LPNs in ICU - page 3

Our hospital recently brought LPNs into ICU, and we are having some trouble adjusting to the change. They were brought in to our units because we have lost so many RNs recently, and have not been... Read More

  1. by   MitziK
    RNinICU, CYA to the max.
    Last edit by MitziK on Jul 31, '02
  2. by   stressedlpn
    wow back up, now there was a blanket comment made about that offended me my prob the POINT I was trying to make is that yes I am an LPN and yes my training is critical care. I dont dispute that ,and have stated in many previous post that as an LPN I want a good RN to have my back HELLO. Most people LPNs and RNs know their limitations what their strenghts and weaknesses are, I do, Just dont count me out because I am an LPN, read all my post do not just pick out one statement and go from there with it deal,like you I do not usually get my feathers ruffled however that statment about I would want an LPN caring for my mother got to me because that is what I do.
  3. by   Flo1216
    Oh, for crying out loud already.
  4. by   MitziK
    stressedlpn, I wasn't referring to your posts.
  5. by   Brownms46
    Originally posted by mattsmom81
    Please LPN posters who are offended....read what RNinICU is saying!

    Those of you LPN's who are critical care nurses ...Brownie and Stressedlpn.....would YOU want to be liable for 4 patients in a real ICU?? (We're NOT talking about a Tele unit)

    With the state and facility restrictions in RNinICU's state that is what she is afraid will happen legally....and I don't blame her.... let's all try to share opinions without feeling offended, so we can all get along.
    Hey mattsmom...I heard your call...but finally awake now...:chuckle:!

    Ok...let me say...this! NO I would NOT want to be liable for FOUR pts. in a critical care unit, with LPNs who have their hands tied behind their backs, or who are inexperienced in critical care!

    I totally feel for RNinICU!! I also feel for those LPNs who allowed themselves to be put in that situation! I would never want to work in an area...where I couldn't do half the skills needed to care for the pts! BUT...I also feel that those RN bullies who are being nasty to those LPNs working in her unit....should get their priorities straight, and take out their fustration out on the powers that be!!! But of course bullies are always cowards....and never have the nerve to really deal with those who have more power than they do!! Sad situation...indeed!

    I appauld LasVegasRN...for her unit being able to find a workable solution to the same situation...but "I" wouldn't want to be the LPN or RN in that situation!

    For those who don't know me...I started out in NICU ..and later transitioned to working ICU/CCUs, and Trauma ER. So I know what can happen ... and just how quickly it can happen! I have been in units where more than ONE pt. started circling the drain! Fortunatley.... I have been blessed never to have had to code one of my own pts. But it would be pretty scary...if an RN is pulled away from direct supervision of the LPNs she is working with...while coding one, and God forbide...have another one of the four she/he is assigned to start going down hill also..!!!

    If the LPNs in the unit...aren't critical care nurses, who have the knowledge, and ability to completely care for the pts in that unit... or restricted from doing so.....then they .. shouldn't be there!!! That's my 0.04 cents worth...
    Last edit by Brownms46 on Jul 31, '02
  6. by   Furball
    Why can't LPN's be utilized as helpers rather than having assignments they can't fully care for? It would be great if RN's had no more than 2 pts each and an LPN or 2 floating to assist all the RN's on the floor. That way RN's aren't expected to stretch dangerously thin ......
  7. by   RNinICU
    Originally posted by Furball
    Why can't LPN's be utilized as helpers rather than having assignments they can't fully care for? It would be great if RN's had no more than 2 pts each and an LPN or 2 floating to assist all the RN's on the floor. That way RN's aren't expected to stretch dangerously thin ......
    This suggestion was made, and the LPNs thought they would end up being "glorified aides," so it wasn't tried. And, to tell you the truth, we don't have enough staff right now to do this. Every nurse in our unit has two and sometimes three patients. Making the LPNs helpers would increase the RN's patient load to at least three all of the time. We also tried to have a different RN cover each of the LPN's patients, but they didn't like going to two different people, said it was too much of a hassle. So the duty has fallen back onto the charge nurse.
  8. by   Brownms46
    RNinICU...this is a very bad situation all around! What kinds of pts. are the LPNs given, and what is the background of those working in the unit? What state are you in? Are the restrictions placed on the LPNs required by the state, or the hospital?
  9. by   LasVegasRN
    ~ sigh ~ LPN's in ICU can work. Takes a lot of trust and mutual respect.
  10. by   mattsmom81
    Thanks Brownie for seeing the predicament RN in ICU is in! I knew we could count on you to understand!!!

    This isn't really about RN vs LPN......and I think the comments from RN's like"I wouldn't be comfortable with an LPN in ICU..." arecoming from THEIR experience, and the restrictions of LPN's practice they have worked with in their areas.

    The real concern is the responsibility level assumed by the RN when LPN's do NOT have ICU training, and are NOT 'allowed' to do ICU work!!!

    I would not want to be responsible for the care of 4 acute ICU patients today...IMHO that is a ridiculous assumption of liability, and dangerous to today's ICU patients. Those of you who are ICU nurses: reread RNinICU's patient load description again please.

    Las Vegas, gotta disagree with your comment completely...this is not about how bad you WANT it to work at all. Luv ya anyway.
  11. by   RNinICU
    Originally posted by Brownms46
    RNinICU...this is a very bad situation all around! What kinds of pts. are the LPNs given, and what is the background of those working in the unit? What state are you in? Are the restrictions placed on the LPNs required by the state, or the hospital?
    The LPNs get the same kind of patients the RNs do, except for post op heart, CVVH, and IABPs. One has years of telemetry experience, and the other one year of med-surg. The restrictions are placed by the state. According to our nurse practice act, LPNs cannot hang blood, hang any IVs other than maintenance fluids and piggyback meds, titrate drips, measure hemodynamics, give IV push meds, take verbal orders, or sign off orders. We had LPNs in the unit 15 years ago and phased them out because our patients acuity was increasing, and they were too restricted. Now with the shortage of RNs they were brought back in because our RNs are leaving faster than they can be replaced. It's not as much of a problem when we have patients with lower acuity, but there are some nights when I feel like I am drowning. Our unit manager has met with our DON several times over this and other staffing issues, but gets nowhere. The DON tries to turn it into an RN vs LPN thing, but it's not that. These two LPNs are nice girls who work hard, but are restricted in what they can do.
  12. by   LasVegasRN
    Originally posted by mattsmom81
    Las Vegas, gotta disagree with your comment completely...this is not about how bad you WANT it to work at all. Luv ya anyway.
    It's okay - I would not work on a unit expecting me to take 4 ICU patient's either. We took 2 at the most. I can only speak from my experience in working with the LPN in our ICU. It worked beautifully, but we may have been the exception, and again, this was a pilot program implemented 10 years ago. All I'm saying is that it can and has worked before.

    Just my $0.02
  13. by   night owl
    The few times I was pulled to ICU, I was like a helper to the RN. I gave her PO meds, I did all of the treatments, trach care, vs, tallied up I&O's, helped her with pt care and they appreciated that I was there to give them a helping hand. They taught me alot of things I didn't know & I appreciated the fact that everytime I went there I learned new things and I always thanked them for it. I know my scope of practice and for those gals I only wished I was able to have done more for them.

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