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 able to replace them. Please don't think I am putting LPNS down, I am not. I was an LPN for four years before I was an RN, and I have a great deal of respect for them. The two that have come in to the unit are sweet wonderful girls with a lot of knowledge and they work very hard. The real problem is the limitations placed on them In our state LPNs are not allowed to give IV pushes, hang blood, or hang and titrate drips. They cannot measure hemodynamics, and cannot take verbal orders from a physician. So an RN must do all of these tasks for them, as well as take on a full patient load of her own. The LPNs get very frustrated too when they need something done for their patient and the RN who is supposed to be covering her can't get away from her own patient to handle a problem. We have tried to have an LPN and an RN share four patients, with the LPN doing meds and treatments, and the RN doing assessments, drips and the like, but this has not worked out either. To make matters worse, some of the RNs are hostile to the LPNs, and give them a hard time. Most of us have been supportive of them, but a small number of the RNs have made things difficult in numerous ways. Most of it is very subtle, and is difficult to take anything specific to our unit manager. A few of the docs have also expressed discomfort with the LPNs being in a critical care area. Again, I am not complaining about the LPNs, I am just looking for some feedback and advise on ways to organize care and make this situation a little easier on everyone.
