As a LPN, I suppose this is a kind of an odd sentiment, but I really don't think that LPNs *should* act as the primary nurse for a group of pts in acute care. I think the LPN role in acute care falls under the team nursing model. The LPN would perform certain "tasky" stuff under the RN like PO meds, insulin, dressings, vitals, caths, routine, ongoing assessmnets, etc. This frees the RN for case management, care planning, initial and complex assessments, team leading. Having a LPN act as the "main" nurse in these environment muddies the waters too much.
Sadly, most hospitals have abandoned team nursing. So, in most parts of the country, if you *do* get a job in the ER or ICU (or even med surg) as a LPN, they will likely hire you as a tech. And, frankly, a LPN who works as a tech is just wasting his time..... he could have been a tech without ever having bothered to get a license.