I had a terrifying conversation but I am not sure if maybe I just do not understand what LPNs can do as I don't know many and haven't worked with them much.

I met an LPN at a new job I started and she was saying how much she missed working in the ICU. She said she learned so much. She's IV certified so she said she could manage all the drips and everything going on in the ICU with just nurse "supervision." Is this a real thing? And she said she doesn't routinely work their and was floated there some. So that means she never really learned ICU. It's something that isn't safe for RNs to just drop in to and do well. I've worked in the medical unit at a hospital that just became my PRN job and I've never heard of an lpn working there let alone working in ICU. And this is not a small hospital (a different one) she was talking about. Sounds insane to me.

Some places do team nursing where both an LPN and an RN are assigned to a patient, with the RN doing the more complex tasks. It isn't as common practice as it used to be but, some hospitals still do it. LPNs used to be utilized more in hospitals too so, if she's older it's possible she could've worked in many areas. I don't know any ICUs near me that have LPNs but, most still employ LPNs in other areas of the hospital, a few even have LPNs working in the ER.

I worked with an LPN in an open heart ICU. We had to do her IV meds, but she did everything else. BTW, some of the best nurses I ever worked with were LPNs. And the best nurses I ever worked with were LPNs before becoming RNs.

I'm feel very ignorant that I assumed that it wasn't possible. That's very interesting to me. I'm still not clear on what LPNs learn and don't learn and what the differences are beteeen an RN and an LPN. Thanks for your responses.

I would think it's a situation where hospitals do it to be able to assign more icu patients to a nurse but they have an LPN with them to do things like meds. The LPN takes on a lot more of the patients but they don't do the assessments or bulk of the charting. They basically function as a tech, but have the responsibility to pass meds. The RNs would have maybe 4 patients and the Lpns would have 10 but working under 2-3 RNs.

It's all about who you know and what you know. RNs and LPNs are all nurses and they both save lives.

Not insane at all. I was an LPN now turned RN and as an LPN I triaged, did IVs, etc. I was doing everything the RNs were doing in my setting (not ICU though). I just could not administer blood or certain cardiac meds. Theres a few hospitals not too far from where I live where LPNs work in the ICU. In the last 4 years is now where a few hospitals took the LPNs out of the hospital setting. Hasn't been long. There are MANY LPNs that are AMAZING and better than a lot of RNs I've work with. Not always about the credentials its about their skills/critical thinking!

I'm totally not doubting LPNs' abilities or intelligence I just thought that the ICU would not be a setting they would get hired to work in. I also thought they could not do initial assessments or assessments period, teaching, care plans, and other things. A lot of nursing is assessing: assessing an IV site, assessing a wound, assessing a reaction to blood, meds. I guess I am unsure how one could work in icu and 1) not hang an IV med or give an IV med (if you're a patient and not on IV meds I imagine you're not in the ICU,) and 2) not have to assess any of the above and a lot more frequently. I guess I still don't understand how an LpN could function in the ICU. Even if IV certified do they have the background knowledge to know what a reaction to a med might be and how it might show up clinically (again assessing)? I can see it somewhat being okay doing the RN/LPN approach but when an RN has 4 ICU patients I'd imagine that could be very bad if one or more goes south... the LpN wouldn't be able to do a whole lot in that case and the RN is now responsible for 4 lives! I'm not trying to be insulting to LPNs because I totally get that it's more about abilities than the credentials but in terms of scope of practice etc., I'm still scratching my head. I will have to do more research. I also know the scope varies state to state.

Every state has their own nursing scope of practice. In my state, the only thing the LPN nursing code of practice expressly excludes an LPN from is an INITIAL assessment and the care plan (LPN's can contribute to the care plan, however). I don't know of any hospitals in my area that allow LPNs in the ICU but I know of an LTAC that cross-trained LPNs in their ICU at least as recently as 2011.

Also in 2011, one of the local hospitals in Tulsa had at least one LPN working in their NICU and she had been for a few years

I went to school with two LPNs that worked ICU. Both were from the same employing hospital. One worked their through nursing school and the other worked there previously. I feel like it goes in wages whether hospitals decide they want LPNs. They definitely have every right to work inpatient as long as they stay within their scope of practice. Although they may not be able to "assess" (which is a major eye roll) they certainly learn when something is wrong and needs further inspection and assessment.

I want to know what about the convo was so terrifying.

I am a retired LPN and in my day, it wasn't at all uncommon for LPNs to work in the ICU. Though its not common these days, it does still happen. The ICU from which I retired still has LPNs working. Most of these places that use LPNs in the ICU are states and facilities that allow an LPN to have a broad scope of practice. It is important to remember that the LPN does not work under the RN license. The LPN is responsible for care under her own license. What is outside of the LPNs scope is the responsibility of the supervising RN. This could be very little in states and facilities that allow LPNs a broad scope of practice or it could put so much additional work on the RN that it probably wouldn't be practical for an LPN to work in the ICU.