What do YOU do as an LPN?

[Haveadream]

LPN jobs vary by state and hospital.....

SO, as an LPN, what do you do where you work?

I are trying to decide b/w LPN or RN. I have yet to be able to give my husband(who's involved in my decision) an answer as to what an LPN does....b/c it varies so much, I hear! Please help us!!!

[MAmom81]

I am also going to LVN Nursing School in hopefully Fall 2008 if not for sure in Fall 2009 and as soon as I graduate and pass my boards I am going back to my local CC and do the RN program!!! I know that I was not the original poster but I got a really good and detailed idea of what an LVN can do and it sounds perfect!!! I cannnot wait until I am LVN!!! Thank you so very much to everyone who posted what an LVN does, thanks!!!

[SuesquatchRN, BSN, RN]

I am currently enrolled in an RN program and if you have the time and the money I would suggest you go straight for your RN. Although LPNs do many of the same things RNs do we have less training and we make less money.

:yeahthat:

[lavender rose]

I work on a subacute/rehab unit at a large nursing home, and I earn approximately $4.00 less per hour than the RNs that work alongside me. I am in Texas, which is a state that has one of the widest LVN scopes of practice in the nation. I am permitted to do everything the RN does with the exception of pronouncement of death, and pushing certain drugs (Vitamin K, ProcAlamine, Potassium, just to name a few). I do IVPB, IV push, initial assessments, and so forth.

Anyway, here is how I organize for the day. I work 16 hour shifts, from 6am to 10pm. Typically, I have about 15 patients to care for. At the beginning of the shift, I'll go through the MARs and TARs with a fine tooth comb and, as I go, I will jot down the things that must be done in my notebook. My notebook is how I organize the rest of the day, and I usually won't forget to do anything. Here is how Sunday's notebook page looked (names have been changed due to HIPAA):

10-21-2007

DIABETICS, FINGERSTICKS: Agnes (BID), Agatha (AC & HS), Bill (AC & HS), Wendy (AC & HS), Rex (BID), Jack (BID), Esther (AC & HS), Margie (0600, 1200, 1800, 2400)

NEBULIZERS: Margie, Esther, Bill, Jack, Jane

WOUND TREATMENTS: Jane, Bill, John, Jack, Lillian, Rose, Lucille

IV THERAPY: Wendy (Vancomycin), Laura (Flagyl), Rex (ProcAlamine)

COUMADINS: Agnes, Agatha, John, Lucille

INJECTIONS: Agnes (lovenox), Jane (arixtra), Rex (heparin), Bill (70/30 insulin), Esther (lantus), Mary (vitamin B12 shot)

ANTIBIOTICS: Wendy (wound), Laura (C-diff), Rex (pneumonia), Agatha (MRSA)

1200, 1300, 1400 meds: Margie, June, Rose, John, Jane, Jack

1600, 1700, 1800 meds: Rose, John, Rex, Lucille, Lillian, Laura

REMINDERS: assessments due on Agatha, Jill, and Louise; restock the cart; fill all holes in the MAR; follow up on Jane's recent fall, fax all labs to Dr. Smith before I leave, order a CBC on Rex...

That is a great way to stay organized. Im a new LVN been on my own for bout a week now counting working days only. I work 12 hour shifts. I know what needs to be done each hour but getting a good organized scheduale helps like when it comes to charting things too so that I won't have to have it all at the end of the shift.

[Mycherry05]

I am an LPN who works on a Med/Surg unit at a hospital. Typically I primary 2-3 patients(from a group of 4-6), depending on how complex they are &/or if the RN I'm assigned to work with will primary the others. Some of the RNs(on my unit) are not used to having an LPN who can function this way, so they're not as open to the idea. They even do this with nurse interns. But this is how I was trained & how my manager wants me functioning.

Here's a list of what I can do: take vitals; check lab results; "data collection", which is the same as an RN assessment; administer meds(incl POs, IVPBs, SQ, IMs, and/or via PEG tubes); all the CNA skills & tasks; get blood sugars & give insulin; access meds from Pyxis; give PRN pain meds(orally only); administer tube feedings; cap an IV &/or flush an already capped IV; do admission database; enter discharge instructions in computer; reinforce teaching already provided by an RN; LOTS of charting of all of the above(including my "data collection under the RN assessment section). If needed, I can start IVs with or w/o Lidocaine, do PICC line dressing changes as well as wound/surgical dressing changes, be a witness for an RN who needs to "waste" meds, &/or be a second verifier of blood.

Here are (most of) the things I cannot do: initial assessment of a new patient, regardless of where they came from(PACU, ER, direct admit, or another unit); chart on care plans; document the narrative note; Med reconcilliations; initial teaching &/or give patient discharge instructions; call in prescriptions to pharmacies; give the 1st dose of IVPB antibiotics or administer any IV push meds; access or flush a capped PICC or central line; remove/take out a PICC or central line; anything with PCAs(except take vitals) or med lines; hanging TPN or blood; take orders from doctors or even call them; give PRN oral pain meds w/o RN approval; anything with consents; give report to other depts or units for patients going for tests, labs, OR, another unit, etc; give updates to families.

I am surprised at some of the things you can't do. I can't push IV meds, hang blood, but I can do the rest. Hospitals must be more strict than LTC?

[Mycherry05]

Thank you all for replying!!!!:monkeydance: I appreciate the time each of you took to tell me about your jobs! :)

It seems that most of you who replied said that I should go for my RN. I think it would be an interesting poll if I asked LPNs if they plan to get their RN or are in the process?!

Thanks again!! :)

It seems where I have worked in last year, everybody is in school for something. LOL Most are going for nursing or their higher degrees. Someday, I hope to go get my RN. I certainly don't think that the LPN program is a waste of time as someone said.Those Haitians must be jealous.

[DarciaMoonz, LPN]

In Connecticut, I think we all do the same. But my duties consist of:-Assessments-FSBS (fingersticks)-Wound treatments and any other treatment on my unit-I.V. therapy (when I have one)-Setting up or taking someone off a CAPD cycler-Manual exchanges for CAPD residents-Vaccinations for flu/placements of Mantoux and reading of it-writing tx orders for small stuff like skin tears (i.e. clean with NS, apply bacitracin, and cover with DCD) the supervisor reviews it and signs off on it-A ton of paperwork-have to do all of my own V/S (they don't allow these to be delegated off at the facility I am currently at which I think is a bummer, and it would save me so much time, if I didn't have to do that in addition to the brutal med pass on my unit)-g/j tubefeeds-supposed to help feed at lunch time, but I have right now 31 residents on my unit and I am lucky if I can finish the med pass at 11!!I am supposed to do all of this stuff and be done by 3 p.m. (hahahaha, I do real world nursing, NOT book nursing, but I think some don't know the difference. Man I wish I was on the day my supervisor was working my unit, I heard it was a hoot, and now she isn't so pushy about me or the others getting things done because she knows how difficult it is lol)

[swee2000]

I am surprised at some of the things you can't do. I can't push IV meds, hang blood, but I can do the rest. Hospitals must be more strict than LTC?

I'm admittedly putting myself on the line by saying most hospitals are more strict with LPNs and what they can/can't do. But it really depends on the facility and it's P&Ps.

Prior to me becoming an LPN, my hospital had not hired &/or utilized them in their true form for a long time. That's all changing and the hospital is trying very hard to get away from this attitude. But as the saying goes, "bad habits are hard to break". Some of the RNs struggled with the fact that I could do more & would even bypass me when an opportunity came about. On the other hand, several of the older LPNs who have worked on my unit for years & in a "glorified CNA" role(as my manager calls it), feel either 1)left out because they haven't been transitioned into functioning as a true LPN yet or 2)"threatened" that they won't be given the choice, especially if they don't want to or don't feel comfortable doing so.

[MzMouse]

Cut/pasted from a different thread:

I am an LPN, working as primary nurse for a general surgeon.

My duties:

-Room patients; vitals, meds and often suture and staple removal

-manage his schedule-both office and OR

-set up sterile trays and glove/assist with minor procedures in the office. We do lump removals, port-a-cath removals, biopsies and hemorrhoid and other rectal procedures

-paperwork for patients scheduling surgery-witness consent-patient teaching

-schedule tests and procedures as ordered by the surgeon-CT, ultrasound, mammo, Colonoscopy-patient teaching regarding prep and the specifics of the test

-answer phones, some Rx-but not a lot compared to family practice/internal medicine

-calling patients, giving tests and pathology (benign-the surgeon calls patients who have been diagnosed with CA)

Also be back-up and help for my coworkers when I have downtime. Which is pretty rare these days. We are really busy.

A typical day is tough to describe as every day is different. But that is one of the things I love about it.