Quote from mama_d
Pagandeva...I'd be interested in finding out if your statement is state or facility related, since it's not the case for me.
I'm a LPN (on tele) and get the same patient acuity as the RNs do and even float to step-down...so I've had my share of unstable patients.
My floor actually has quite a few LPNs (for a hospital anyway...) and we rotate who cares for each team...example is RN got them on days, LPN gets them on nights, RN gets them on days. I actually get stuck on high acuity teams sometimes b/c they know I can handle them and still get out on time. I don't think that's necessarily fair, but it's an arguement I know I'm not gonna win, so I don't fight it.
My state does say that we are supposed to care for stable patients with predictable outcomes, and that we are not allowed to do assessments (at least initial ones). Also, we don't do IV push except for heparin or normal saline, no central lines, no chemotherapy or TPNs. That is why I said that it is 'supposed' to be stable patients with predictable outcomes; it doesn't mean that the opposite doesn't happen. In fact, it usually does, which is why most LPNs decide that it is better for them to obtain their RN...they feel that they are doing most of the same work for much less pay and recognition.
I have worked in step-down per diem. My responsibilities are a bit different, however...I administer medications, do treatments, hang IVs, but past that, the emergent situations and assessments really go to the RN. Of course, if I see that a patient is decompensating, I can intervene a bit, but, the response is more expected for the RNs. It just happens to be that way for my hospital, but if they are short RNs, I can see if shifting out of convienence. Our sister hospital has the RNs care for patients upon admission, but if the patient is stable, then, the care can go to an LPN, but the RN and LPN are on the same team, anyhow, so, if a change occurs, the LPN would not be responsible alone.
Basically, it comes down to semantics, really. Once the word is changed from 'assessment' to 'screening', and you keep it moving...the same as you, sometimes, it is not worth the arguement.