LVN in MICU

  1. With managed care, more hospitals are looking into utilizing more LVNS. Do you work at a hospital who is using LVNs? Is this working out? What kind of patients can they safely take care of in MICU?
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  2. 11 Comments

  3. by   jcolburn
    I am an LPN on a 23 bed MICU/CICU, at Indiana University Med Center in Indianapolis. I was hired directly to the ICU right out of school. I was oriented by RN's and allowed to take some of the sicker pt.'s we have on the unit, for a better "learning experience". I have now been here for a year and a half without any problems. I float to the SICU, and take fresh post-op patients. The only restraints on my ability are that I am not allowed to shoot Swan numbers, take care of pt's on the IABP, or CVVH. I have been allowed to take many pt's with Swans, I just have to have an RN get the numbers for me, which lately due to short staff and a high turn over, I have been having to show some of the "RN's" how to do it. Recently one of my pt's crashed and had to have a Swan inserted, and while I had to switch assignments with my "resource RN" I also had to show her how to set up for it and assist the Doc's with it. She has been on the unit over 2years. Bottom line, I take care of very sick patients, and so do the other LPN's on my unit, and with the lack of experience on the unit, the patients are a lot of times better off with us than another RN. The experienced RN's know this and treat us accordingly.
  4. by   whitedog
    I agree wholeheartedly. The LPN/LVN"s in my unit, although there are only 2, are excellent caregivers with clinical skills that rival the most experienced of RN's. Our LPN's shoot theirPA numbers but have most of the other restrictions you named, as we have special certification exams required for CABG, IABP, etc. Either of our LPN's could be my nurse anytime. Carol

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    whitedog
  5. by   HazelLPN
    I have been an ICU LPN for over 35 years and I have similar restrictions but I can handle 90% of the work on my patients. The other restrictions are that I can not take charge, carry the code beeper, function as a primary nurse or delegate to nursing support personelly (nurse techs, Nursing assistants, etc). Experience is the best teacher and LPNs are certainly capable of working in ICU if they are willing to learn.
  6. by   sharann
    What states do you all work in? I wonder because in California (so far) LPN's/VN's(acute care) are not allowed to push IV meds or hang piggybacks or any med in an IV except for KCL and electrolyte dolutions etc. At our hospital the RN's ahve to cover most of the meds given as well as co-sign all assesments.
    I'm really intereste in how it is with you all.
  7. by   sharann
    Well.......?
  8. by   EmeraldNYL
    I work in a MICU in a Level I trauma center, my hospital does not hire LPN's at all.
  9. by   Brownms46
    Originally posted by sharann
    What states do you all work in? I wonder because in California (so far) LPN's/VN's(acute care) are not allowed to push IV meds or hang piggybacks or any med in an IV except for KCL and electrolyte dolutions etc. At our hospital the RN's ahve to cover most of the meds given as well as co-sign all assesments.
    I'm really intereste in how it is with you all.
    That would need to be answered by some who lives in your state, as has been said many times, "it depends on where you practice! I practice in Washington state, which allows LPNs to do IVP, and hang IVPB. Also in the state of Texas you are allowed to do anything your employer wishes to teach you.

    I have worked Critical Care MICU, ICU. CCU and NICU. On at least three contracts in S. C. I worked ICU/CCU, because the RNs I worked with wanted me there. And because they did, the NM continued to renew my contract. There are MANY, MANY critical care LP/VNs out there, and have been for years. I started in NICU straight out of school in 1980, and the ones who taught me, had been there for years before me!
  10. by   sharann
    I have nothing against qualified LVNs doing anything. I was jsut asking carlota a question regarding her post. Our LVNs work in most areas except for PACU and GI lab or Special Procedures. Our ICU RN's still feel they have a double load because they are doing so many IV meds in ICU for both sets of patients. If I was an LVN and was asked to do the same skills as RN's, then I might want to be compensated as such. JUST my opinion. Take care everyone!
  11. by   HazelLPN
    RNs in my unit that have full patient assignments do not cover LPNs. Instead, the charge nurse covers an LPN who takes a full assignment. I can pretty much manage everything on my own, including my shooting my PA cath numbers, drawing gases, most IV drugs, titration of pressors, and blood products (as long as it is checked with an RN/MD). I do not usually take IABP or ECMO patinets and I don't take new admissions. Otherwise, I'm self sufficient and there is very little for the charge nurse to do except co sign my assessment. In states where LPNs are restricted, it seems like they should not take a full assignment. With our nursing support staff..nurse techs and nursing assistant II, the RN takes an expanded assignment. The pair will usually take three 1:2 patients or a 1:1 and a 1:2 together. This works out very well. Perhaps states that do not allow LPNS the full scope of their practice could use a system like this.
  12. by   Brownms46
    Originally posted by sharann
    I have nothing against qualified LVNs doing anything. I was jsut asking carlota a question regarding her post. Our LVNs work in most areas except for PACU and GI lab or Special Procedures. Our ICU RN's still feel they have a double load because they are doing so many IV meds in ICU for both sets of patients. If I was an LVN and was asked to do the same skills as RN's, then I might want to be compensated as such. JUST my opinion. Take care everyone!
    That is the reason I do travel, so I can be paid more than for what I do!
  13. by   sharann
    It sound like Hazels hospital has a system that works well. Too bad this is not the norm here. Thanks for the info gals.

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