[Haveadream]

LPN jobs vary by state and hospital.....

SO, as an LPN, what do you do where you work?


I are trying to decide b/w LPN or RN. I have yet to be able to give my husband(who's involved in my decision) an answer as to what an LPN does....b/c it varies so much, I hear! Please help us!!!

[TheCommuter]

I work on a subacute/rehab unit at a large nursing home, and I earn approximately $4.00 less per hour than the RNs that work alongside me. I am in Texas, which is a state that has one of the widest LVN scopes of practice in the nation. I am permitted to do everything the RN does with the exception of pronouncement of death, and pushing certain drugs (Vitamin K, ProcAlamine, Potassium, just to name a few). I do IVPB, IV push, initial assessments, and so forth.

Anyway, here is how I organize for the day. I work 16 hour shifts, from 6am to 10pm. Typically, I have about 15 patients to care for. At the beginning of the shift, I'll go through the MARs and TARs with a fine tooth comb and, as I go, I will jot down the things that must be done in my notebook. My notebook is how I organize the rest of the day, and I usually won't forget to do anything. Here is how Sunday's notebook page looked (names have been changed due to HIPAA):

10-21-2007
DIABETICS, FINGERSTICKS: Agnes (BID), Agatha (AC & HS), Bill (AC & HS), Wendy (AC & HS), Rex (BID), Jack (BID), Esther (AC & HS), Margie (0600, 1200, 1800, 2400)
NEBULIZERS: Margie, Esther, Bill, Jack, Jane
WOUND TREATMENTS: Jane, Bill, John, Jack, Lillian, Rose, Lucille
IV THERAPY: Wendy (Vancomycin), Laura (Flagyl), Rex (ProcAlamine)
COUMADINS: Agnes, Agatha, John, Lucille
INJECTIONS: Agnes (lovenox), Jane (arixtra), Rex (heparin), Bill (70/30 insulin), Esther (lantus), Mary (vitamin B12 shot)
ANTIBIOTICS: Wendy (wound), Laura (C-diff), Rex (pneumonia), Agatha (MRSA)
1200, 1300, 1400 meds: Margie, June, Rose, John, Jane, Jack
1600, 1700, 1800 meds: Rose, John, Rex, Lucille, Lillian, Laura
REMINDERS: assessments due on Agatha, Jill, and Louise; restock the cart; fill all holes in the MAR; follow up on Jane's recent fall, fax all labs to Dr. Smith before I leave, order a CBC on Rex...

[sleepyndopey]

I have done many different things in the 16 years I have been an LPN.

My first job was in a hospital on a step-down critical care unit. I would have 3-4 patients assigned to me. Under the direction of the RN charge nurse, I was responsible for their care for the day. I would give their medications, take vital signs, sometimes I would be the telemetry monitor, I would do any dressing changes that were due, draw blood, do EKGs, trach care, ventilator monitoring, peritoneal dialysis, take specimens, insert catheters, hang IVs etc.

My second job was at a drug/alcohol rehab. I would be the only nurse on duty for 60 clients. I was responsible for scheduling clients for their initial assessments with the medical director, drawing blood(not always easy with IV drug abusers!), intake assessments, determining need for client to be seen by MD if any medical issues came up. Scheduling clients to be seen by dentist, maintaining medical files, giving any scheduled medications, handed out a lot of tylenol, handle emergencies-mostly if something terrible happened I would call 911 or if not extreme emergency the rehab driver would take client to the hospital.

My third job was in on an in-patient psychiatric unit. This was a good job! The unit had 26 beds. There were usually 4 RNs and an LPN. As the LPN I was responsible for giving all the medications and injections, EKGs, I ran a community meeting group.

I now work at a sub-acute rehab and pretty much do the same as the previous poster.

I am currently enrolled in an RN program and if you have the time and the money I would suggest you go straight for your RN. Although LPNs
do many of the same things RNs do we have less training and we make less money.
I hope this helps. Good luck.

[swee2000]

I am an LPN who works on a Med/Surg unit at a hospital. Typically I primary 2-3 patients(from a group of 4-6), depending on how complex they are &/or if the RN I'm assigned to work with will primary the others. Some of the RNs(on my unit) are not used to having an LPN who can function this way, so they're not as open to the idea. They even do this with nurse interns. But this is how I was trained & how my manager wants me functioning.

Here's a list of what I can do: take vitals; check lab results; "data collection", which is the same as an RN assessment; administer meds(incl POs, IVPBs, SQ, IMs, and/or via PEG tubes); all the CNA skills & tasks; get blood sugars & give insulin; access meds from Pyxis; give PRN pain meds(orally only); administer tube feedings; cap an IV &/or flush an already capped IV; do admission database; enter discharge instructions in computer; reinforce teaching already provided by an RN; LOTS of charting of all of the above(including my "data collection under the RN assessment section). If needed, I can start IVs with or w/o Lidocaine, do PICC line dressing changes as well as wound/surgical dressing changes, be a witness for an RN who needs to "waste" meds, &/or be a second verifier of blood.

Here are (most of) the things I cannot do: initial assessment of a new patient, regardless of where they came from(PACU, ER, direct admit, or another unit); chart on care plans; document the narrative note; Med reconcilliations; initial teaching &/or give patient discharge instructions; call in prescriptions to pharmacies; give the 1st dose of IVPB antibiotics or administer any IV push meds; access or flush a capped PICC or central line; remove/take out a PICC or central line; anything with PCAs(except take vitals) or med lines; hanging TPN or blood; take orders from doctors or even call them; give PRN oral pain meds w/o RN approval; anything with consents; give report to other depts or units for patients going for tests, labs, OR, another unit, etc; give updates to families.

[sleepyndopey]

I forgot to tell you I work in New Jersey.

[jewelzz72]

Go for your RN, trust me.

I have worked as a charge nurse and do exactly the same things as the RN's in Long Term Care. I often have worked alone and call all the shots on my shift. Supervising, Critical Decisions, Any type of care and assessment you can imagine. The only difference in our positions is that I make anywhere from $3 to $6 less per hour. Most LTC facilities don't deal with IV's, but I even have certification in that and have worked with a few.

Go for the RN, you'll not regret it. With the increase of UAP's (unlicensed personel that are trained to pass meds) the LPN positions may become more rare, hopefully not, but I'm seeing happen where I live (S. Dakota).

Best wishes in your journey through school!

[Trabbie93]

Originally Posted by jewelzz72

Go for your RN, trust me.

I have worked as a charge nurse and do exactly the same things as the RN's in Long Term Care. I often have worked alone and call all the shots on my shift. Supervising, Critical Decisions, Any type of care and assessment you can imagine. The only difference in our positions is that I make anywhere from $3 to $6 less per hour. Most LTC facilities don't deal with IV's, but I even have certification in that and have worked with a few.

Go for the RN, you'll not regret it. With the increase of UAP's (unlicensed personel that are trained to pass meds) the LPN positions may become more rare, hopefully not, but I'm seeing happen where I live (S. Dakota).

Best wishes in your journey through school!

Hello,

Just wanted to say this is a great thread, and the participation is extremely insightful.

P.S. I hear conversations about "med aids" aids that help pass meds or some such? I know LPN's do this, and is a major part of the job. But hope it wouldn't phase out LPN's in the long run.

[NC Girl 35]

Definetly go for your RN if you can get into a decent program without a lot of hoopa la. I chose LPN because of competitiveness in RN programs and the wait list. I have no regrets for going into the LPN program. I had a lot of hatin co-worker at the nursing home I use to work at telling me why don't I just wait because LPN is a waist of time. Well its funny to me now because they are still CNA's , on wait list for the RN programs and still taking classes because in their eyes " The LPN program is a waste of time." Their still giving baths,performing incontinent care and I'm on the cart increasing my knowledge about various meds, passing pills, treating wounds, catherizing patients, giving injections,doing skin assessment, doing paperwork and educating my patients, etc.

[Haveadream]

Thank you all for replying!!!! I appreciate the time each of you took to tell me about your jobs!

It seems that most of you who replied said that I should go for my RN. I think it would be an interesting poll if I asked LPNs if they plan to get their RN or are in the process?!

Thanks again!!

[Sweet Pea 1]

I am hoping to get into the LPN program that starts in March, but do plan to go back as soon as I am done to get my RN.

The reason I am doing it this way is because I live in Georgia and we have what is called the Hope Grant which will pay for a Diploma prgram but not for a degree program. So doing it this way I do not have to pay anything for the first part and will have most of my classes out of the way.