I need info from NY LPNs please

[JDougRN, BSN, RN]

Hi everyone- I'd appreciate input from any LPNs working in hospitals in NY- I was an LPN for years, and when I first graduated, LPNs were hired in hospitals all the time, and with the exceptions of taking phone orders, pushing IV meds, and starting blood, there wasn't much difference in what we were allowed to do as opposed to the RNs. Over the last several years, there was a nasty trend in my area, stripping LPNs of their ability to do there jobs by limiting their scope of practice. I lost a job I loved and had been good at, where I had worked for 10 years, because they decided it was too costly to maintain the insurance for LPNs to work in maternity. I was crushed! I went and upgraded my occasional job in another hospital to full time, and worked there for several years. About 4 years ago, the hospital announced that NY state had clarified what the scope of LPNs entailed, and that for YEARS we had been doing things we shouldn't have- Mainly taking an assignment and managing my own pts, including listening to LS, BS, charting what I heard/saw- giving meds, signing care plans, ect. We were told we were no longer qualified to do that, and we had to be "paired up" with an RN. They would do the assesmants, teaching, ect. We were to pass meds, do treatments (although we couldn't chart about the wound, ect, because it was "assesing") and do all of the physical care for the patients. It was a rather nasty blow to now have to answer to RNs about every little thing involving our patients, took all of our autonomy away- It really made the job terrible.There were two of us LPNs who had 20-30 yrs experience being paired up with new RNs, and we had to go to them for everything, even if they didn't know what to do in a situation.....not great for your self esteem!

So I finished my RN, and continued working on the same floor. Fast forward a few years. There is one LPN left on our floor- who has worked there for 42 years. She is an excellent nurse. The management decided that because we are being upgraded to a stepdown unit, she no longer has a place on the floor, and gave her 6 weeks to find another position. She is devistated as you can imagine, and I am sick about it. They also did the same thing to two LPNs on the fifth floor, for the same reason. Again, one of the nurses has been a hospital nurse since the late 80s- We work short all of the time, they have 7 positions open on our floor, and they are ditching our LPN....HOW DOES THIS MAKE SENSE????????????????? So I need to hear from other hospital LPNS please...What do you do in the acute care setting? I'm fixing to try and fight this...it is just so wrong. The US is looking at 500,000 nurse positions needing to be filled in the next 15 years....and NY is pushing the LPNs out? What sense does this make? Please help me "fight the powers" and prove that LPNs have a place in hospitals. Thank you.

[pagandeva2000, LPN]

I am moving this to the New York Forum in hopes that you receive more responses.

[guiltysins]

I know it's frustrating but as someone on a different post said about a year ago, it doesn't come down to experience it comes down to the scope of practice and regardless of how qualified an LPN is, even if more than an RN, you can't fight the scope of practice for an LPN.

The practice of nursing as a licensed practical nurse is defined as performing tasks and responsibilities within the framework of casefinding, health teaching, health counseling, and provision of supportive and restorative care under the direction of a registered professional nurse or licensed physician, dentist or other licensed health care provider legally authorized under this title and in accordance with the commissioner's regulations. Section 6902, cited above, does not include nursing diagnosis within the scope of practice of Licensed Practical Nurses. Thus, Licensed Practical Nurses in New York State do not have assessment privileges; they may not interpret patient clinical data or act independently on such data; they may not triage; they may not create, initiate, or alter nursing care goals or establish nursing care plans. Licensed Practical Nurses function by law in a dependent role at the direction of the RN or other select authorized health care providers. Under such direction, Licensed Practical Nurses may administer medications, provide nursing treatments, and gather patient measurements, signs, and symptoms that can be used by the RN in making decisions about the nursing care of specific patients. However, they may not function independent of direction.

You mentioned that there are 7 spots open on your floor, obviously RN spots. So perhaps they are removing her because you are short staffed and they feel like they can't find an RN to supervise over her. Which of course someone with 20+ years experience shouldn't need supervision but it's the scope of practice and the hospital can't really do anything about that.

[pagandeva2000, LPN]

I don't think that anyone is arguing the scope of practice...I think that the OP is saying that this person should not be totally displaced. I am not an RN, so, I don't really know what it is to supervise an LPN, but I strongly believe that there are many roles right within the scope of practice that LPNs can be useful for within the hospital system.

[JDougRN, BSN, RN]

I understand what you are saying, but there is "wiggle" room. We could argue that the LPN ALWAYS was under the direction of an RN- The charge RN always knows what is going on, issues with patients are brought to her. When I was an LPN, I could listen to LS- if I heard rales, I went to her, she called the MD and got lasix ordered. That should fit the paramaters that you posted above?That is what the issue is. And as I said, I know there are still LPNs in the hospitals in NY- I'd be very interested in knowing what they are allowed to do.

[pagandeva2000, LPN]

I also believe that there is 'wiggle room'. If I were an RN, and had to have someone report abnormal observations, I would sure be happy that I can trust that an LPN...a NURSE knew what they were talking about.

I work in a clinic in a NY hospital. I do patient teaching, administer medications including vaccines, direct admissions, draw blood, etc... The only thing LPNs cannot do in our hospital clinic setting is triage--and even that really depends on how things are worded. We have a nursing list in my GYN clinic where walk ins can have their various issues addressed, such as PPD readings, WIC forms, health questions and sometimes there are emergencies. We don't know what the situation is until we call the patient, sometimes, and even when I have determined that this patient's issues need an assessment, I can go to an attending and have him make a decision (and that is what I document; the subjective/objective signs/symptoms, reported to which provider and then, what their decision is).

On the floors, at my particular hospital, the LPNs have basically been reduced to administering medications and not much else. Some of the ones that have been employed for some time may still offer to do more under the cuff, so to speak, but basically, the LPN now gives meds (including IVPB) and not much else. The LPNs working in our ER have now been monitoring the telemetry monitors. It has been this way since I received my license in 2006.

[noreenl]

Is there a possibility of switching with an RN in another part of the hospital to keep her employed and still keep to the practice act. Is her facility unionized with connections toother facilities in the area to help her get another position as quickly as possible? If not PM me and maybe I can help her !