I am a LPN not a RN - A rant of sorts!

I have what is called a "float" position at work. This means that if someone is sick, on vacation or away from work for any reason they can fill the shift easily with some one like me as I am already booked to work. Typically I am an extra staff and put on the schedule as "workload" and in the few incidences where no one is away from work I go to my "home site" and become extra for them. At all times I know what days I am working and whether I am doing a morning or afternoon shift. The only thing I am uncertain about is which of my two sites I will be at. I am usually called the night before or the morning of my shift to be notified of my worksite/unit for the day.

This past week during my last rotation I received a call that I would be going to a particular site to work on a unit that could use another LPN. I was told I would be "workload". It is the nature of my position for this to happen so I was okay with it. I prepared for work as per usual and made my way there. Five minutes after I arrived I wanted to leave.

It is annoying when you go to work expecting one thing and something you weren't prepared for happens. I was there as an extra person expecting to work as a regular LPN, instead I was put in charge and told that I would have to do the duties of the RN as we didn't have one for the day. I was not expected to do all the duties that the RN is usually assigned and responsible for doing. I was overwhelmed and stressed to say the least. Thankfully I had an ESN (employed student nurse) who just finished her RN program. She was able to help me out with much of the work. I was extremely mentally exhausted that day. It is times like this that my job is not loved by me.

I was called and told I would be back at the same place for the next day. I asked them if there was a RN booked for the day and the staffing office said no. I told them I was not comfortable with the situation they put me in the last shift and I was not willing to be put there again. I told them to make sure the got an RN for the day. They said "we will do what we can". Damn. I got to work and it appeared as if it was going to be a repeat of the previous day as we ended up without a RN again. Staffing was still unable to find someone willing to come in on either day over the course of the weekend. No surprise. The staffing office was able to make things easier by scheduling two extra LPNs for the day. So between us two extra LPNs and the ESN that came in again the unit was well staffed and all the work was accomplished as it should have been.

Just so you can understand why this was such a hard couple days for me and those I work with I will explain a bit about what things are like.

On this residential care unit in particular there happen to be 70 elderly residents (in residential care units the average patient compliment for each section ranges from 20-35).  It is expected of one LPN to administer medications for half of these residents and a second LPN to administer to the other half of the unit. In essence the unit is split into two sections and a LPN is assigned to each section and made responsible for the medication for up to 35 patients.

 Giving out the medications is not a case of popping a pill or two and saying "Here you go." We have several steps we go through to ensure that we are giving out the right medication to the right person in the right dosage in the right route at the right time. You want to make sure that you are correctly and safely providing the medications that are prescribed for each person and in many cases there are patients who have a lot of medications to receive first thing in the morning. While you are doing this each patient is getting ready for the day. It is also expected of you to check blood pressures, blood sugar monitoring for the diabetics, visual/physical assessments, dressing changes for those with various wounds/injuries, receive calls and visits from multiple doctors and document everything as you go along.

If you have a RN on the team with you then much of the latter stuff can be done for you while you concentrate on medication administration. You typically start giving out the medications around 07:30am and if you are fortunate you are done by 10:00am. If you are unfamiliar with the unit as I am at this time then the medications can take you longer and you might not be done until 11:00am, just in time for the next round of medications. On a heavy unit you can be stuck doing nothing but medications while the RN accomplishes all rest. The unfortunate part is because of that the RN is also overloaded with work as she/he is looking out for all 70 patients. As I said each unit is typically separated into two sections with a LPN on each section and the RN oversees the whole unit. As a LPN I only am expected to focus on my section, not the whole unit.

When I arrived the first day of my rotation I was told I was the one doing the overseeing of the whole unit like the RN is expected. Between myself and the ESN we accomplished all that we needed to do that day. It was stressful and wore me out. I was like a zombie when I got home. The next day was a repeat of the same. That is a situation that should not be happening.