Do You Have LPN's in your 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!
    Last edit by Chevelle on Aug 7, '04 : Reason: At least say why I am asking...
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    No................
  5. 0
    If not -why not,so I'm asking why so many defib's? instead of precordial thump
    Question
  6. 0
    Quote from Chevelle
    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!
    No we don't have any LPNs working in our PICU and will likely never have. Our jobs are heavily skill-dependent and LPNs don't have the skill set needed.
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    Yes we have Lpn's in our picu and Nicu and I have worked bouth ends and yes I do have the skills to work there. Making that statement lpns don't have the skills is to broard I have met some RNs that didn't have the skills needed to be on a regular floor nor would I want them to be my nurse. Every nurse is capable they just need to be orintated.
    Amber628 and NurseJenny:-) like this.
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    Where do RN's attain their skill sets for PICU? In school ? I didn't realize that you aquired these specific skills in school .
    Amber628 likes this.
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    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.
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    I'm an LPN who worked post partum, (and ante-partum until it became an all RN unit) and can honestly say I've never had the desire to work NICU. The students' I trained with all wanted to work with babies for some reason. But after working, I've never ran into any of them in maternity. The assessment training that Alberta LPN's obtain is superior to that offered in many provinces. I've seen it on this site that BC LPN's have to retake Physical Assessment to obtain an Alberta License. I have assessed many newborns in the "regular" nursery when an LPN has been on coverage for an RN, the only thing we couldn't do was the administration of Vit. K because we can not perform an IM on anyone under 5yo. (Provincial Regulation)

    As, Jan says many of the skills are not in our scope of practice. However, having said that, Jan, LPN's in Alberta can take the IV start course offered at GMCC, however most employers will not let us utilize that skill. IV meds were added to our scope of practice last November, and the youngest person I've ever catheterized was a baby girl at the Children's Hospital when I was a student.

    The rest are things I have no desire to ever do. This wasn't meant to start a "war" but to let you know what we are capable. of.
    Last edit by Fiona59 on Jan 21, '05
    Amber628 likes this.
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    It's important to note there is a HUGE difference between Canada and the US in this matter. In my experience American LPNs can do a lot more in the hospital setting, but even here I don't see them in NICU or PICU. Peds or special care nursery will use them, but not the intensive care areas.
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    I don't think this was meant as a knock on LPN's. In our hospital we have a few that have been there for 15+ years but they don't hire LPN's to the unit anymore. For us, it's because of hospital policies, scope of practice issues that say an RN has to do certain things. It varies from state to state. For example in my state an Rn has to do all IV meds, has to do all initial assessments (so even though our LPN's were perfectly capable of doing those things, an RN had to come behind them and do it again), if an LPN was assigned to the patient an RN had to be assigned to that patient after the LPN so that two LPN's couldn't be assigned to the same patient back to back, an RN had to hang blood etc etc.
    I've done both NICU and PICU and often these kids can turn on a dime and need IV meds, blood etc stat. I could see it being an issue if an LPN is assigned to a crashing patient and can't do those things ( hospital won't allow it; not they aren't capable) it could be a problem. Just my observations.


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