LPN's Role in the ICU? - page 3

I am an RN in a 24-bed ICU. Currently, we have 1-2 LPN's scheduled per shift. Our policy is no more than 2 patients per RN unless you have an LPN working along with you, in which case you may have... Read More

  1. by   lady2
    Quote from RN34TX
    Convenience works both ways.
    When I was an LPN I worked with some RN's who dumped, I mean "delegated" responsibilities on me based on their convenience and preference rather than appropriateness for an LPN.
    Some RN's only want to step up to the plate and be RN's when it is convenient for them as well.
    Some are all in favor of restricting LPN practice, then groan about having to hang blood or push meds on an LPN's patients. So then they want an all RN staff to solve this problem but fail to realize that replacing LPN's with RN's costs money in order to pay an all RN staff and it has to come from somewhere.
    That said, the topic at hand here is not about LPN's wanting to be RN's and "walk like" them without going back to school or who is dumping on who and not pulling their load.
    It is about their role in ICU, whether they should play any role at all, how this role can be appropriate for the ICU patient population, and the impact of state laws and facility policy.
    I think it is a great idea for the LPN to learn but, ICU is not the place to do it. In Illinois they can not do IV push medication, they can't do an assessment, they can't hang blood and they are not able to give or calculate drips. If they want to learn they should be in a nurse intern program for their RN so legally they can function in the capcity they strongly desire.
  2. by   blueheaven
    Geeze!!! One LVN stated that she got OJT. If many of you out there are honest, I'm sure that is part of the way you obtained your ICU skills also. When I was a brand new nurse, if it wasn't for the EXCELLENT cardiac LVNs (who had been there a few years) to steer me in the right direction, Lord only knows.
    I worked 14 years in a small community hospital ICU and many times it was only myself and an LPN working. The LPNs I worked with were professional, knew how to complete a good physical assessment and many were the times I wished I was working with one of them as opposed to the lazy butt RN that would get assigned to me at times.
    Current situation, no LPNs are allowed to work in the critical care areas...but then we have a PCA. (go-fig)
    Seems like sometimes we get all caught up in the number of letters after someone's name and forget that not all are the same, nor should they be all judged the same.
    God Bless Us Everyone
  3. by   txspadequeenRN
    LAWD, what is this anger toward LVN's about? I would never work in ICU even if it was permitted, to many pumps, lines, alarms and such but ... GEEEZZZZ.



    Quote from lindarn
    LPNs have no place in critical care. They make for very unsafe conditions for the patients and the RN's who are ultimately responsible for their work. I have never worked in an ICU that employed LPN's nad I would refuse to have the respoNsibility for their work. They are a liability, not a heLping hand in ICU. Period. The hospital that I worked in here in Spokane, laid off ALL OF THEIR LPNS ABOUT TWO YEARS AGO. The writing is on the wall, all of you LPNs out there. Go back for your RN degree if yu want to work in ICU, and the nurses who are stuck having to work with LPNs in ICU should get together with administration, and yOur union, if you have one, and change the policy. I would refuse to work with an LPN in ICU. Period. And you should too. I was under the impression that it was decided years ago to go with an all RN staff in the ICUs. What happened? It is very definately AACN policy for an all RN staff in the ICU. JMHO. and $0.02.

    Lindarn RN, BSN, CCRN
    Spokane, Washington
  4. by   tferdaise
    Quote from AlexCCRN
    Our hospital employees LPNs but NOT in the ICU. Too many cooks in the kitchen. I find LPNs mostly distracting on the floors.
    Its funny that I see very small minded people on thie board that are nurses, we are taught to be open minded since we are going to be working with a large and diverse population of people. For any RN to just come on this public board and write such garbage and then RUN into the corner shows me that that RN isn't someone I want to work with. RESPECT is the key to a good working relationship, with all who are on the team.

    I have run into RN who try and push, I have a degree and you don't, so I'm smarter then you, attitude. Degree here is ADN or BSN, so I ask them, so if someone has a higher degree, does that made them smarter then you. 9 x out of 10 I get a yes. I have a masters Degree, but don't flash that on my badge. I do not know howmany BSN's I have trained to work on our unit, I work Step Down ICU, granted I can't not PUSH IV meds, the state I work in does not allow me to do assesments, does that mean I don't know HOW to assess my patients, does that mean I do not know HOW to push IV meds. The Answer is NO, just my scope does not allow me to do these in this state of AZ. Everytime a NURSE or CNA goes into a room and does something with a patients/Resident, you are assess that person...

    Agian there are LPN's that I would have them go back to school since they didn't learn anything same with RN's. I'm just wondering how they passed thier boards...

    Tony-LPN
    Goal is be a CRNA
  5. by   txspadequeenRN
    This is just wrong, wrong, wrong!!!



    Quote from AlexCCRN
    Our hospital employees LPNs but NOT in the ICU. Too many cooks in the kitchen. I find LPNs mostly distracting on the floors.
  6. by   lady2
    I think the LPN'S are a Little touchy! But I guess they have just cause. My point is if they went back to school and became an RN, there would not be any discussion about their presence in the ICU unit.:kiss
  7. by   lostsoulsfly
    I am an LPN. I am only an LPN b/cuz it was faster to take this route and do a bridge program to RN than it was to wait on a waiting list. I work in SICU. I followed an RN with "years" of ICU experience the other day and she kindly hung levaquin on a filter "y'ed" into lipids and connected TPN to a completely different port w/o a filter. My piss poor LPN assessment found this. Theres dumb/ignorant/uncompassionate nurses out there~ be it RN or LPN... I know I surely wont be an LPN for long knowing Im smarter than half the RNs I work with, get treated with this horrible stigmatism, and make ten times less $$... please!.. thanks RNs you are my motivation to one day be your boss or perhaps the jackass CRNA or DR that treats you like an ignorant fool!
  8. by   txspadequeenRN
    OH MY!!!



    Quote from lostsoulsfly
    I am an LPN. I am only an LPN b/cuz it was faster to take this route and do a bridge program to RN than it was to wait on a waiting list. I work in SICU. I followed an RN with "years" of ICU experience the other day and she kindly hung levaquin on a filter "y'ed" into lipids and connected TPN to a completely different port w/o a filter. My piss poor LPN assessment found this. Theres dumb/ignorant/uncompassionate nurses out there~ be it RN or LPN... I know I surely wont be an LPN for long knowing Im smarter than half the RNs I work with, get treated with this horrible stigmatism, and make ten times less $$... please!.. thanks RNs you are my motivation to one day be your boss or perhaps the jackass CRNA or DR that treats you like an ignorant fool!
  9. by   txspadequeenRN
    I am not touchy, but more along the lines of taken back at some of the increasingly harsh comments posted here. I have no intention of ever working in ICU, its not my bag baby. I know my limits and it stops well short of anything critical. However, I do get the feeling that some posters in this thread look towards LVN's as incapable of nursing period. Just my opinion. No need to start the LVN/RN war again.


    Quote from lady2
    I think the LPN'S are a Little touchy! But I guess they have just cause. My point is if they went back to school and became an RN, there would not be any discussion about their presence in the ICU unit.:kiss
  10. by   RN34TX
    It's now become more of a turf war than anything.I just don't remember this much fuss and controversy over LPN's working in ICU back when I did it. Of course with so much of the ICU stuff being new to me at that time, I'm sure I wasn't any source of intimidation or threat to anybody.I'm sure that some RN's might feel slighted if an LPN co-worker might be more experienced and have to show them how to do something instead of the other way around but that's a pride thing, it doesn't mean that anyone is better than the other. The experienced folks need to teach the newer people, no matter who holds what title.I guess different states and units have their own culture about what's acceptable.
  11. by   Kate28
    I'm a new member here, I just recently started LVN school here in Texas. I came to the forums to see what kind of wonderful advice I could get from fellow LVN/RN's on how to make my year go a bit easier. I've been here 5 minutes and I have already been offended beyond words. It pains me that I have to read about how horrible LVNs are on the floor, how they jack around or how they don't do their jobs. Of course there are going to be those out there, I understand that. But I REFUSE to be looked down upon simply because I don't have the time or money to go to school for 2 additional years. Critical care is where I want to go. Unfortunately most of the larger CC units in the Texas Medical Center are "wanting" to phase out LVNs. Who knows if it will happen, I don't know. I understand that LVNs can't do certain things. I know that we have to be monitored by a RN. That's fine with me. But when you go throwing your weight around by stereotyping all LVNs, subliminally saying that we aren't as good as RNs, that is going too far. The number one job of the nurse is to be the patient's advocate. Take care of the patient, do anything in your power to protect them. It sounds like the majority of those criticizing are more concerned with their power trip than taking care of the patient. I wont be coming back here, I already have too much to worry about rather than to listen to ignorance. I may not be an RN, but once I get my LVN degree, I will be proud as hell.
  12. by   Dalzac
    I have to say I am just flabbergasted at the comments that have been in this thread!!!!! I am a LPN and I have worked in ccu/icu for 27 yrs. Before that I was a CCU Tech. and knew when I got my lpn I was going to work in CCU. I have worked in Oklahoma City hospitals ,5 of them, and always in CCU or ER. My bos whom I have worked with 13 yrs calls me her cost effective RN. She trusts me, period. When she was given the chance to open a new chest pain center she called me the first day and assk me to work in this new unit.
    When I went to nursing school my instructors knew I was going to work in critical units and they made my assignments and they were not easy patients. They were tough tough tough patients. I am just amzed at the lack of knowledge some of these posters have spewed out.
    We are in an age of such nursing shortages that any help would be grateful and wanted. I have to say though, I would never want to work with some of these nurses and their frame of mind. I want to be where i am wanted and appreciated. The one good thing about where I work I am wanted and appreciated.

    Oh yeah the only things I can't do is hang blood and that is pretty much it.
    Last edit by Dalzac on Oct 29, '05
  13. by   RN34TX
    Quote from Kate28
    I'm a new member here, I just recently started LVN school here in Texas. I came to the forums to see what kind of wonderful advice I could get from fellow LVN/RN's on how to make my year go a bit easier. I've been here 5 minutes and I have already been offended beyond words. It pains me that I have to read about how horrible LVNs are on the floor, how they jack around or how they don't do their jobs. Of course there are going to be those out there, I understand that. But I REFUSE to be looked down upon simply because I don't have the time or money to go to school for 2 additional years. Critical care is where I want to go. Unfortunately most of the larger CC units in the Texas Medical Center are "wanting" to phase out LVNs. Who knows if it will happen, I don't know. I understand that LVNs can't do certain things. I know that we have to be monitored by a RN. That's fine with me. But when you go throwing your weight around by stereotyping all LVNs, subliminally saying that we aren't as good as RNs, that is going too far. The number one job of the nurse is to be the patient's advocate. Take care of the patient, do anything in your power to protect them. It sounds like the majority of those criticizing are more concerned with their power trip than taking care of the patient. I wont be coming back here, I already have too much to worry about rather than to listen to ignorance. I may not be an RN, but once I get my LVN degree, I will be proud as hell.
    I know it gets ugly in here, esp. for someone new and impressionable to nursing. Just a word of advice:
    ICU and ER jobs for LVN's are out there in TX but not all that plentiful and they generally will want someone experienced rather than a new grad.
    My advice to you upon graduation is to go straight to Telemetry.
    It's a great place to start for someone wanting to move eventually to ICU and there are plenty of telemetry units in TX who hire LVN's.

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