Why lvn's /lpn's should not work in labor and delivery

ramkatral · Dec 31, 2009

Eh, I have no actual answer for you but I have a lil comic relief: Why shouldn't she be able to? There's nothing to labor and delivery but catch, suck, cut, wrap... I've delivered three little ones in the pre-hospital environment. And yes, I'm just joking around about there being nothing to it, before I get flamed to hell. :smokin:

wooh, BSN, RN · Dec 31, 2009

i need specific reasons that mandate why this nurse should not work in l&d.

if she's not charting enough, it has nothing to do with being an lpn/lvn. there's plenty of rns out there with inadequate charting. she needs to be counselled by someone from management on her charting to get it up to par. the question is, "is she a safe nurse?" if not, then get rid of her based on her merits, not because she's an lvn. if she is practicing effectively and safely, then why are you so concerned about it? i've practiced with many lpns that didn't have an rn signing beside them. that kind of thing is based on state practice acts and facility policies. if she's practicing within your state's practice act, and within your hospital's policy (which your hospital seems to think she is), then once again, why are you so concerned about it?

ramkatral · Dec 31, 2009

If she's not charting enough, it has nothing to do with being an LPN/LVN. There's plenty of RNs out there with inadequate charting. The question is, "Is she a safe nurse?" If not, then get rid of her based on her merits, not because she's an LVN. If she is practicing effectively and safely, then why are you so concerned about it?

All I can do to this is simply nod my head. Nothing else need be said.

feisty · Dec 31, 2009

We have a LPN working on our LDRP floor; however, she does not triage, care for labor or preterm labor patients. She is awesome!!!! I love working with her because she knows her stuff, knows her scope of practice and will flat out refuse to step outside of those guidelines.

Instead of not allowing them to work on your floor it might be best if your facility established clear guidelines using her scope of practice. The floor manager and those making her assignment should also take responsibility for seeing that she isn't given an assignment outside of her scope. Along with these steps she needs to have the guidelines review with her.

As for the lack of charting or wearing of the badge, this isn't the result of her LPN title. These are personal performance issues that need to be addressed.

An LPN at our facility can scrub in for a c/s, catch baby and recover/assess them, admit c/s patients, and recover c/s patients. She may have more which she is allowed to do, but these are the ones I have observed. She normally has postpartum assignments and I think it bares repeating...she is an awesome nurse!

destiny5 · Dec 31, 2009

You never mentioned anything about her lack of nursing skills or her putting patients in jeopardy. If I were you I'd focus on my own skills and charting and leave the managing and directing to the people who have the jobs. The fact that she doesn't wear a badge is actually none of your business, nor is anything you mentioned in your post. It sounds like you have it out for this LPN who probably is a good nurse. Please Please get a life. What goes around comes around :down:

tencat · Dec 31, 2009

Is she unsafe? Then you have a reason to be concerned. If not, those issues you mentioned are really not worth getting your panties in a bunch over.....There may be other issues that you haven't mentioned, but just based on what you posted, there is not a pressing reason to get rid of the nurse IMHO

PostOpPrincess, BSN, RN · Dec 31, 2009

Scope of practice

If she is NOT working within her scope of practice, she doesn't belong there.

LVNs/LPNs have been removed from all critical units including L & Ds for those specific reasons.

georgiapeachNP · Dec 31, 2009

Oh dear, what negative comments....I'm so sorry. I think it's important to remember that in a place like L&D and so many other specialty floors, it requires a team effort and you're team is only as strong as your weakest link (please excuse the corny). It does however, beg the question what level of risk your L&D cares for. If you transport most over the level of, say, preterm labor then I think her job performance may overshadow her credentials. On the other hand, if you are a high risk unit, then quite possibly her credentials could be a challenge. I'm not trying to put down any credential....I think the important thing is that nurses (all nurses) remain unified.....this is what the college of medicine has had over us for years. However, it is important to consider that among "nurses" testing standards for "safe practice" are different between LPN/LVN's and RN's. I commend you for being brave enough to stand up and ask the questions that everyone else considers none of your business! (Who she's dating....another story.) You just may be an excellent department manager one day! Kudos!

tewdles, RN · Dec 31, 2009

I need some specifics about why your hospital does not allow LVN's to work in Labor and Delivery. We are having a HUGE problem with the one and only LVN in our unit. She charts very little--even on cases that wind up in stat C-Sections. We changed to all QS computer charting about a year ago. Since then, NO nurses co-sign her assessments or notes. She refuses to wear her badge because she doesn't want the patients to know she is an LVN. She takes care of Mag. Sulfate pts, critical pts.....and on and on. I have addressed this with our manager and the Director Of Nursing to no avail. I have looked up AWHONN guidelines and looked up "Scope of Practice" for LVN's on the BNE site......to no avail. PLEASE HELP ME!!!! I need specific reasons that mandate why this nurse should not work in L&D.

I am sympathetic to your concern, I am just not sure of it's origin. Is her charting the huge problem, her care of critical or mag sulfate patients, or her lack of name badge? Or is the "huge" in reference to the number of concerns? Do you have evidence or suspicion of unsafe care?

I think it is a good habit to reflect on the practice of those LPNs who may be practicing under our supervision, I am presuming that you are her charge nurse or RN responsible for signing her charts. The first place to start is with the hospital policy manual. If you cannot find what you need on-line about scope, your hospital library can help you find the info relevant to your state. Once you have concrete and substantive evidence that this LPN is somehow misbehaving professionally speak with your manager.

If you are not in a supervisory or management position you are treading on slippery ground here. You sound pretty passionate in your post, but it is not clear why you should feel so strongly that she should not work there. Assuming that the hospital policies are not being broken and she is within scope (her managers should know and they aren't concerned), you have not provided any information would support termination. In the absence of evidence of harm or jeopardy you may end up looking elitist and petty. My best advice to you, respectfully, is to take a deep breath and re-examine why you feel so strongly about this.

realnursealso/LPN, LPN · Dec 31, 2009

:spbox: Obviously you don't care for this nurse. But let me tell you, LPN's work in alot of places you don't know about. I am very angry that you took it upon yourself to slam an occupation that you have shown you know very little about. If this LPN was truly guilty of what you say, I'm sure someone in management would be aware of it and take the necessary steps to correct this. Wonder what your coworkers think of your performance? Unless you are her supervisor, I think I'd be very careful about identifying someone and insulting her in public. Lawsuits, other people belong to ALLNurses, one of your coworkers may read your post and tell her. Now I'll get off my soapbox, wish you a Happy New Year, and hope you find a professional way to resolve this issue.:typing

2bNurse-88 · Dec 31, 2009

I need some specifics about why your hospital does not allow LVN's to work in Labor and Delivery. We are having a HUGE problem with the one and only LVN in our unit. She charts very little--even on cases that wind up in stat C-Sections. We changed to all QS computer charting about a year ago. Since then, NO nurses co-sign her assessments or notes. She refuses to wear her badge because she doesn't want the patients to know she is an LVN. She takes care of Mag. Sulfate pts, critical pts.....and on and on. I have addressed this with our manager and the Director Of Nursing to no avail. I have looked up AWHONN guidelines and looked up "Scope of Practice" for LVN's on the BNE site......to no avail. PLEASE HELP ME!!!! I need specific reasons that mandate why this nurse should not work in L&D.

Let me just say, your extremely ignorant. The fact that she's not charting properly, or doing her job properly has nothing to do with her being an LPN. LPN's are very knowledgable people, and can do many things that a lot of RN's like yourself, are too ignorant to recognize. Actually, here in Canada alot of RN's are being replaced with LPN's in every sector except ICU. Where I work, 65 RN's were laid-off, with LPN's being brought in. I guess the level of education isn't much different between the two now is it.