Would YOU accept this position?

[NJFek]

I was recently offered my first position as an RN in a LTC/SNF in northeast FL. I completed orientation and was scheduled for nights (7p-7a). The thing is, when I looked at the schedule, I noticed that I am the only RN with 3 LPNs and several CNAs. I tried to ask the ADON who would be in charge in that situation and all she told me is that the company expects all of their RNs to oversee everything and that if there were a code I would have to run it... I've never even been in one! I asked her a couple more times in different ways thinking maybe I wasn't very clear in what I was asking and she seemed to be dodging my question. My intuition is telling me this is a potentially unsafe situation (there are 100 residents and I would be the only RN in the building). I'm going to call again today and have a conversation with the ADON and try to get some straight answers. I'm scheduled for Saturday, but I really don't want to put myself in a situation that jeopardizes any residents/employees or my license.

I just wanted to see what others thought about this situation. I tried to ask the ADON who would be liable if anything went wrong (legally, I am sure it would be me), but again, she dodged me (at least it seemed like it). The pay is great for starting, but when I was hired I honestly felt that the reason I got hired is b/c I have a pulse and a license. There was NO competition for the job at all (which is FAR from the norm in my area)... I'll update later after I've spoken to her again, but I would like to hear other people's thoughts on this.

[jjjoy, LPN]

Praytell, did I sleep through the management coursework in my BSN program? We had one catch-all "professional issues" course that touched on ethics and legal issues. Maybe that's where I was supposed to learn how to manage?

When IS a supervising RN considered liable for any LPNs they are working with? We were taught (well, it was mentioned in passing once or twice) that as RNs that we were responsible for the LPNs we delegated to. It would certainly help with work relations if it were clear to both LPNs and RNs where their responsibilities lie when working together in various different relationships.

[Selene006, BSN, LPN]

As a senior nursing student, management of LPN's and CNA's was literally a 5 minute lecture about what sort of tasks are appropriate to delegate. Having worked as an LPN, feeling comfortable with managing staff members takes some experience, and getting used to.

NJFek, you did what you felt was right and that facility has lost a contribution to the nursing team. It's their loss!

[MattiesMama]

When IS a supervising RN considered liable for any LPNs they are working with? We were taught (well, it was mentioned in passing once or twice) that as RNs that we were responsible for the LPNs we delegated to. It would certainly help with work relations if it were clear to both LPNs and RNs where their responsibilities lie when working together in various different relationships.

The RN is responsible for the actions of the LPN as far as ensuring that the tasks assigned to the LPN fall within the LPN scope of practice. But it is likewise the responsibility of the LPN to know their own scope of practice and to operate within those parameters.

The only situation I can think of where an RN would be held liable for an LPN's actions would be if he or she assigned a task to the LPN that the LPN was not qualified to do-if the LPN did it anyways and a patient was harmed as a result, I believe the RN would be held liable for that-but the LPN would also be held responsible.

And I completely agree with you about the need for more education on the responsibilities and roles of LPN's and RN's...I could be wrong but I get the impression that this is something that is overlooked in RN programs more than it is in LPN programs...Just from my experience, in my program we went over scope of practice and delegation exhaustively, pretty much from day one. We even had to memorize our state nurse practice act (that was fun ) whereas most RN's that I've talked with seem to know very little about what an LPN is and what our responsibilities entail.

I'm thinking this might be because LPN's are primarily employed in LTC settings, where these issues play a bigger role-whereas RN's are generally prepared for working in the hospital setting where it isn't as big of an issue. But I think that developing a mutual understanding would go a long way towards improving work relations and putting an end to the silly "LPN vs. RN" debate once and for all!