All Lpn's Please Read

I am in Massachusettes and LPN's do the same work as RN's but can't start IV's (unless IV Certified) and can't hang blood. That's it!!

I work in ICU now, but when I was on the floor, LPN/RPN's did nothing........because they are not there- we did primary nursing and the hospital laid off ALL the lpn/rpn's .......they are all gone. When they where there, they did vitals, baths, personal care. I am curious, I see many posts refering to LPN's "pushing meds" In the hospital that I work in, only pts in ICU or a step down unit can push meds. Why? Because for many meds the pts need to be on monitors.

Tell me, the LPN's who are pushing meds.....what kind of meds are you pushing............ I am very curious. IF you are pushing lasix, what precautions do you take? If you are pushing cardiac meds, are all your pts on monitors????????????

Let me know OK..........my curiousity has been peaked!

Well JMP, yes, if I'm pushing cardiac meds during a code situation you can bet that the patients are on the monitor -- a lifepak at the bedside. All pts during a code are on a monitor. And in my medically complex unit, all of our pts are on telemetry at the very least, and most are on space lab monitors at the bedside. I use the same precautions as you should when pushing Lasix or any other med. I took Pharmacology in nursing school. I was IV certified during nursing school as were all the students at my school. The Canadians RNs I've worked with aren't allowed to start an IV, much less push meds thru them. Is this just a condition of their licensure in the states or typical of all RNs in Canada? Do I detect an attitude towards LPNs in your post? Do you not feel we are qualified to push meds? Do you consider yourself to be more qualified than my stateboard to determine whether or not I should push meds? Attitudes like the one I sense from you need to be trashed. We are all nurses and teamwork is so necessary. Get off your high horse and accept that LPNs are often more experienced, more knowledgeable and much more capable than so many RNs coming out of schools now. There may come the day that even YOU need an LPN to help, so watch how you talk to us!

I have started lots and lots of IV's - so what is the point of that comment.
I was a RPN before I became a RN- reason? here, RPN's have limited scope of practice. They have NO ROLE in most large teaching hospitals here.

Watch how you approach people who's background is unknown to you........ and always remember, dogs are trained......nurses are educated.

SKill sets can be taught to anyone....... but to understand the rational why you are doing something is key.

oh, yes, only RN's in step down units or ICU can push lasix. It is an ottotoxic drug and pushing it can and does cause profound deafness. On the floor we hang it in a minibag to prevent this from happening. In the unit we push it over minutes.

Lasix is commonly pushed on the floor ALL THE TIME. In fact, I've never seen it given by IV piggyback ( in a minibag as you say). Yes, ottotoxicity can occur and so can any number of other adverse side effects. Lasix is a potent non K sparing loop diuretic with many consequences along with many useful and often necessary properties. The main thing to watch with Lasix is the blood pressure, then of course lung sounds and the urinary output. Then it's necessary to monitor lab values, especially potassium levels. Personally, I push 10/mg per ml lasix over 15 seconds which works out to 40mg per minute or 80mg over 2 minutes. I've never seen any ottotoxic indications after using Lasix but I have seen severe nausea and vomiting and hypotension. As far as training versus education -- get off of it! Experience is the best teacher. And ability to get along with all the members of the healthcare team is necessary -- surely even in Canada. The nursing shortage here in the states has made the LPN just as desirable as an RN. We are licensed, educated, trained, capable and experienced. And so are some of the RNs I've worked with over the years

Not nearly enough time- not worth it. I remember the RPN days only too well.
Been there, done that, have the t-shirt.

You live in your world, I'll live in mine. Hopefully the worlds never collide!

JMP, WOW! I'm an LPN only a year, but I really thought I've heard every slam I could about the profession, until now. Why are you so bitter toward LPN's? Did you have a bad experience as a RPN? and what exactly is the difference between LPN and RPN?
Do you realize that it's attitudes like yours that are the reason we as nurses are having such a hard time getting the respect we deserve? as long as we have this animosity between RN's and LPN's managment is winning! Remember...divide and conquer? Think about that the next time you don't want to "cross worlds with an LPN" You have to be feeling the crunch of the nursing shortage, and some day you'll have to work side by side with one of us, and you'd better hope he/she hasn't seen your attitude!

Hello,
I worked in a hospital acute care/med/surg/ortho before i went to agency nursing.my responsibilities varied maybe because the facility knew that i had strong clinical ecperience and went half way through rn school.iv push meds are supposed to be rn or supervised by and rn.my mentor questioned my critical thinking and let me do pushes on my own,if there were questions,there was a comfort level in asking.Drsg changes and patient care were also included,rn's did patient care too. i've worked in large teaching hosp where the techs have done drsg changes up to stage three i think,they've also done the catheter spec collections. this was on an ortho floor,when i worked in the other sectins of the hosp,nurses did all of those that i dtated that the tech's did!

Just a reminder from one who has worn both the LPN and RN caps. The biggest problem I see is RNs who do not know the LPN's scope of practice. and LPN's who don't know their owns scope of practice because the LPN comes for another state. Know the scope inside and out. Then listen to you LPN's. They will be your best source in learning what they can and can not handle.

I question the practice of setting nurse patient ratios. I truly believe assignments need to be made based on patient need and nurse's abilities. I have had 2 patients that took all my time and then some, and 7 patients that that took no more. Look at acuity and the skills needed and the skills the nurse has. Keep in mind that no two LPS will have the same background. LPN's are capable of handling as many patients as you but some patients need the knowledge of an RN because of their acuity. As an LPN I have cared for some very sick cookies but I had an RN there to back me up or even take over when necessary.
I work with some very good LPNs in critical care. I have a great deal of respect for them. But some times I forget that they do not have an RN's education even though they have more years on me. This can be a problem at times because there are sometime things I assume they know and of course they never were taught. This is not so much in the area of skills but more in the realm of indebth scientific knowledge, that is often assumed by RNs and physicians and the LPN never needed to learn.

So remember the very complex patient probably should not be assigned to and LPN unless they are stable or unless an RN is assigned with her/him.