ICU Nursing Support Job

HazelLPN, LPN · May 20, 2012

It sickens me that that your program gave you no acute care clinical experience. A nursing program that doesn't train you to work in a hosptial setting shouldn't be allowed to operate. In my day, we LPNs trained and lived at the hospital where we trained. Your LPN program certainly didn't prepare you for acute care nursing, so if you take this job in the ICU you will need do a lot of studying on your own. I worked as an LPN in the ICUs for over 40 years assuming total care of my patients and obviously I had to learn well beyond what I learned in LPN school to do what I did.

If the RN has ten patients in the ICU with an LPN, than it sounds like its more of a step down unit than a proper ICU, as most ICU patients are one nurse to two patients, and the sickest may be one to one care or even two nurses to one patient depending on acuity.

I think that you should pick up the phone and call the nurse manager and ASK what skills you need for this job and how the LPN is utilized. Ask her about acuity in the unit and what the LPN is responsible for. Remember, an LPN has a license that can be lost just as easily as an RNs can. For example, if caring for a patient with an unstable airway is in your scope, and you injury your patient while suctioning their ETT, that is your license on the line, not the RNs who is covering you. You must know your scope of practice and nurse practice act for the state you live in and what the facility you work in allows you to do. Can you give IV meds? Can you perform a shift assessment? Can you draw labs off an A-line? These are things you need to know before you start working because if you work outside of your scope of practice you could lose your position and your license.

Best to you,

Mrs H.

ncnrse2b · May 20, 2012

I'm an LPN with 2 years exp working LTC. My LTC job is pretty decent, 28 residents max, 1st shift, always same unit. The usual mix of dementia, demanding, and med seeking residents. Its not horrible, the AM med pass takes 2 hours at quickest, 3 at the worst. I put an app in at a local hospital that posted for LPN for ICU. Its a nursing support job in an ICU unit. 5 RN's, 10 patients. Delegated duties from the RN's. No CNA's in the unit. I got an offer, the pay is well below what I make in LTC. Im afraid of being treated like a CNA and only given the most basic patient care to do, or whatever the RN's don't want to do. I have no hospital experience, not even in school clinicals. Is it worth it for the experience?

Its a support position. The 5 RN's each have 2 patients at the most. It would be a job supporting them and their 10 patients. Not that they have 10 patients each. Even me with my no acute care experience would not work in that atmosphere. As an LPN in the unit I would not have my own patients to care for, but to float and take direction from the 5 RN's in the unit.

HazelLPN, LPN · May 21, 2012

I misread your initial post....I'll call it a senior moment.

If you wish to work in acute care, I would take this job, while knowing what the state BON and facility allows you to do as an LPN.

Best to you

Mrs H.

KimberlyRN89, BSN, RN · May 21, 2012

It sickens me that that your program gave you no acute care clinical experience. A nursing program that doesn't train you to work in a hosptial setting shouldn't be allowed to operate. In my day, we LPNs trained and lived at the hospital where we trained. Your LPN program certainly didn't prepare you for acute care nursing, so if you take this job in the ICU you will need do a lot of studying on your own. I worked as an LPN in the ICUs for over 40 years assuming total care of my patients and obviously I had to learn well beyond what I learned in LPN school to do what I did.

My program called it a "liability" issue. We had a few limited days at Johns Hopkins for our Maternity/Pediatrics clinicals, but even then we couldn't do too much other than observe. I think a lot of hospitals just don't want LPN students on their floors :shrug:

On topic: OP, is it possible for you to keep your position at your LTC and work at the hospital as well? I met a couple of LPN's who worked as a tech in a hospital just for experience's sake & also worked as an LPN in LTC. Best of luck with whatever you decide to do :)

ncnrse2b · May 21, 2012

Thanks for the replies. I think I'll stay on in LTC PRN to keep my feet in it. But I think this will be worth the experience. I was honest about my skills and experience so I'm hoping its a good fit. Plus it will be great when looking at bridge programs.

KimberlyRN89, BSN, RN · May 22, 2012

Thanks for the replies. I think I'll stay on in LTC PRN to keep my feet in it. But I think this will be worth the experience. I was honest about my skills and experience so I'm hoping its a good fit. Plus it will be great when looking at bridge programs.

Good idea! Plus, when you finish your RN program, you will have a better chance of getting a new grad position :-)

HazelLPN, LPN · May 22, 2012

Best wishes to you on your career move. Learn as much as you can in the ICU, get ACLS certified, start reading journals and study study study on your own time. Have a pt with a CHI? Learn about them....learn why they become hypokalemic and why we take their temp down so low...learn how the body works and what action you do as a nurse will effect the body...and that is where you learn your critical reasoning skills...not in nursing school. Learn about the drugs, even if you can't give them yourself. Find a veteran nurse and make friends and ask lots of good thoughtful questions. Again, know what your state scope of practice according to you BON and what the facility allows you to do as an LPN. If an RN delegates something outside your scope and you do it, both you and the RN are liable.

LPNs should be trained in the hospital as there are still places that use them. I would encourage anyone who is looking into LPN programs to take their money and talent elsewhere if that program does not offer a well rounded education that includes a med/surg clinical in acute care. One should at least be exposed to various aspects of nursing to determine one's forte. Liability? SPNs are no more a liability than students persuing their RN. They both work under the supervision of their instructors.

Best to you,

Mrs H.