Skill level not high enough for acute care

2 A RN on a M/S unit was recently 'asked to resign' .....I heard thru the grapevine that 'her skill level wasn't high enough' was the reason the manager gave. However I know it had to do with something else - however that is besides the point. This RN had been there over 1 year. I think it is a loaded statement IMHO but it got me thinking....and btw there are LPN's employed on this unit.

I guess it has to do with the whole education vs. experience issue.....what ensures a 'skill level high enough for acute care?'

Any thoughts?
My unit has also asked RNs to resign before, when after multiple chances they were still deemed to be a danger to the pts due to their inadequate level of care. They were all given opportunity after opportunity to improve themselves, to no avail. Usually it was a P&P technicality that was cited by the end, in order to avoid potential legal issues.So in short, a "high enough skill set" is one where you can provide adequate care, without endangering pts or consistently violating policies, within the working environment that you are in. Some areas give more leeway than others, and will actively do everything possible before termination, some have an attitude of "don't let the door hit ya on the way out."BTW, not wanting to start trouble...you may not have realized how it might come off on a message board...but whether or not LPNs are on your unit or not is really a moot point. Some nurses are safe and have a good skill set, some are not, regardless of level of education.

Three sides to this story exist: (1) the manager's side, (2) the RN's side, and (3) the truth, which is somewhere in the middle.Although I do not have all of the details, I am conjecturing that office politics had something to do with the demise of the RN's job unless, of course, she truly did lack the pace, sense of urgency, and skill level needed to stay afloat on a general med/surg unit (basic assessment skills, documentation, IV starts, medication administration, timely reporting of changes in condition, dressing changes, Foley insertions, ostomies, and so much more).

I think the OP met by LPNS being employed on the unit means that there is a lot more nursing support on this unit. This whole skill set is dependent on what one what the unit needs. I couldn't start an IV to save my life.. because I was never trained I work in psych sure I could take a $700 IV course. Sometimes its people not having common sense and putting patient safety first. Then again... each situation, unit, hospital and state is different.I find it funny that working in sub-acute or Long Term Acute Care (aka the dumping grounds of hospital ICU Patients) if your an RN doesn't count as med-surg hospital experience to some white coat nurses. It all depends.. whats funny is that the people deciding how much experience you need may have not worked the floor since Clinton was in Office. Some competency is needed though. This is why I wish I could take a seasoned older nurse with me everywhere I go if I worked in a hospital.. They have answers the the books don't have. Up here in the Northeast LPNs are gone out of most hospitals or "disarmed" meaning they can't do any nursing tasks like pass meds.

BTW, not wanting to start trouble...you may not have realized how it might come off on a message board...but whether or not LPNs are on your unit or not is really a moot point. Some nurses are safe and have a good skill set, some are not, regardless of level of education.

Quote from drmorton2bI think the OP met by LPNS being employed on the unit means that there is a lot more nursing support on this unit. This whole skill set is dependent on what one what the unit needs. I couldn't start an IV to save my life.. because I was never trained I work in psych sure I could take a $700 IV course.

Quote from TheCommuterThree sides to this story exist: (1) the manager's side, (2) the RN's side, and (3) the truth, which is somewhere in the middle..

Quote from hope3456Actually, no there isn't. What is unfair is that they cant push IV narcs or do blood transfusions, that is about it. Thereby, one of the other RN's, who already has a full patient load, has to do these tasks if one of the LPN's patient has them ordered. So actually the LPN has a pretty sweet gig. I was simply pointing out the irony that the nurse with the more education being deemed to have 'skill level not high enough.'

I was simply pointing out the irony that the nurse with the more education being deemed to have 'skill level not high enough.'

Quote from hope3456a rn on a m/s unit was recently 'asked to resign' .....i heard thru the grapevine that 'her skill level wasn't high enough' was the reason the manager gave. however i know it had to do with something else - however that is besides the point. this rn had been there over 1 year.

Just have to jump in on this one....There appears to be some misconception about "LPN vs RN". LPNs are not a replacement for RNs, these are 2 separate roles / scopes of practice. LPNs are focused on technical aspects of care - that are defined by each state - and must work under the supervision of an RN or physician. RNs can certainly perform the technical skills, but they are also responsible for overall management of patient care. RN responsibilities are not the same, so it the fact that there are LPNs working on the unit has no bearing on the termination of the RN.

Houtx - I agree that is how it supposed to be but not the case on this unit. The LPN's took on the same assignments as the RN's and if one of their patients needed a blood transfusion or IV narc push she would grab one of the RN's to do it. This is a rural hospital. And obviously the LPN was a' better nurse' than the RN - thereby going to show that education doesnt matter as much as skill level. However, one of the highly experienced RN charge nurses recently quit and went to work at a ALF. She said one of the 'straws that broke the camels back' was that she was doing this LPN's narc pushes while the LPN was talking on the phone and it was obviously a social call. This unit has crazy high turnover but they just hired several new grads so i wonder how many will be deemed to 'not have high enough skill level for acute care.'

Hope...re:above...That's how it is on my floor...I take my own team and am the one responsible for them, just as the RNs do. (We have a more liberal scope than in other states.) Still can't do IV pushes, but the trade-off is that the other LPN and I are the go-to nurses for hard sticks, so it evens out. The charges won't even stick people if one of us is there. So we generally end up doing at least three or four hard sticks a night, compared to the one or two pushes we have. It's all about the teamwork and swapping tasks. As far as blood goes, you need two nurses to verify anyway, so no biggie. (I can independently monitor once it's spiked.) Sounds like, if the LPNs on your unit had a "sweet gig" b/c of the difference in scope, they need a talking to from management about how to be better team players. Unfortunately some people will use any excuse to make their job cushier by pushing stuff off on others without helping out in return. I'm sorry that you're experiencing that and have to deal with it.