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

rph3664 · 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.

Slightly OT: There was a local news story a couple weeks ago about a mom whose baby didn't wait to arrive at the hospital. It was also the first time either woman on the ambulance crew had ever seen a footling breech.

:eek:

The TV crew went to the place where the delivery happened, and there were rain-soaked bandage wrappers all over the place. Is that customary, that this isn't cleaned up? I could understand leaving the mess at first because the patient needs to be transported.

Not_A_Hat_Person, RN · Dec 31, 2009

I live in the northeast, where LPNs in hospitals are very rare. It's because of their scope of practice. In my state, LPNs can't do anything with IVs or hang blood.

It sounds like you have a problem with a specific LPN working L&D, not LPNs in general. If she refuses to wear her name badge and is putting patients at risk, being an LPN isn't the problem.

ILuvNewBabies! · Dec 31, 2009

I think that the OP should check her state's nurse practice act. That will outline the specifics of what an LPN can or cannot do. In my state, LPNs are not able to care for Laboring patients at all, but they can receive a baby if they have current NRP and it is an expected "well baby".

Side bar: I think that some posters are making this an RN vs LPN/LVN argument. It doesn't appear to me that the OP has a problem with all LPNs, just the one who is causing all the problems. As a previous poster mentioned, your team is only as strong as your weakest link, and if management is doing nothing about an unsafe nurse, I might be looking for another job.

nerdtonurse?, BSN, RN · Dec 31, 2009

Hands on knowledge and experience are what save lives, not the initials on an ID tag.

allnurses Guide · Dec 31, 2009

You've said that you have "addressed this with your manager and the Director of Nursing to no avail". Either you don't trust their judgement, or you have a personal vendetta against this person.

When I started as an LVN, we worked in the PICU with RNs. Our IV team was all LVNs. I'll let you recover from the shock for a moment. Many states allow LVNs/LPNs a fairly broad scope of practice.

Unfortunately, your attitude seems to be becoming more common. An LVN posted here not long ago that she was forced out of her decades-long job on an acute-care unit to a job scheduling outpatient clinic appointments because of a new Nurse Manager with exactly the same bias. She really misses her co-workers. They miss her. I tell people who want to work anywhere other than LTC or Private Duty not to become an LVN.

Midwest4me · Dec 31, 2009

i tell people who want to work anywhere other than ltc or private duty not to become an lvn.

(sigh!!) there are other places where lpns can find work besides the ltc and private duty areas; namely psych hospitals, md clinics, dialysis clinics and such. lpns are not being phased out as much as some would like to believe(or hope for).

Midwest4me · Dec 31, 2009

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.

this brought a huge smile to my face! kudos to canadian hospitals for recognizing the value of us lpns. they are saving money by laying off those rns and still getting good nursing care.

Midwest4me · 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

:yeah: i applaud your post. unless the op is in management, this is none of his/her concern. there's way too much back-biting in this "profession". let the supervisors take care of the lpns issues.

allnurses Guide · Dec 31, 2009

(sigh!!) there are other places where lpns can find work besides the ltc and private duty areas; namely psych hospitals, md clinics, dialysis clinics and such. lpns are not being phased out as much as some would like to believe(or hope for).

yes, you're right. it's not impossible to get a job in other areas. you will just have to cast a very wide net. believe me, i'm not slamming lvns-- 'cause i am one and everything. . . and i live in a large city, so that is the perspective i'm coming from. i was licensed in (deep breath) 1976. i think that gives me enough time to see trends.

we're drifting off topic- so not gonna continue on this discussion, though it's a very valid one. happy new year!! :jester:

cjcsoon2bnp, MSN, RN, NP · Dec 31, 2009

Before we make this a verbal clash of the titans between RNs and LPN/LVNs or a fruitless breakdown between the levels of education (Diploma, Associates, Bachelors etc.) we need to focus on the specific issue at hand.

To the OP: You need to first ask yourself is this an issue you have specifically with this nurse (notice I'm not saying LPN/LVN because its irrelevant at this point) or an issue you have with LPN/LVNs working in this setting? If you have an issue with LPN/LVNs working in the same setting you are because you don't think that their scope of practice allows them to properly take care of patients in that setting then do yourself a favor and drop it. You have already voiced your concerns and they have been noted but unless your in a management position or in a position to change policy then your only causing trouble by singling out LPN/LVNs. If your issue is with this nurse then you have a few more questions to ask yourself. Let's take a look at your post and we can break down the questions.

We are having a HUGE problem with the one and only LVN in our unit. I have addressed this with our manager and the Director Of Nursing to no avail.

Exactly who is "we"? Apparently, your clinical manager and director of nursing do not share your concern about the performance of this nurse so again I ask. Who exactly has a problem with this nurse? Is it a majority or even any of your other coworkers or is it just you? Next issue...

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.

Is she required to have an RN sign off her assessments or notes? Are you the RN who is supposed to sign her assessments or notes? Unless your the RN who is supposed to sign off on her assessments or notes then don't worry about it. If her charting is inadequate then she will have to answer for it, especially when the Joint Commission comes around. Unless you are her manager or something then don't worry about it, let her get in trouble for it. If you are supposed to sign off on her assessments or notes because your supposed to be working with her on a patient then tell her you won't sign a specific assessment or note because it is missing XYZ or add it in yourself and then sign. It would be at that point that you might offer a few helpful charting tips or suggestions to help the nurse to improve her practice. Next issue...

She refuses to wear her badge because she doesn't want the patients to know she is an LVN.

Have you heard her say "I don't like wearing my badge because I don't want patients to know I'm an LVN/LPN?" or something to that affect? If she didn't say those words or something to that affect then don't just assume she doesn't like wearing her badge because she doesn't want patients knowing she is an LVN/LPN. I find it odd that she would ever say that because I have found that most patients do not ask about initials or specific credentials that often so I don't really know why she wouldn't want to wear her badge. But to be perfectly honest how is this any of your business? Is she going around saying "I am an RN" or doing things that are within the scope of practice for an RN but not the scope of practice of an LVN/LPN? If she is, then those are the things you should be saying to your manager or the director of nursing because both are really big issues. And finally...

She takes care of Mag. Sulfate pts, critical pts.....and on and on.

Is she specifically picking up these patients or are they being assigned to her? If they are being assigned to her then you should perhaps talk to the person who is assigning her these critical patients. Your manager and director of nursing believe that she does have a place on the unit and unless she is going out of the scope of her practice or else using unsafe nursing practices then you don't have a right to try to push her out of the unit or question her assignments. I would suggest that if you really believe she is unsafe as a nurse (not as an LPN/LVN but as a NURSE like yourself) then find get some specific examples of unsafe practices or of her acting outside of the scope of her practice. Its good that you are concerned about patient safety and the integrity of the unit you work on but you need to make sure that your intentions are for improving the quality of patient care and are not self-serving. If your going to take on this crusade then you better have the proof to back up what your saying about her with specific instances of unsafe practice or you may just find yourself out of a job and being replaced by an LPN/LVN. If you are so concerned about this then you should become more familiar with your states LVN/LPN scope of practice, you might learn something.

!Chris :specs:

babyktchr, BSN, RN · Dec 31, 2009

In my state, LPN's or LVN's cannot give IV push medication and have to cannot do initial assessments of a patient. Employing them in L&D on my unit would not be productive. I will say that the labor nurse I had when I was in labor was phenomenal and was a LPN. She inspired me to become an OB nurse.

As a manager, I would say that I would have some work to do from what you have described...but I am dealing with many of the issues that you describe with my RN's. Documentation of any violation of policy or procedure will at least start a paper trail. Be careful not to interject personal feelings into your cause. It is not up to you to get this person fired or removed. If she truly is not safe, then you have to prove that with facts, not just opinion.

SharonH, RN · Dec 31, 2009

(sigh!!) there are other places where lpns can find work besides the ltc and private duty areas; namely psych hospitals, md clinics, dialysis clinics and such. lpns are not being phased out as much as some would like to believe(or hope for).

this is so very true and i would hope that no lpns would feel restricted to private duty or ltc because of this belief. i have worked with lpns in every setting i have ever worked including: corrections, home health, research, occupational health and chronic disease management in addition to every acute care setting i've ever worked.