I am an RN, and my clinic’s chain of command is structured in such a way that an LPN did my latest annual performance review. How should I address this with administration?
Friday October 30, 2009
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In an outpatient clinic setting, we have LPNs as our “office manager” and “clinical coordinator.” Their immediate supervisor is an RN who is at the “director” level, and she reports directly to the vice president of nursing at the clinic. We are told if we have clinical issues to address them with the director, but the LPN office manager did my annual performance review last month, and the clinical coordinator provides me and the two other RNs with whom I work with required education. We all are certified wound nurses. I also am ostomy certified and am the only one of us that has a BSN.
The LPNs are wonderful people, but the professional nurse in me keeps telling me that this is wrong and is a poor example of organizational accountability. I have a meeting with the vice president of nursing, director, and a legal RN representing the clinic. I have contacted the state board of nursing, and they have indicated that no LPN can supervise an RN, nor can they supervise LPNs. I have a feeling nursing administration is going to interpret the board of nursing ruling in a way that turns the LPN positions into business accountability – not nursing. Any suggestions?
Carla
Your position on the role of an LPN is correct. LPNs work under the direction of an RN or other healthcare provider designated in the state nurse practice act and rules (e.g., physician, dentist, APN). Your inquiry to your state board of nursing clearly supports your position.
If you believe your concerns are continuing to be ignored, you may want to consider a consultation with a nurse attorney or attorney in your state who is familiar with nursing practice and the act and its rules. The attorney will probably discuss the fact that as a nurse licensee, you have an obligation to report nursing practice that is not compliant with the act and rules. In most states where this is a requirement, not doing so may subject you to disciplinary action by the board. You will need to consider how you want to handle this situation and seek the attorney's advice on how you should proceed.
Sincerely,
Nancy
Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.
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dewright1207 12/20/09 3:45 PM
I agree. I too work in a setting where the ADON is an LPN and I am an RN with a BSN. I also noticed in the state where I currently reside, that LPN's are promoted to mgmt.positions over RN's.