Lpns in the er

[brigirl246]

I Will be graduating this December. The emergency department has always been what I want to do. Have you ever heard of lpns getting hired in an er? I do plan to get my rn in the next year or two. Would it help to have ACLS and PALS? I eventually want to become a flight nurse. Any advice?

[libran1984, ASN, RN]

I work in an Emergency Department and I'm an LPN.

Prior to the ED I worked in a prison.... Prison was much harder than working in the ED. In the ED I just deal with more medicines and organized chaos. My state (Indiana) has minimal provisions on my licensure and thus most of my limitations are imposed by the hospital itself. The following is a list of what I can do in the ED.

I can do....

IV starts

Administer non-cardiac IVP medication

Administer IVPB medication

Initiate and monitor a blood / blood product transfusion

Arterial blood gases (only from the radial artery)

Access ports

Access PICC lines

Foley Catheters

Initiate Triage (RN is supposed to sign off upon completion)

Act as Primary Nurse for ESI acuity 3 and below

I cannot do...

initial assessments

administer IVP cardiac medication

initiate protocol

take verbal orders

act as primary nurse for ESI acuity 2 and above

transport pts to ICU alone

discharge a patient

What I do most of the time...

IV starts

administer IVP narcotics

perform foley cath's

transport patients to PCU and Med-surg units

My ED was going through a push by the director to hire more LPNs for cost efficiency ($14/hr) as opposed to an RN ($22/hr) and then she was let go a year ago and since have not hired any more LPNs. We have been replaced by medics who cannot hang IV antibiotics (per hospital policy) but thank God, under hospital policy they can intubate (like that has EVER happened at my place of work). Oh... and they're not allowed to administer cardiac IVP medications under hospital policy, despite their highly specialized training.... There are so many things wrong with the politics of this whole thing.

[T-Bird78]

In nursing school I did my externship in a small ER and LOVED it! I was terrified when I got the assignment but loved the actual experience. They do not hire LPNs in the ER, most near me don't, but I'd love it if I could work there. Try urgent care centers. They use LPNs a lot, you get the variety and urgency of ER, nothing too severe, and they close at 7 or 9 p.m. so you're not working overnights. If urgent care whets your appetite maybe it can be a springboard to get into an ED that will use LPNs.

[msjellybean]

My ED was going through a push by the director to hire more LPNs for cost efficiency ($14/hr) as opposed to an RN ($22/hr) and then she was let go a year ago and since have not hired any more LPNs. We have been replaced by medics who cannot hang IV antibiotics (per hospital policy) but thank God, under hospital policy they can intubate (like that has EVER happened at my place of work). Oh... and they're not allowed to administer cardiac IVP medications under hospital policy, despite their highly specialized training.... There are so many things wrong with the politics of this whole thing.

So put them in the field, in a full arrest situation and they're pushing ACLS drugs like nobody's business. Walk through the door of the hospital and suddenly they can't? That's weird.

[Fiona59]

So put them in the field, in a full arrest situation and they're pushing ACLS drugs like nobody's business. Walk through the door of the hospital and suddenly they can't? That's weird.

But that's reality. When I first started working as an LPN. I could give injections in the hospital and when I crossed the street to LTC for a shift, I was not allowed to. Facilty policy and ancient RNs in control.

Politics not cost effectiveness rules many a hospital

[EuroRN]

In south CA, there are hospitals that have LVN's in the ER. ratio is 14:1.

ACLS and PALS are not needed, because you won't be allowed to push those meds regardless.

[StinkMomBomb]

My nursing instructor who is an RN BSN in the ER is always stunned when a new grad is hired into the ER, let alone an LPN. It's just such a fast pace with a broad range of skills and pt.s that it's probably best to gain some footing and experience as a nurse.

I was told it's hard to orientate in the ER because something is always diverting your attention. Could you try to find a float position for now to become acclamated to nursing specialties? Then you would at least have some experience when you see those things in the ER.

You're just starting, find a path to get where you want to be and the destination will be worth it!

BTW, I'm just starting my path too and it's frustrating to wait but we don't want to compromise our licenses.

[libran1984, ASN, RN]

If you've ever worked fast food or waited tables and done well, you can be an ER nurse (LPN or RN).

[TheCommuter, BSN, RN]

If you've ever worked fast food or waited tables and done well, you can be an ER nurse (LPN or RN).

That excludes me!

I've worked at two different fast food places many moons ago, but was crappy, disorganized, forgetful, and sometimes had a bad attitude.

[libran1984, ASN, RN]

Lol! That describes serving tables alright! It also describes the ED on a bad / busy day!!!

[brigirl246]

Just an update. Since graduation from lpn school, I have a night shift job on a busy med-surg floor. After six months on this job I will be eligible for a job in my hospital's emergency department. I am very excited for this opportunity. Thanks for all the feedback I recieved. I will be taking ACLS next month. I am also going to be taking my emt-b classes in the near future. Thanks!

[LTCNS, LPN]

Congrats!! In my area of MS. large hospitals still hire LPNs in Med-Surg. and smaller hospitals hire them in EDs. One of the best nurses my mom had recently in an ER was a LPN who knew her stuff. I hope you have much success in your career :)