LPNs in ICU - page 8

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   Brownms46
    mattsmom....YOU go with ya bad self..:chuckle

    OOOh yeah..I forgot! Since I have worked in Level I trauma ERs,.... I know for a fact, .... "I" have never seen an Art Line or IABP insertion done while their in the ER! They're placed on the Vent, with RT managing them just as RNinICU stated! I want to know where an ER Nurse would gain the knowledge about complications of IABPs,(especially in certain pts), and have the experience of understanding timing, weaning, without being ICU trained??

    :chuckle...I'm playing nice mattsmom...(hiding my typing fingers)...see..
    Last edit by Brownms46 on Aug 6, '02
  2. by   stressedlpn
    How about some humor ya'll to lighten the heavy load here, last week I (me an LPN) had to train an RN in ICU. we had a blast with the irony. she was wonderful to work with and I hope we get to work together often.What was really funny was I went to school with her son. anyway just thought that was funny hope everyone is doing well. question though will some of yall consider moving down here with me? we need a few good nurses. RNinICU you have a job here if you want night yall can you tell I have been up for over 24 hours.lol
  3. by   Brownms46
    Originally posted by stressedlpn
    How about some humor ya'll to lighten the heavy load here, last week I (me an LPN) had to train an RN in ICU. we had a blast with the irony. she was wonderful to work with and I hope we get to work together often.What was really funny was I went to school with her son. anyway just thought that was funny hope everyone is doing well. question though will some of yall consider moving down here with me? we need a few good nurses. RNinICU you have a job here if you want night yall can you tell I have been up for over 24 hours.lol
    Heyyy stressdlpn...!

    Thanks for the break...! What a small world we live in, that you would end up working with the mom of a guy you know. Now go to bed...:chuckle
  4. by   stressedlpn
    okey dokey I will try love to all kelli
  5. by   StrawberryBSN
    [quote]originally posted by fadingyouth
    originally posted by strawberrybsn
    brownms...doesn't it seem a little "enlightenning" to you, that your responses to posts, myself included, are toned a little (lot) harsh?. i'm really not trying to pick on you. i do appreciate that you are thinking out of the box and really trying to understand the complexity of it all. i'm impressed you've got us all thinking. you'd be great in battling policies and procedures. but some of your responses, to me and others are equivelent to a bull-dog attack with a smiley face at the end. calm down a little...you can attract more bees with honey than vinegar.
    hmmmmmmmmm, is there then the assumption that lvn's cannot think, that they cannot perform complex tasks, cannot assist with care plans or critical care management?
    personally speaking, a lot of lvn's( and yes i am one) are able to and often asked to provide input into the total care of the critical care patient. in some cases, physicians who have known you for years would rather have your input then a young rn's that they do not know.
    i'm not sure, but i think that it's known as a matter of respect.
    i have new grads that come to this "seasoned" lvn to ask about drugs ( how to give it, side reactions, the effects), ask about the primary and secondary diagnoses and possible interventions so that they can write their care plans adequately.
    do i ,or anyone else, have all the answers---of course not.
    we have all at some time has a "i don't know" from someone who was supposed tobe our resource person.
    i, like brownms, have been offerred positions that we kindly bow out of. i do , however, love the look on the face of someone who has shunned you when a particular physician or supervisor comes to give you a hug and talk.
    perhaps you might consider taking your own advice and place a little sugar around your comment.
    being an rn does not equal a genius level iq and we can always equate strawberry to something else.
    good thinking!!

    fading beauty, i don't get your post to me here. i got that i should take my own advise on a comment i made and that strawberry equates to something else. ?????

    i agree and you've got my vote...lpn's are often times the smartest on the team. i was a lpn for years before returning to school. i sometimes want to go back to being a lpn. i think i've posted many kudos' for my lpn peer's.
  6. by   StrawberryBSN
    [quote]originally posted by mattsmom81
    originally posted by strawberrybsn

    now i sense you're feeling a bit angry because brownie is confronting some of the things you are saying...i have to say i question some of your comments as well. perhaps you aren't realizing it, but some of your comments have come off like "what's the big deal here?" you've done this in other threads too...like the one about the cna calling herself "nurse judy" ...maybe you have not intended this attitude, as the written word doesn't always translate well...

    whether an er nurse, lpn or rn is sent to be my 'helper' on a short icu shift, there comes a time when 'helpers' in lieau of competent practitioners will create an unsafe environment...critical care nurses can only be stretched so far in providing supervision to helpers. most of the critical care nurses in this forum have felt 4:1 carries an unacceptable liability and safety risk, and we are concerned for rninicu.

    we need both competent icu nurses, and safe icu nurse-patient (2:1 core) ratios to provide today's level of icu care!

    now...no more fightin', chilluns, can we talk????:kiss
    i'm actually laughing hysterically. "no more fightin' chilluns" is hillarious.

    ok....i really don't know any other way to say that my original intentions was to offer a quickly posted "idea" to rninicu. did i think long and hard about it? no, probably because i didn't get the impression that each and every noun and verb would be analyzed and scruntinized, which is kinda the way i felt at one point here. brownms didn't really make me angry as much as annoyed me with the tone of "i'll make this simple for you...", "did you read", (i'm thinkin' did she ask me can i read?...ha!) and other comments. i did feel a little bull-doged. and for what....an idea? come on....an idea!!!!....???

    but never did i feel "what's the big deal here?" because rnin icu's situation is a big deal, and i think i expressed that in the post yesturday and the original post. you say "you've done this on other threads". i was and am concerned. but lets say i wasn't. wouldn't i have the right just as anyone else to post my opinion? i can't see how my first response on this thread would bare an uncaring tone? (the nurse judy thing isn't a big deal to me. sorry, that's the way i feel!).

    i think what hasn't come across loud and clear is that i agree with everyone here. it's bad the position rninicu is in. but i didn't want to continually cry "shot em all" without offering some suggestions, whether they be good, bad, un-do-able, basic, stupid or not worked out to a tee. i thought maybe i could spark an idea with an idea and rninicu could take it from there. after awhile of going back and fourth, rninicu posted a reply that my idea was a wash, so the extra time spent on explaining it didn't and doesn't seem important. i'd rather move on to the next idea?

    your point above says:
    we need both competent icu nurses, and safe icu nurse-patient (2:1 core) ratios to provide today's level of icu care!

    i totally agree! how do we get there? i stated it will take some time, but education will kick in eventually with those newer rn's brave enough to hang in icu. yes, i know rninicu's problem is right here and now. i suggested she possibly recruit trusted networks. bad idea? what's another idea? i have a three part form letter that we turn in to our union whenever we feel acuity versus nurse ratios is unfair. these forms are tracked, and are pretty extensive in verbage. even if the hospital is non-union, turning in one of these puppies to the manager on a regular basis and encouraging others in the unit to do likewise might be worth a try. would you like a copy?

    if i didn't care, i sure wouldn't have taken the time to post. i guess i thought rninicu had enough "sisters" to drink with and call the man a dirty dog (smile.). i thought a different approach would be to "see if this will work"....nothing magical to erase the injustice....just another approach/idea.

    take care all

  7. by   StrawberryBSN
    originally posted by brownms46
    mattsmom....you go with ya bad self..:chuckle
    i want to know where an er nurse would gain the knowledge about complications of iabps,(especially in certain pts), and have the experience of understanding timing, weaning, without being icu trained??

    :chuckle...i'm playing nice mattsmom...(hiding my typing fingers)...see..
    ...here we go again...

  8. by   StrawberryBSN
    originally posted by rninicu

    i don't mean to be sarcastic, but you admit you don't understand the situation, yet you seem to have all of the answers.
    i have a clear understanding you are frustrated. that's what i started with in my first response to your post. i don't know everything nor do i have all the answers, just suggestions and ideas. take what you can...toss the rest...

    originally posted by rninicu
    you also seem to take a lot of what is posted here personally.
    only when i find myself walking wounded after reading responses personally to me! :d

    originally posted by rninicu
    i am not saying that lpns cannot function in icu, just that they are not allowed to in my state and facility. i do however believe that staff from other units, including the er cannot function independently in an icu. our staff goes through a one on one orientation, as well as critical care and dysrhythmia courses. have you ever managed a swan catheter or a balloon pump in the er? could you handle them if you are pulled to icu? without training in how to work with them, how could you "anticipate" what i need for these patients if you do not know anything about the equipment?

    we have been told that the lpns are in our unit to stay. two of our rns have left within the past three months because they do not want the responsibility of four high acuity patients. i have been employed here for 25 years, and i am seriously thinking about leaving also. i don't want to give up the benefits i have now and the time i have accrued, but i don't want to be a part of this situation...
    "ayyyyy"....sighhhhhh....i give up. its hopeless and nothing will get better...

  9. by   Brownms46

    It seems I'm not the only one, who thinks you need to re-examine your posts, and your ideas. I didn't write "did you read"...to state that you couldn't read. I wrote it because it seems to "me", that you couldn't have read the entire post....when I read your post...if you thought that an ER LPN was in anyway a solution to RNinICUs problem! I didn't state for a fact you didn't read it...I asked you a question...period! Also your statement of
    If I HAD to work with an LVN, I'd rather work with one that can "anticipate" what might come next after any given emergent procedure or treatment, as opposed to being ???lost???.
    Now where in RNinICU post...was there any mention this was a CCU?? Where in that post did RNinICU state the LPNs in the unit were lost??? When did RNinICU ever post any problems with having the LPNs in that unit... except for their restrictions??? It would seem to me...that you didn't read the entire post!! "IF" you did read the post...how did you come up with the suggestion you gave???

    Also I was "trying" to be helpful in providing the link...not condesending! I wanted to save you the time in looking for the passage, that pertained to your statement about LPNs. Nothing more! I felt your suggestion for me to read the very link I had posted for you...to be very condesending, and offensive! And the statement
    get back to "us"
    ....made me think...who the heck is us??? And this statement..
    let us know what you've learned and are no longer confussed about.
    I was totally NOT confused about what the vocational nurse practice act had stated. I asked you to "help me understand" why you felt the BVN had stated anywhere, that LVNs couldn't give ABX...but could give blood. Which made no sense...since I had already read the section..prior to giving the link to you! So it appeared where I didn't intentionally try to insult you...you did!

    But in your post to me....your were not only condesending...but you preceeded to try and put words in my mouth...or text!
    Your statements towards my suggestion remind me of an inflexible person sitting at a meeting waiting for the chance to say "No...This is BS...It won't work!!! Bah-humbug!!!! I hope I've simply read your posts wrong. The nursing field does not need more "Nothing will work" attitudes.

    I stated I was "confused" by your posts! I also asked you to state...how an med-surg Rn with ACLS would be able to be anymore assist than the LPNS there! I gave you examples of critical care knowledge that would be needed in order for that med-surg RN to be of more assistance than the LPNs there already, who probably did have that knowledge. If you couldn't explain your position without becoming offensive...why bother to present it???

    I challenged your "idea"..and your statements about what the board said! I didn't "attack" you! I didn't go on to make deragortory remarks about you or your education, as you did in this statement
    If you are to become a RN, please be more open to mere suggestions

    What has my becoming an RN have to do with anything....who the heck said I wanted to?? I have been an LPN for 22yrs...and I have been on this board for over a year...no one has ever heard me say I wanted or desired to be an RN! I'm proud of what, and who I am..period! A GREAT nurse...with an awesome resume!

    And your statement...
    What you are refering to has nothing to do with this BB. Again, let's talk offline
    . Who made you boss to tell me to take anything offline, or to decide what does or doesn't have anything to do with this BB???

    I also realized...you were trying to be helpful...but your idea....didn't make much sense to me. So rather than saying exactly that...I stated I was confused by your post...and was hoping you would provide me with a better understanding...via a well thought out explanation...not an attack!

    Last edit by Brownms46 on Aug 6, '02
  10. by   Brownms46
    Originally posted by stressedlpn
    How about some humor ya'll to lighten the heavy load here,
    S_BSN - I'm actually laughing hysterically. "No more fightin' chilluns" is hillarious.
    Well stressedlpn...we tried humor...it didn't work..:chuckle
  11. by   fadingyouth
    Where is it written that RN's know the why's and what-for's and LVN's do not? Where is there documentation that RN's have all the rights and LVN's don't. Where is substantiation that they know and we have difficulty knowing?
    Sorry to say that I have worked with PCA's who were more knowledgeable, had greater common sense, and deeper concern then some RN"S or LVN's. Some licensed, degreed persons have been seen bounding down stairs or hiding to avoid a crisis.
    If you read your practice act, understand it, implement it, and tie that together with hospital protocol there should never be any questionable doubt. At no time should there be a controversy over abilities, demeaning overtures, or a lack of working together towards the good of the patient.
    It seems to me that the more biased we become, the more negative the issues addressed seem to be the less time we have to perform our duties.
    If in fact the old joke of what BSN means is true then I'd rather stay an LVN.
    ROFLMAO !!!!!, HMMM I wonder when the claws on this subject will retract ???
  13. by   stressedlpn
    Brownie maybe we should try this.....
    Okay everyone sit back breathe slowly in, exhale do it again and again until everyone agrees that wk sucks because deep down this is the power that be(managment)way of getting us all riled up and at each others throats so that we cant be the happy go lucky folks we are. If the breathing thing doesnt wk dont worry you will soon pass out be rushed into the nearest ICU and lo and behold there is going to be this person leaning over you with what is that ,could it be LPN on the badge, an RN ready to IVP some powerful narcotic to calm your protest and once again you slip into sweet deep narcotic induced sleep. love to all kelli