LPNs in ICU - page 2

Our hospital recently brought LPNs into ICU, and we are having some trouble adjusting to the change. They were brought in to our units because we have lost so many RNs recently, and have not been... Read More

  1. by   RNinICU
    I did not start this thread to foster resentment or hard feelings between RNs and LPNs. I was simply looking for some feedback from anyone who might have some advise about how to better organise patient care in our unit. The LPNs in our unit are limited by state laws, not their own shortcomings. They work hard and are just as frustrated by the situation as the RNs are.
  2. by   Stargazer
    LPN's were phased out of the ICU where I worked simply because--and it sounds like RNinICU's in the same boat--they were limited by the state's Nurse Practice Act so much that it made the logistics of providing full-coverage patient care too difficult.

    I have seen LPNs from other states post here and based on how they describe their scope of practice--able to hang blood, give IV push meds, etc.--it would be reasonable for them to work in a critical-care unit.

    I don't agree with Renee that the LPN's are definitely there to stay--management tries these things on, certainly-- but initially it is usually regarded as a test or trial period. My unit tried to partner an RN with a tech and give them 4-patient assignments. It was trialed--mainly by me, I might add--for 6 - 8 weeks and finally scrapped, because invariably 2 or more of my patients would crash simultaneously.

    We recently trialled some "innovative staffing" in my current company--because we were basically ordered to by HR--and we've given it a fair and lengthy trial, but it appears that it's not going to work out, either.

    The key? Detailed notes about what does and doesn't work and WHY, safety/pt care issues, errors of commission or ommission, etc. Get the LPNs' views on the problems as well; then organize and type it up neatly into a nice little report for your NM (with copies to his/her boss, also the medical director of your unit, and Risk Management). I understand it may be difficult to pin down some of the nuances, but simply saying, "Most of it is very subtle, and is difficult to take anything specific to our unit manager" will get you absolutely nowhere. Document, document, document!

    Good luck. Sounds like a difficult and frustrating situation for all the nurses involved.
    Last edit by Stargazer on Jul 29, '02
  3. by   stressedlpn
    Originally posted by Flo1216
    In my hospital you have to be critical care certified to work in any of the units and only RNS can work there and I don't think that is wrong.Nothing against LPNS but I wouldn't want an lpn taking care of my mother if she were in critical condition and on a ventilator. Their scope of practice is different than that of an RN. It's nothing personal, it's just the way I feel. Where I live, lpns go to school for 1 year and don't go in depth with anatomy and all. I say if you want to do all that, then become an RN. When we are short of RNS in the units we use agency nurses who are critical care certified.
    , would you rather me, as an LPN with years of critical care behind me not to mention that I have been trained and only ONE of 6 at my hospital who are capable of hooking up and maintaing the vent, or an RN fresh out of school take care of your loved one. MY scope of practice IS critical care and I am D++n good at it .or since I am an LPN would you not even give me a chance. Just for referance It is usually the RN that beeps me in the middle of the night, to come help if a trauma shows up in the ED, Its the RN on duty when there is a vent that asks me to stay with them so If something goes wrong I am there. Please dont look at someone because of their title judge them by what their "scope of practice is"
    Last edit by stressedlpn on Jul 29, '02
  4. by   EXOTIC NURSE
    I have seen this many times before..........this topic anyways.....I feel that the nursing shortgage is so wide spread that something will have to be done. The only thing I can say is that we all should try and work beside each other as best as we can as I would not even try to work in a critical care area as a LPN due to my restrictions in my state as a LPN. I would prefer a competent nurse to take care of my familiy member regardless of the title LPN verses RN. I will be taking my boards soon and I plan to try to be a good RN just as I am a good LPN. (Just my two cents)
  5. by   Robin61970
    Sorry Rebel, but I think you are way out in left field on this one......no one here said anything negative about LPN's to deserve the comments posted by you........those that did not want to comment said so and left it at that. The reason for this thread was to help find a solution on working together and helping each other. So that is what everyone is doing not LPN bashing.....normally I try not to be rude, but you seemed not to have a problem with it in your post........chillout already!
  6. by   mattsmom81
    Please LPN posters who are offended....read what RNinICU is saying!

    Those of you LPN's who are critical care nurses ...Brownie and Stressedlpn.....would YOU want to be liable for 4 patients in a real ICU?? (We're NOT talking about a Tele unit)

    With the state and facility restrictions in RNinICU's state that is what she is afraid will happen legally....and I don't blame her.... let's all try to share opinions without feeling offended, so we can all get along.
  7. by   Flo1216
    My, so defensive. Like I said, where I live,LPNS go to school for ONE year. The" fresh-out -of school" RNS have a 6 month orientation and go to school for four years. No one is saying anything bad about LPNS, but they are trained differently here. Maybe where in other areas they go more in depth.I don't know...all I know is how it is where I live.But I guess the defensive LPNS should be allowed to work anywhere they want, so that their feelings don't get hurt.
  8. by   rebelwaclause
    Originally posted by Flo1216
    .... but I wouldn't want an lpn taking care of my mother if she were in critical condition and on a ventilator.
    Originally posted by Flo1216
    But I guess the defensive LPNS should be allowed to work anywhere they want, so that their feelings don't get hurt.
    Originally posted by Robin61970
    Sorry Rebel, but I think you are way out in left field on this one......no one here said anything negative about LPN's to deserve the comments posted by you........
    (Thinking to myself..."Can she read?...What in Sam Hill..?")

    .... OK...Yep...I get defensive over comments like the ones above, JUST AS ANYONE ELSE WOULD if their discipline was constantly attacked and insinuated as worthless. Uhgggg! So.... I resign to posting on this thread. It's not worth banging my head against a wall, which would be my next outlet. This thread started as "looking for some feedback and advise on ways to organize care" between RN's and LVN's in the CCU setting. But I think more often than not, most posters (not all) gave a lot of personal opinions that where worth a grain of salt. The "letter to RN's" was written in frustration, and I'm guilty for feeding into the sucker punches like those qouted above.

    Are my feelings hurt? Well...No, strangers rarely hurt my feelings, "Flo". But nevertheless it is frustrating to the max to see how careless people can be with someone else's livelihood.

    Don't ever wonder why there's a nursing shortage.

    THE END.
  9. by   Flo1216
    I'm sorry, but I never "attacked" your discipline or called it worthless.I merely stated an opinion and I have the right to do so. Please don't put words into my mouth. If YOU have a problem with your discipline, that's on you, but I never put it down. You seem to be one of those people who cannot maturely handle an opinion that deviates from your own.
  10. by   LasVegasRN
    I worked with LPN's in my ICU before. It was a "pilot" study. I apologize for not being fresh on this as this was 10 years ago. The LPN was also an EMT. A guy, a great guy, very willing to learn. He could record vital signs, monitor the drips the RN had set, and provide bedside care. He was WONDERFUL during codes. He could give meds through G-tubes, do I & O's, all sorts of things which made an higher case load a LOT easier. Once he got used to the way ICU worked, how the nurses handled their patients and the docs, it worked seamlessly.
    So.... LPN's in the ICU can work.. if you want it to.

    Just my $0.02.
  11. by   stressedlpn
    originally, I wanted to help due to the fact that we DO have a very successful ICU unit where we all work together, RNs and LPNs and yes I am allowed to do alot here in Ark. so in return in school we are trained to do more even though we only go to school for a year. I rout. take care of more than my share of the load and usually I take the less critical in the ICU or I deal with all the Resp. failures because that is my cup of tea, so to speak. That is how we get along so well in my unit. Yes I was offended by some statements that were made by Flo there. as many people would have been. Like RNs we all have our "specials" My main point was dont say you wouldnt want an LPN taking care of you until you know what that LPN "scope of practice is" any love to all kelli
  12. by   Flo1216
    Hey, I was talking about the training of lpns where I live and they are not trained to handle critical patients. I cannot speak for the entire U.S. nor was I trying to. But it's a mute point. I guess we will just have to agree to disagree.
  13. by   stressedlpn
    agree to disagree love to all