Does any Rns who work in a hospital have LPNs assigned to them?

DNP54 · Mar 26, 2009

Hi - I've been an LPN for 17 years and I've pretty much only ever worked in a Hospital Med/Surg environment. In my state, there is no 'defined' scope of practice for an LPN, basically the law states that an LPN can do whatever the facility that employs her feels she has been trained (school, continuing ed, inservice, skills lab) to do.

Our assignment for night shift is 1 RN, 1 LPN and a student/cna for up to 10 or on a bad night 12 patients. It's a small county hospital, so we get a little bit of everything. My facilties policy is that I cannot hang blood, although I have had to several times, initiate a care plan, do an admission assessment (again, all the time...its night shift) and thats about it. We take orders, hang and push IV meds and give insulins. There has been alot of discussion about 'critical drips' on the med/surg floor, but in the end, they are all critical. Sometimes the computer charting system requires co-signing, but that's the same for RN's as well. In our hospital its required for insulin, TPN, K+ protocol bolus and some cardiac drips. Only chemo nurses do chemo, but everything else is just kind of out there needing to be done.

There are not any LPN's in Pediatrics, not that they couldn't be, there just aren't right now. Same with L&D and ER. Personally, I have been telemetry certified and ACLS, but thats just because my hospital paid for me to take the course and I up date it with my BLS every 2 years. I have worked in Dialysis out patient clinic, organ transplant (stable post op only) and private duty for a couple of quads on vents (adults, alert and oriented). After reading these forums, I realize that I am EXTREMELY lucky, as most LPN/LVN's don't ever get to do some of the stuff that I have gotten to do. There are 6 LPNs in my hospital Med/Surg, and 5 of us are in ASN or BSN programs. One is just working to support her golf habit.

The RN assesses the patients, I pass meds, and we round and reassess q 4 hours. We both do patient care and prn's, and I tell her what I have done, or am about to do, or if I am thinking it through, I'll run signs and symptoms by her. I do the line draws for lab, she starts the IVs, not by policy but because I'm a crappy stick. If we need help the house supervisor helps us out. It works out pretty well. I'm alot older than alot of the RN's and we respect the roles. We use our resource people if it gets wild, and it does.

I have worked in much more restricted states; no IV meds, only PO and injectables, co-signed. Basically I have been a CNA with a license. So its a really broad range of stuff out there.

So, are you thinking about working in a hospital? Its really different than clinic or long term care.

lovehospital · Mar 26, 2009

Wow I must say the patient ratio is high:))))

nerdtonurse?, BSN, RN · Mar 26, 2009

As an LPN, I can do anything except cancer drugs. I'm ACLS certified, and have completed the Acute Care Course at my hospital. I do initial assessments and interviews (but they have to be "validated" by an RN, which usually consists of one of them yelling, "hey, you done? Good, you're validated"). I can't start a care plan. I can't be charge (oh, big boo hoo), and I can't sign a death certificate. At my hospital, I can do pretty much everything else. However, you go down the road to the next hospital, and they can't hang blood, or push narcotics. I'm also nightshift, and we "ladies of the night" tend to work right at the edge of our license -- not because we want to, but because that's what happens. Now, if I was at a bigger hospital, there would probably be more constraints, but here, we're so short, there's no option.

And, no, I'm not "assigned" to a RN, I'm her coworker.

ohmeowzer RN, RN · Mar 26, 2009

that is a high nurse to pt ratio even for noc shift. the noc shift at our hospital their highest is 7, for days 6 to 1. we donot hire LPN's at my hospital ,but i wish we did .

APRN., DNP, RN, APRN, NP · Mar 26, 2009

Do any RN's on this forum have LPNs assigned to them and do all of you have a nursing assistance tech?

Hi,

I'm an RN. I don't have any LVN's assigned to me, but neither do I have any nursing assistance/tech assigned to me. (I work in ICU). The hospitals in my area have phased out the LVN's in acute care. (It's REALLY sad!!)

nurseinak · Mar 26, 2009

The pendulum swings back and forth on the topic. When I started as an RN, we had several LVN's on our Pediatric floor. They then phased them out only to later realize "oh we really need them". I do have to wonder why anyone would be an LVN or LPN? You basically work your butt off, don't always get the recognition, and definitely never get paid enough unless you are an antique . By the way, my best friend is an LVN, and she is the BEST nurse I have ever worked with.

tj_Medic_RN · Mar 26, 2009

I could only dream of 1RN 1LVN and a CNA per 10 patients... In our facility it is not uncommon on the med-surg floor to have 2RN's 4LVN's and 1CNA per 40 patients. The RN's split the floor and each takes 20 pts and the LVN's have 10 pts each with the CNA doing vital signs and assisting whenever and wherever they can... depending on how many patients are on Q2hr vitals, Q4hr Vitals and Q8hr vitals as to how often the CNA is available to assist with toileting, bathing and assisting the patients with ADL's, then the duties fall upon the Nurses LVN's and RN's to make sure the patients are medicated and cared for. I know that there are different ratios in different areas of the hospital and we are not full all the time but here lately we have been having between 35-40 daily and it is taking a toll on the staff, they do not staff by acuity they staff by number of patients.. and our acuity level has been high lately... several nights I have had 3-4 patiens recieving blood or blood products, 12hr post op knees, hips and shoulders all requiring Q2hr neuro checks and scheduled pain meds, add to the mix 4-5 resp Isolation patients, 2-3 contact Isolation patients and this is just in my 20 alloted patients the other RN has a similar mix of patients.... but I am hanging in there until I can get some expierence under my belt, I am a new RN just licensed Dec 31 2008. I have 11 years as a paramedic so it has helped me alot on the nights we are really under the pressure as I am used to working under pressure but not for 12 hrs straight... usually as a medic I at least got a few min to just collect my thoughts before I was going again..I know I went on a rant but as far as having a LVN assigned to me.. no we most certianly work side by side.... as co-workers...

Mollypita · Mar 26, 2009

On my med-surg floor, the LPN takes her own assignment and does her own meds and assessments, except for IV push meds. Then she's "assigned" to an RN who does the pushes, because LPN's can't do those in MD. It usually works out pretty well.

HeartsOpenWide, RN · Mar 26, 2009

We do not have LVN/LPNs in our hospitals anymore. For a short time they even did away with CNAs too, but now they have about 2 to a floor except OB there are no CNAs; although one of the hospitals has a tech but only during the day.

flightnurse2b, LPN · Mar 26, 2009

i work on a mixed RN/LPN floor and we all have our own assignments with 2 techs assigned to the wing we are working on to help us with vitals, ADL's, etc.

we are all co-workers.

RheatherN, ASN, RN, EMT-P · Mar 26, 2009

Being an RN, we do have an LPN on our floor and yes, she has a scope of practice. we dont have to co-sign her stuff, but we need to double check her things if we see fit, or however you want to (RN i should say), you can completely do an assessment like its your pt. she will do all except IV anything. our LPN had been there for yrs so she knew what she was doing, and she was awesome!! i loved her! she is not doing so well not, and my heart goes out to her.

hope this helps!

-H-RN