Switch to all RN staff with LPN\'s getting the boot
I have a general question for everyone. Does anyone work in a all RN unit?
Our "management" came to the four LPN's on a very busy Ortho/Neuro unit and basically said, 'you have 6 weeks and you are gone'. 'You can work in the nursing home, etc. or take severence pay'. We are devistated, THIS is all I have known for 18 years. In total, we have 103 years of nursing experience.
Is this legal? No other unit in the hospital is affected, only us.
Our doctors are behind us 100% and are fighting just as hard as we are to save our jobs. Our RN's have gone out on a limb for us too. We have a great "team" we spend all our days with.
Any suggestions to a reasonable solution to our dillema?
Thanks in advance for the input![font=Comic Sans MS]Text[/f]
we don't have LPN's in labor and delivery and we only have 4.5 in postpartum/gyn. There are none in nursery and only 1 left on peds, none in ICU. Medical, tele and surgical have a few more but I think their jobs won't be posted if any of them leave. I've learned lots from the LPNs I've worked with but sometimes there is a strain on the workload just because there are things LPN's can't do d/t nurse practice acts.
When I was on peds, only RN's could start IV's and at night it was me and an LPN. RN are still the only ones to push meds or draw labs from central lines and there are more and more patients with lines. We have lots of IV pushes and if there are 18 patients with me and a LPN I can really get tied up with those pushes.
I don't know that there is a solution. Sorry you have to worry about your job as I've said I've learned lots from LPN's.
We have LPN's in almost every on of our units except CVICU. Most of them work independently except for some of the legal aspects of charting. Our LPN's are trained to push most meds, start IV's. After the training the get a tag after there LPN depending on the training.
LPN's are going to be here for some time. There are places with needs for the LPN.
Sorry for your circumstance. I can recall about 1996 or 1997, in Detroit They had RN's, LPN's, and Nurse Assistants. They had had such a difficult time with the budget that it was decided to implement a program that cross-trained nurse assistants to draw blood, begin IV's, EKG's, and a host of other things, over a period of about 6-8 months. The purpose I was told was so that the LPN's( I think there were about 8 at the time) could be let go and 1 and 1/2 of the salaries saved, could be split between the Nurse assistants giving them a 2-3.50/hr raise, freeing up 6 and 1/2 the salaries to go towards fixing the budget. Of course the nurse assistants were thrilled going anywhere from 8-9.00/hr to making 10-12.50/hr. Now they are called PCA I's and over the years they have increased to as much as 14-16.00/hr depending on where they work. The few LPN's that did remain, took a new title PCA II which my understanding in the difference was the ability to pass certain meds. Mind you this was @ 8 years or so ago. I don't really know of a solution but I just hope it gets better.
OMG they tried to do that here. They called it patient focused care. Admin spent thousand of dollars for the study and the program lasted less than 6 months.
They had environmental services drawing blood. ENVIRONMENTAL SERVICES!!!!!!! Can you see that.
"Sir when I am done cleaning the toilet I have to draw you blood" OMG.
Yes, we tried this for a short time. The program did try to decrease the amount of LPN,s. It did not work. We trained and increased the responsibility of the LPN.
Things are much better now that things are back to normal.
We (on med/surg floors) used to have module nursing with RN doing assessments, LPN's passing meds, and NA doing personal care. Then they went to primary care with RN's & LPN's taking their own patient loads with assessments, treatments and meds and the NA's still doing pt care. But the RN still has to sign behind the LPN and make at least 1 assessment per shift on the patients assigned to the LPN and the LPN can't push any meds or even hang piggyback if it's to a central line. RN's draw all labs from central lines.
I like primary care better then modules as I like to know what meds my patients are getting, what my assessments are etc. But for the hospital I think the modules really are better there is lots of turn over on our medical unit. I was in a charge nurse class the other day and one of the long term charge nurses up there just talked about what a pain it was to make assignments based on acuity and trying to get the LPN's patients they can care for with the least amount of assistance needed without running everyone all over the halls all day.
The LPNs we have on our postpartum unit are wonderful and wonderful resources (especially the one that is 65 and won't retire she knows everything and has seen everything)But then PP is a small unit with relative low acuities with short stays.
Update: Mgmt put the brakes on, our RN's and Doctors let them know just how they felt. It is a temporary victory for now. Eventually, an all RN staff will become a reality on our unit, just not the way they tried to do it here. The front door is always better than sneaking in the back!
Our RN's have never had difficulty making assignments, we are a very unified team of nurses. What one cannot do, the other can and vice versa--it all works out in the wash.
Today our hospital had employee forums for a general opinion survey--preplanned, and nothing to do with this. Oh, but what an opportunity for us to give our opinions. I am sure they didn't exactly want to hear mine today.
On a good note, we got stickers that had our hospital logo on it and said, "we cannot spell s_ccess without u"--our RN's wrote the four LPN's names on the stickers and attached them to their name badges. I could have just cried for the wonderful support! Our nurses are truly THE BEST!
Hi
Im am interested as a mature-aged nursing student as to what
preceptors really think about students and their expectations of us in our final year. have you any horror stories that you want to share?
trier
With the nursing shortage being so severe I am surprised a hospital would be in a position to do such a thing. In absence of a union or a contract the hospital can do whatever their little heart desires. Laying nurses off could run up an unemployment bill and might cause LVN's to initiate all kinds of lawsuits. I dont agree with drastic measures. I think if the hospital was moving in that direction they should have not hired anymore LVN's. And just waited for the ones who were already there to retire, move on , etc.
Part of the "problem" with nursing (as a profession) is that health care takes place in one of two places: a corporate owned hospital - or a taxpayer funded hospital. Much of the switch to and from using RNs vs LPNs is a direct result of the condition of the economy - and the unstable flow of students through nursing schools. Neither the corporations nor "the government" give two hoots or a holler for YOUR patient OR for your JOB. As far back as 1965 (yes, I am an OLD lady), I saw BSNs working for minimum wage. ALL nursing students changed their majors. 20 years later, when the old nurses all died or retired, those who were left got "rich"... then EVERYbody majored in nursing, flooded the market, and drove salaries down yet again. Right now though, its a "business expense issue"... for a while, there was a move to use all RNs and work them half to death. Now - I am watching job advertisements and notice that the swing is back toward using "cheaper" LPNs. Since I have watched this roller-coaster for about 40 years, I advise ANY nurse to save his or her money during the good times... 'cause bad times WILL come again. The only thing you can do to protect yourself is to get a skill that they can't do without - or take up traveling (which sounds like a whole lot more fun to ME than hanging around at home getting beaten up every time the economy changes.
That sounds really exciting!! IF you don't mind telling, where is it that you are presently practicing? Do they hire LPN's with no hospital experience? (I'm dying to get out of LTC)
Hi
Have any of you ever had any experience with nurses who do radar obs, you know they've recorded the obs but haven't done them and all the BP and pulses are the same. what was the outcome? Only one RN said she was aware of this practice last year and a teaching instructor said there was no such thing as radar obs. It's a bit scary really it's like someone signing a patient's chart for insulin when it hasn't been given. The patient asked when he was going to get it when I came on shift that morning. (I am only a student and it was prac) I took the patient's BSL and discussed it with my preceptor (the BSL indicated from the reading that he hadn't had it) and it was given under supervision with the original signature crossed out and countersigned. Unfortunately there are so many areas for slip-ups despite care and a few fake obs doesn't help either.
trier
one of our OB's will say how far was she. If I say 3 cm he says 3 cm. I don't think he finds a cervix half the time when he breaks water just sticks the hook in there and goes with it...guess that's why a couple of scalp lead have been on butts he didn't feel the presenting part after breaking water just stuck it in there and that was that until the next time a nurse checked (2-3 hours later) and it was butt.. now how did that baby flip, take the lead off it's head and attach it to it's own butt? Long armed co-ordinated baby I'd say.
We do not use LPNs in the ICU because of the many complexities of the patient. We rarely even have Aides, or Techs, or PCAs or whatever title you want to give them... although it would be nice.
LPNs, however, still play a big part on many of our other nursing units. Each institution has it's own way of thinking. I say, if your institution cans you as an LPN... don't fret, you DO have options... remember, this is America!!!
You should be able to find work as an LPN in every state in the union. If not in your town, then maybe you could decide to get your RN license... if not, relocate, or take up travelling. Or if your fed up with system, find another career... although I really don't recommend that... because I believe a nurse is a nurse, LPN or RN or BSN or MSN etc...
they are all nurses, just at different levels.
We may not always like the hand we are dealt, but always remember... YOU DO HAVE OPTIONS!!!!!
I am an LPN and never worked with IV placement let alone the lines and forget IV pushes and blood draws. Then I moved to north carolina and they taught me everything and I am so greatful I too dont like relying on an RN to do my pt. care. I love ya all but I like to know each and every aspect of my pt.s including reactions to all meds given. And I really like my pt.s to have my pt.s have pain med as quickly as possible. I say hurray for NORTH CAROLINA for utilizing all staff.
Hello, I dunno if you will still be able to read this reply... but then, like youm I am also a chronologically-advantaged nursing student, since this is my 2nd course. :-)
I guess pretty much, the preceptors view "us" (although am not that matured-aged you know..hehehe) as the more responsible and dedicated in our duties as students. There are advantages & disadvantages though. One of the advantage I think is that they trust our best judgement on certain decisions and are confident of the effort that we are exerting in our academic requirements. The disadvantage comes when they become to lax and overly trust us, that sometimes, they assume we can just try to figure things out on our own. Atleast from the school that I went to.
The one thing that healthcare isn't going to ever be able to do is switch to an all RN staff. First of all it is a waste of manpower. I don't think that the RNs knowledge of care would be wasted on doing something that someone with less training would do.
A hospital in my area decided they would try a all RN staff. Do you know how long that lasted? Five weeks and they were hiring LPNs again. They undervalued LPNs and what they contribute to the overall healthcare team. They realized pretty fast that patient care dropped out and patients and their families were not too happy. I would really point out what the typical day would be like for the RNs on the unit if the LPNs weren't there to help carry the load.
Paprika, you are not alone. This happened at a hosiptal where I worked as a CNA. They told all LPN's they would now be classified as CNA's if they stayed. All but two left, the reason I got hired. Also they would not get anymore pay raises until the CNA staff was up to/equal with the once existing LPN staff.
Which really shuts a lot of doors because most hospitals are owned by the same corporation, simply meaning, if they do this in one of their facilities they will do it in the rest.
The only two states in this country that extend a hand to LPN's, as I see it, are CA and TX. What I seem not to grasp is this.....if the LPN level of nursing is no longer acceptable by these facilities (which are extremly powerful enities) why do schools still insist on providing the LPN program?
[ QUOTE ] SoftSteel said:
The only two states in this country that extend a hand to LPN's, as I see it, are CA and TX. What I seem not to grasp is this.....if the LPN level of nursing is no longer acceptable by these facilities (which are extremly powerful enities) why do schools still insist on providing the LPN program?
[/ QUOTE ]
I'll give you one big reason, Long Term Care.
Here in the North East, the majority of nurses in nursing homes are LPNs, with a few RNs at best.
It's much more cost effective to use LPNs to pass medications and do the bulk of the nursing work than to have RNs do the same.
This is probably consistent throughout the U.S. The nursing home industry is growing extremely quickly due to the baby boomer generation reaching retirement age.
I wouldn't expect to see the lack of demand for LPN/LVNs go away anytime soon. With the shortage worsening by the month, hospitals may too soon open their doors to LPNs.
