LPN's Role in the ICU? - Page 9

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  1. Sep 9, '08 by
    Then do not get sick in TX o FL, as they use LPN's in ICU, since thier scope of practice is much wider then most states. But I have to say, this, remembering my first hospital job, there was a LPN in PICU here in AZ, who had been working there for omething like 25 yrs. She was the only one there, and I remember talking to some of the RN who told me they loved her and she was a wealth of knowledge... Just because someone is a LVN/LPN doesnt mean they aren't knowledgeable and can't function at the same level as a RN.... With that kind of attitude, the split between LPN and RN's well continue...

    regarding the new grad, I wish hospitals would adapt no new grads in ICU.. I spent 2 yrs on our med sur floor, have working Tele and have work in the LTACH (long Term acute care hospitals) vents, trachs, feeding tubes, wounds etc... I have a wealth of knowledge and info that most floor nursess (RN's) do not have. My transition into ICU will be an easy one. We have a 6 month long preceptor program. I'm looking forward to the jump..

    Quote from tfunkrn
    She states that she was an ICU LVN in California, and just moved to Kansas. She is approximately 60 years old.. and I know in Kansas LPN/LVN's scope of practice is very limited, as well. My main concern was if this would be a new 'trend' to counteract the nursing shortage, and the safety factor, for both the nurses and the patients. Thank you both for answering my question.
    I know at the hospital I work at has recently adopted a policy that new grads are not to take patients until they pass the boards and work as nursing techs.. anyway in the ICU's. I am not sure why they changed the policy, since the hospital is rather big, but what about new grads where you all are from? I am sorry if this is off topic, but I would like to know. Thanks.
  2. Sep 9, '08 by
    To tell you the truth, some of the new grads scare me, too. In Florida and Texas, LPNs are allowed to administer IV meds and monitor vaso-active drips and access central lines, including arterial lines? Are they allowed to do sterile dressing changes, too, and do it all under their LPN/LVN license? Can they also be ACLS and PALS cerified? Believe me, I am not trying to say that LPN/LVN's are not intelligent.. I am asking about the scope of practice allowed in other states. Thanks
    lindarn likes this.
  3. Sep 10, '08 by
    First off, what does being ACLS and PALS have to do about being an LPN. I work tele and its required to be ACLS, I get floated to PEDS and have to have PALS.. Its just a requirement of my job. I also get floated to couple care and yes I am NRP certified.

    Now I had a good laugh at the sterile dressing change.. What only an RN can do that.. Why can't an LPN do that?

    Quote from tfunkrn
    To tell you the truth, some of the new grads scare me, too. In Florida and Texas, LPNs are allowed to administer IV meds and monitor vaso-active drips and access central lines, including arterial lines? Are they allowed to do sterile dressing changes, too, and do it all under their LPN/LVN license? Can they also be ACLS and PALS cerified? Believe me, I am not trying to say that LPN/LVN's are not intelligent.. I am asking about the scope of practice allowed in other states. Thanks
  4. Sep 10, '08 by
    Hopefully I won't get in trouble or flamed for saying this....but I'm an LPN....couldn't afford that extra year of school at the time.

    I do get floated to stepdown and have cared for ICU overflow patients. I always get my own team...I can't imagine having another nurse hovering over me like I was at clinicals. I am also ACLS certified. I have cared for vented patients in a long term care facility, although that was a long time ago.

    In my state I can draw off of lines, assess my own patients, hang and titrate drips, monitor chemo and blood, call docs for orders, etc....mainly I can't spike a bag of blood (but if another nurse is in there to check it, what's the extra five seconds it'll take you, really?) or do IV pushes.

    IF I could do the pushes, I would feel totally comfortable working in ICU after an orientation. IF the ICU was staffed with RN's who were willing to help out (I usually volunteer to do labs, pass po meds, etc. in exchange for pushes being done) I'd be willing to do it, and I'm sure I'd do it well. I'd be fine working stepdown regularly now, except I like the nurses I work with now too much to leave, even though the charge nurses from there try to poach me from my floor.

    When I do get pulled to stepdown, I constantly get "You're just a LPN? I thought you were a RN by the way you acted!" I try to take it as a compliment but I always want to ask just what exactly that means....
  5. Sep 10, '08 by
    Quote from tferdaise
    First off, what does being ACLS and PALS have to do about being an LPN. I work tele and its required to be ACLS, I get floated to PEDS and have to have PALS.. Its just a requirement of my job. I also get floated to couple care and yes I am NRP certified.

    Now I had a good laugh at the sterile dressing change.. What only an RN can do that.. Why can't an LPN do that?
    ACLS and PALS has nothing to do with being an LPN, but is a requirement in most hospitals in the ICU. I did not realize, as an LPN, that you would be able to be ACLS or PALS certified, sincing pushing vasoactive meds are usually within the LPN/LVN scope of practice. So.. I want to be sure I understand this.. It is permisable for you to practice in the ICU in your state - Texas - under the LPN/LVN scope of practice without an RN needing to sign off? Believe me, I am not trying to 'widen the gap', but I do believe in practicing within our own legal scope of practice. I have also seen LPN's that are envious of the RN role and try to practice outside their legal scope of practice.. and that DOES bother me, especially when it is my patient and they are placing my patient and licence in jeopardy. I know you are going to be an RN soon, but I am asking strictly about the legal ramifications.. and if there is any title as ICU LPN. Also, in certain states, sterile dressing changes 'legally' are changed by RNs.. so if it is a laughable matter to you as an LPN, it is not laughable to me when I have a lawsuit placed against my licence for something someone else did.
    lindarn likes this.
  6. Sep 10, '08 by
    Quote from mama_d
    Hopefully I won't get in trouble or flamed for saying this....but I'm an LPN....couldn't afford that extra year of school at the time.

    I do get floated to stepdown and have cared for ICU overflow patients. I always get my own team...I can't imagine having another nurse hovering over me like I was at clinicals. I am also ACLS certified. I have cared for vented patients in a long term care facility, although that was a long time ago.

    In my state I can draw off of lines, assess my own patients, hang and titrate drips, monitor chemo and blood, call docs for orders, etc....mainly I can't spike a bag of blood (but if another nurse is in there to check it, what's the extra five seconds it'll take you, really?) or do IV pushes.

    IF I could do the pushes, I would feel totally comfortable working in ICU after an orientation. IF the ICU was staffed with RN's who were willing to help out (I usually volunteer to do labs, pass po meds, etc. in exchange for pushes being done) I'd be willing to do it, and I'm sure I'd do it well. I'd be fine working stepdown regularly now, except I like the nurses I work with now too much to leave, even though the charge nurses from there try to poach me from my floor.

    When I do get pulled to stepdown, I constantly get "You're just a LPN? I thought you were a RN by the way you acted!" I try to take it as a compliment but I always want to ask just what exactly that means....
    What state do you live in? I think it is great as long as you are comfortable and able to do this on your own licence under your state's LPN/LVN legal scope of practice. As far as blood is concerned, we have to have 2 signatures checking the blood out of Blood Bank, and 2 signatures before spiking the bag. You sound very capable.. Are you going to go back to school to get your RN?
  7. Sep 10, '08 by
    I've never worked with a LPN in the ICU and wouldnt want to. The fact of the matter is that hospitals want to cut the staff to handle more pts, paying the LPN's less and having few RN's on duty. I would not want to be in charge of 4-5 critically ill pts and doing duties for another nurse on my "team". This is a lawsuit waiting to happen.
    lindarn, OncologyRN23, and tfunkrn like this.
  8. Sep 10, '08 by
    Hi (excuse me about my english, i'm still learning)
    My name´s Magdalena, I'm a chilean new grad nurse. I was reading all the comments posted here, and what can i say, here in my country we have the same troubles with our teammates...But the issue here is different because in Chile there are only two types of nurses, "professional nurses" like me, trained during 5 years only at a college, and "tech nurses", who were trained only at tech institutes during years. So, the gap in knowledge between professional and techs is giant...For me is very strange what you are commenting, about RN signing the other's job. I found it a very unsafe and unfair practice, because accountabilty or whatever yoy may call it, is absolutely personal and untransferrable (impossible to charge other with the own responsibility for the care).
    In my opinion, your problem is that you have 2 nurses, doing essentially the same tasks...and paid differently. In Chile, tech nurses are capable of draw blood samples, not always, but they can do, and I as a nurse, wouldn't feel jeopardize my career because drawing blood is a techique, no critical thinking in a high grade is required for that.
    So, i think you (RN) feel jeopardize your jobs because the RN aren't capable to differenciate of a LVN.
    Saludos
    Magdalena
    tfunkrn and lindarn like this.
  9. Sep 10, '08 by
    Quote from Magda_PatagoniaNurse
    Hi (excuse me about my english, i'm still learning)
    My name´s Magdalena, I'm a chilean new grad nurse. I was reading all the comments posted here, and what can i say, here in my country we have the same troubles with our teammates...But the issue here is different because in Chile there are only two types of nurses, "professional nurses" like me, trained during 5 years only at a college, and "tech nurses", who were trained only at tech institutes during years. So, the gap in knowledge between professional and techs is giant...For me is very strange what you are commenting, about RN signing the other's job. I found it a very unsafe and unfair practice, because accountabilty or whatever yoy may call it, is absolutely personal and untransferrable (impossible to charge other with the own responsibility for the care).
    In my opinion, your problem is that you have 2 nurses, doing essentially the same tasks...and paid differently. In Chile, tech nurses are capable of draw blood samples, not always, but they can do, and I as a nurse, wouldn't feel jeopardize my career because drawing blood is a techique, no critical thinking in a high grade is required for that.
    So, i think you (RN) feel jeopardize your jobs because the RN aren't capable to differenciate of a LVN.
    Saludos
    Magdalena
    Hi Magda,
    The difference is there are many states here in the US that have their own statutes for scopes of practice. The pay is not the same, but neither are the content of knowledge, years of schooling, responsibilities, or the testing for licensure the same.
    We have CNAs, CMAs, LPNs, and RNs.. and each have certain people who are licensed as one, yet appear to have classification envy and attempt to practice outside their scope of practice... or make up titles I had not heard of before, such as ICU LVN. I restarted this thread, out of curiosity after hearing a title I never had heard before, and have since determined my initial insticts were correct about someone who said they were ICU LVN in California.. this person is a person with 'classification envy', since she is retired. But most of all, I am curious as to what the different states allow the LPN to do in their scope of practice on their own license.
    I am not stating that either is smarter than the other, but RNs have more training than LVNs because they went the extra mile to acquire the extra knowledge. If LVNs want to practice as an RN, they need to go back to school and pass the licensure test. It has nothing to do with intelligence, and all to do with motivation. I will say this in all honesty, I refuse to be responsible for an LVN practicing under my license. If they want to be an RN, instead of exerting energy into complaining, they need to channel their energy into going back to school to do it! It is not any RN's fault that they are not allowed to practice outside your scope of paractice.. only they can make the change by persuing a degree.
    lindarn, OncologyRN23, and NurseCutie like this.
  10. Sep 10, '08 by
    In the hospital I work, LVN's are rarely used on the floor and are not employed in the ICU. The couple of LPN's that I have seen working in the ICU work in the capacity of a nurse assistant, basic nursing care.

    I think this thread is very interesting, as I read through, I could not help but wonder why even bother becoming an RN (granted I would not change my degree and hope to move on to a masters some day)? I still can't help but wonder what some of the LVN's that have posted hear hope to have RN's do? I pose this question because many LVN's have stated they are fully capable of taking MD orders, pushing drugs, titrating drips and the like. Things I was thaught to believe were outside their scope of practice. If you do exactly what an RN does, then why even bother with the title distinction? If your job function falls under the definition of a 'professional nurse (assess, etc)', then whats the difference between an LVN and an RN (other than pay obviously)? If an LVN can take a two day class to be IV certified, then why even bother spend all those years in ADN/BSN school?

    I certainly don't have a problem with LVN's, but let's give credit were it's owed! If LVN's could do the same job as RN's, and in some cases could "run circles around an RN" then why would hospitals even bother hiring RN's? Why not just hire LVN's, afterall they are payed less?

    Just my


    TfunkRN, to answer your question, I live in California, and I am yet to see an LVN work in an ICU. My hospital will only use them as nurse assistants.
    lindarn, OncologyRN23, and tfunkrn like this.