other member of the team. I try to treat everyone with respect even when they are snooty or disrespectful to me. For me in most cases this means we can pull together a a team when the fit hits the sham!

We had a registry nurse on one night who felt any CNA duty was beneath her so when one of our CNA who is pregnant was puking in the bathroom and a resident needed assistance with a a code brown she just sat there and said that's not my job - I'll send the aid as soon as she's available. I could see any justification for making a resident lie in their own waste while this "RN" sat behind the desk, so I went down and met a very green in face CNA at the resident's room and we performed the task together.

Hppy

Tired nurse · Jun 7, 2023

If you are so concerned about LPNs supervisors then get the hell out of LTC. Most nursing homes only have 1 RN even on staff and that is the DON! So get used to it! And stop whining and get over it, it's LTC not a hospital were RNs rule. No one in LTC wants to hear the high and mighty RN attitude!

Tired nurse · Jun 23, 2023

If RNs are so afraid of LPNs what are you doing in LTC? You know that they use LPNs in place of RNs. Go back to the hospital and leave the hard working LPNs alone!

allnurses Guide · Jun 23, 2023

Tired nurse said:

If RNs are so afraid of LPNs what are you doing in LTC? You know that they use LPNs in place of RNs. Go back to the hospital and leave the hard working LPNs alone!

I worked LTC for a year and the LPNs I worked woth were for the most part amazing/ The do supervise certain aspects of the facility. They do not supervise an RN's duty though. I mostly administered IVs and rounded with the wound care doc who came once a week. When a family member complined I was more than happy directing them to the Charge Nurse.

Tired nurse · Jun 26, 2023

BlueDevil,DNP said:

Do you feel that patient safety is being threatened by having a LPN in charge? Is that why you feel you must act in some way?

"It just annoys me that the Scope of Practice for RN and LPN in Michigan clearly states that an LPN cannot clinically supervise an RN, yet this is actually happening at my facility! What can I do about this?"

If not, then it is merely ego. And that is rather unprofessional, and frankly, unbecoming. Contemplate this for a while and then just breathe, and let it go. It isn't important.

This is what you can do about it take your damn RN *** to the hospital and stop whining about the hard working nurses in LTC.

Tired nurse · Jun 26, 2023

Why do some RNs come to LTC and then start *** and moaning about the LPNs. The LPNs do it all there!

Asystole RN · Jun 29, 2023

Tired nurse said:

Why do some RNs come to LTC and then start *** and moaning about the LPNs. The LPNs do it all there!

Did you really resurrect an 8 year old thread to complain about others' having legitimate scope of practice concerns? Kudos to you.