Do You Have LPN's in your PICU?

Specialties PICU

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Hi everyone! Thanks for taking the time to answer. I am just wondering if you have LPN's on your PICU.

The reason I am asking was because I was watching a coverage thing on tv today and they were in the PICU...the PICU had a LPN working and I was just wondering how common that is.

Thanks again!

I don't work PICU anymore, but when we did, we didn't have LPNs. In fact, I've never seen LPNs in any critical care setting. Not because LPNs are not valuable members of the health team (of course, they are), but because many of our skills (initial assessments, IV bolus meds, accessing/deaccessing central lines, etc.) are things that are not within an LPN's scope of practice.

Now I work on a neurobehavioral unit with several wonderful LPNs.

We used to have LPN's but our hospital made them all become RN's to work PICU, or they had to go to the floor.

Did they all become RNs? Were they allowed to remain in the PICU while they were in school?

In Alberta, the following common skills required in our PICU are not within the scope of practice of LPNs:

IV drug administration (particularly cytotoxics and anaesthetic agents)

IV starts

short-term central line care

arterial and intracardiac line care

care of the patient with an open sternum

administration and monitoring of vasoactive drugs

monitoring and care of the patient on ECMO

endotracheal tube suctioning and maintenance

monitoring and care of intraventricular drains

monitoring and care of intracranial pressure monitoring devices

bladder catheterization

small bowel feeding tube placement

and probably several others I can't think of off the top of my head.

Assessment skills are also extremely important. The depth of assessment taught to LPNs just isn't the same.

Many of these skills are not acquired in nursing school but through a lengthy orientation to PICU. There are courses available across the continent for nurses wishing to learn the theoretical and practical skills required to care for the critically ill child, but the individual will still require an orientation and gradual introduction to more complex skills.

I work in a level one trauma center and we do not have LPN's in the units or emergency room.

In our hospital LPN's are valuable in certain situations but when it comes to trauma medicine they are not utilized.

I work in a cardio-vascular surgery ICU and we have a lot of hemodynamic interpretation and quick thinking life saving decisions that are made quickly.

I'm not saying that LPN's don't have those skills but in Florida they need someone to hang blood and push IV push meds as well as other things.

In the ICU setting things happen quick and you don't have time to hang someone elses drips, start CVVHD, handle Swan-Ganz catheters and other procedures.

Before I start getting the hate email, I used to be an LPN and there was quite a few things that I could not do. I gained experience clinically as an LPN but gained more knowledge as an RN and studying for the CCRN exam while working in the ICU.

Denise RN, BSN, CCRN

Did they all become RNs? Were they allowed to remain in the PICU while they were in school?

They were allowed to stay in the PICU, however, this happened before I came on staff a few years ago. I only know of one nurse in our unit who stayed and is now a RN. :)

Specializes in Adult ICU/PICU/NICU.

We do, but not many. We enjoy a full scope of practice in the critical care units, but the NMs will only hire an LPN if she/he is enrolled in school to be an RN or has some sort of "in." The last LPN the PICU hired used to be their unit clerk.

LPNs are able to fuction in the critical care setting with the right training if they are bright and willing to learn .....as long as the hospital and state allow them a full scope of practice. Its about the individual person vs the type of education as to who should and should not work in ICU

Specializes in Physicians office, PICU.

Our Children's Hospital does not hire LPN's. We do have a very few LPN's on the med-surg floors but they can not float to the ICU's. They are there because they got in under the "grandfather clause" before Children's stopped hiring LPN's. I use to be a LPN before I got my RN and I believe LPN's are a vital part of the healthcare team. However, having said that, we do not have LPN's in the ICU because their scope of practice does not allow them to carry out the neccessary nursing skills needed for the ICU, such as blood administration, passing narcotics, ng insertions...this would require an RN to go behind them an do these things and it is just not beneficial to the unit especially in an emergent case such as a very busy admission or a code situation. We routinely perform these functions and I can say if I had my own patient load ad had to do these things for other patients because an LPN couldn't..I would be more frustrated than ever. Patients come first! I really enjoyed working with LPN's in the Drs office I use to work in but not for an ICU.

Specializes in pre and post op. surg. and med. heart..

Actually we do in our french hospital montreal and in OR. The training is 6 months in both units. But not everybody are able to function in. In my hospital the LPN does everything like a RN (all dressing,meds,IM,

SC,glocose metre check,install catherters do the ECG, remove stitches,heperin,bloodwork,vaccination install nasolgastric tubes,ect...)Now since 2010 LPN are being trained to install IV. So the LPN has a important role in health care in Quebec Canada.

Reading all of these comments helps me understand differences in areas and states. I am going to become an RN one way or another, but right now its not feasible with money concerns, so I am going to go for becoming a CNA, and then become an LPN. I will hopefully by the time that schooling is done, find a good entry level BSN online like or some other new program that may be in the works right now.

Hoping for it because I really want to become an RN. I am okay with working in LTC for now as a care giver.

I live in one of those states where the nurse practice act for lpn's is intentionally vauge and hospitals set their own standards. I have known quite a few LPN's practicing in the ICU setting, but they all worked in smaller hospitals or in more rural areas. All of the big hospitals in my area either no longer hire LPN's or don't allow them in critical care.

I was a LPN working in peds before I became an RN working in PICU. Honestly, I didn't learn any new skills in RN school that I didn't learn in LPN school first. I'd been able to hang blood, handle all IV skills, bolus all but a few cardiac meds. The Initial RN assessment was about the only thing out of my scope of practice that I can remember. I learned all the technical skills for PICU on the unit during orientation. But each hospital varies. I was able to d/c central line's/picc's as an LPN in peds with just a check off by an RN, but now as an RN in a bigger peds facility, I can't d/c either. I could hang blood as an LPN in certain clinical facilities I rotated though, but other hospitals didn't allow it.

I do know that there is a big variation in the acuity level of the PICU's/NICU's in our state. Basically anything very critical or complex gets transferred to our large children's hospital, and the smaller facilities only handle stuff I would consider "step down" worthy.

Specializes in NICU, ICU, PICU, Academia.

Nope - all RNs except our one clerk.

Specializes in Adult ICU/PICU/NICU.
Reading all of these comments helps me understand differences in areas and states. I am going to become an RN one way or another, but right now its not feasible with money concerns, so I am going to go for becoming a CNA, and then become an LPN. I will hopefully by the time that schooling is done, find a good entry level BSN online like Western Governors University or some other new program that may be in the works right now.

Hoping for it because I really want to become an RN. I am okay with working in LTC for now as a care giver.

I'm a retired PICU LPN and we still have a few LPNs left working in the PICU where I retired, but as a general rule they no longer hire LPNs in critical care. When an LPN retires, they are replaced with an RN. As the above poster mentioned, I worked in a state with a broad scope of practice for LPNs and I could do everything except the admission assessment....so I simply didn't do new admits. I also didn't take charge, carry the code beeper, serve a patients primary nurse and write the care plan or train to be an ECMO tech. Otherwise, I took care of my own patients under my license and there was very little for my RN charge nurse to have to do for me....usually just checked blood products with me before I gave them.

I would advise you to get your BSN ASAP from a good nursing program with a good reputation and skip the LPN route if possible. Getting that BSN will not make you a better nurse, but it will give you the most options in your career. It will give you the best job security as well. Online BSNs are extremely expensive and many have questionable credentials. The hospital from which I retired will not consider applicants who have an online BSN for positions that require that degree. Your best bet is your local state school which will also be the most cost effective. AVOID the for profit schools that could care less about your qualifications and just want your money.

Best to you,

Mrs H.

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