florida nursing???

NurseguyFL · May 28, 2007

All depends on perspective---and perspective is always skewed when you compare apples to oranges. Even in Florida, the scope of practice for LPNs is a little different than the one for RNs. There are certain things that the Florida BON does not permit LPNs to do independently, and there are hospitals in Florida that no longer hire LPNs.

This doesn't mean that LPNs are not valuable, educated, and skilled people because I know quite a few of them who could run circules around many RNs, but its not simply a matter of job security for RNs either. If the hospitals could hire only LPNs and pay them lower salaries to do what they are paying RNs a higher salary to do, you can be assured that most of them would get rid of the RNs---for no other reason than the labor cost savings. Many hospital administrators have determined that its more cost efficient to hire an RN that they can charge with 100% responsibility for patient care, than to hire an LPN who will require RN supervision in certain circumstances. For instance, they can assign more patients to an RN, regardless of the acuity of the patients, and hold that RN fully responsible for independently assessing, overseeing, and executing 100% the patient's care needs. The BON's rules do not permit them do this with LPNs.

Why am I still here? Well, I own a home in Florida and have lived here most of my life. I don't dislike Florida, but there have been many, many changes here over the years and not all of them have been good. Some of the hospitals in south Florida used to be quite good...until they got taken over by you know who. That's when things really began to go downhill for the nursing profession in this area, and many of the more experienced RNs have since left.

You said that LPNs in New York can give IV therapy, but per the BON, they can't do it in Florida either unless they complete an IV therapy certification course. You said LPNs in NY can't given insulin in a patient's home. It used to be standard nursing practice for even RNs to cross check insulin with another nurse before giving it. Some hospitals don't require that this be done, but I've worked in hospitals that still do. Even when I'm working in hospitals that don't require a co-signature for insulin, I always ask another nurse to look at what I'm drawing up in that syringe. Same with blood. Some hospitals do not permit LPNs to give it or cross-check it, others do. Sometimes it depends on the hospital and whatever policies the risk management people feel are appropriate.

I also disagree that anyone is on here to "bash" certain hospitals. People are merely commenting about their experiences and observations. Since you love working as a nurse in Florida so much then, by all means, you should come back.

NYSNOWBUNNY007 · May 28, 2007

Yes i agree... it all depends on perspectives...My whole issue was that everything that was mentioned on that thread was extremely negative...i KNOW many stay in florida due to personal circumstances i am not totally ignoring that issue...im well aware of the scope of practice in both states...my whole point was that anyone reading the thread would get discouraged to work in florida...yes i know things have changed too...i have seen how bad few places have gotten and the way the rn's are treated..its not right...i for one am VERY proud to get my training in florida...i think it was better than New York...and i am a born and raised new yorker...I wouldnt say i totally LOOOVE working as a nurse in florida but for the fact that as an LPN there are more options in florida as far as work...there are many things an lpn can do in florida that is not allowed in new york..florida has flexibility with agencies, like home health visits..very rare up here in ny...working in schools, prisons etc...i dont plan on being an lpn forever...but as far as lpns scope of practice with the rn's scope of practice everyone knows there is a difference, well at least we would hope so:lol2:...but the state of fl allows lpn to do more than the average lpn in ny or other states...i heard tx was another state as flexible as florida..i was angry to get my iv therapy certification with all my CEU's and come to ny to find out that there not needed...we are not allowed to do iv therapy in ny...why?...because they just want you to go on to the floors and pass meds to the 50 residents...:angryfire....i felt as though my credentials where worth nothing...yes there is a shortage in fl...yes there are really bad conditions as far as nurse patient ratio...but maybe florida nurses can rally together like they did in tx, ct(as far as their mandation issue) and other states and protest for better working conditions!!(lets see how far that would get)..if we as nurses allow these organizations to do what ever the h3ll they want to do to us then conditions will always get worse...im all for better working conditions and for a better place to be...they key is how many brave people will ACTUALLY get together and vote for better?...and yes like i mentioned before i agree with you 100% on percpective many love to work in certain hospitals others don't...we can only hope for the best!...where abouts in fl are you from?...are you doing EC?...thanx for the reply!

NurseguyFL · May 28, 2007

I live in Broward County, but I've worked up and down the entire east coast of the state. I confess that lately I spend most of my time working outside the state, because I was making better money and found better working conditions working elsewhere as a traveler. I'm now back in FL on the back end of a local contract, and although the money is good, I'm daily reminded of some of the reasons I stopped working staff here in the first place.

I'm not trying to discourage anyone who wants to come to this area to live and work as an RN. But, some people might find it helpful to know ahead of time what they might be getting themselves into. During the busy season, working on the floors in most area hospitals can be quite a frightening experience. I've seen staff nurses get written up because they refuse to take 8 and 9 patient assignments on a tele floor. And some of the other stuff I've seen happen here during the past few months make my head spin. Back when I used to work as a full-time staffer down here (which wasn't that long ago), I don't remember things being that bad. I usually work in the unit, but I've done a lot of floating to the floors and sometimes its just ridiculous the workload being dumped on the nurses, often with no CNAs on the floor at all. The poor CNAs!!!! Sometimes, when we're lucky enough to have one, its just that one CNA to help with a whole floor with 40 or more patients. Mind you, a lot of these patients are older adults (many from nursing homes) who are total care. Everybody needs to get bathed, and most of them need help with toileting, eating, etc. Its just not possible to give the best quality nursing care to everybody under these circumstances. Some things either don't get done, or don't get done within the time they are supposed to be done. Patients complain, physicians complain, families complain, and nurses complain---but nothing changes.

In a few hospitals you can't even find supplies or decent equipment to work with, and management doesn't seem to care, except when somebody from Joint Commission or a big wig from the corporate office is touring the floor.

Even in the intermediate care 'step-down' units where some patients are on titrated drips, they are giving the nurses 7 patients! Worst of all, I recently did a per diem stint in one hospital where a couple of their nurses called out, and they didn't have any staff, so they tried to get the rest of us to pick up 4 patients a piece---in ICU!!! Of course, I refused, and I've been told by the agency that they made me a DNR at that facility. But, whatever...!

True, it would be good if all Florida nurses got together to fight the system for better working conditions, but I doubt its going to happen. Most Florida nurses are not unionized, and although many complain about the conditions they aren't willing to get too vocal about it because they don't want to risk stirring the pot and getting fired.

NYSNOWBUNNY007 · May 29, 2007

Broward...thats where i plan to relocate...i hear you!...LOL!! i feel your pain!!...did you ever work in Mount Sinai? sounds like your talking about them! :lol2: ...have you tried wellington or jfk in palm beach?...i lived in pb for about a year and a half...if im correct i believe they're both non-for-profit...yes it is very true that many are afraid to stir up fire...but we can only hope for things to get better...i lived in Miami NW area...it was nice...but it seemed like every hospital i went to one had what the other one didnt...crazy huh?...well..i plan to do HH when i get back down there while finish up my RN through EC...cuz some places are ruff...i have many friends that are RN's in south florida..most of them work agency..they are iffy about going staff...Are you working on your BSN?...that must be such a good feeling...there are times i wish i had my RN already..but eventually i will get there...Good luck!