LPN question for RNs in hospitals

[mazy]

I would like some feedback from RNs working in hospitals with LPNs. I have several years experience in a very high-accuity SNF and am thinking about moving on to working in a hospital.

My question is what kind of issues or concerns does that create for RNs? One thing I can think of is that LPNs, even IV certified, can't touch PICC lines. Does that create a lot of extra work for you?

Where I work I have full autonomy regarding patient care issues. I am expected to make my own decisions, even in crisis situations, with a minimum amount of intervention from RNs. If things go south I will tell my charge nurse that such and such is happening and my plan is to do so and so. This formula works well at my facility, but how does that play out in a hospital setting?

Does having LPNs in a hospital create a lot of extra work for RNs? What kind of things should I know and do to make things go more smoothly?

[ceecel.dee, MSN, RN]

Couldn't do without them, in my experience!

[grandee3]

Thank you C, could not do without you either.

Hospital LPN here, we usually have one more pt than the RN.That way, the RN can do our pushes and give IV meds, hang blood, etc.

Usually there is a charge RN who has no pts. That way, she is free to assist everyone.

[classicdame, MSN, EdD]

I think it depends on the scope of practice for your state and the dept in which you work. For instance, we do not employ LVN's in critical care or the nursery or pediatrics. We have plenty elsewhere. Our state requires an RN to make the initial assessment and at least one full assessment every 24 hours so the Charge nurse assigns those roles. The LVN's do total care in the areas they work, except they may not hang blood or do IV drips for narcotics & cardiac meds. Only a few RN's are certified to do PICC lines. LVN's may not access any type of central line, including PICC's. Hope this helps. You will need to ask HR or the hiring nursing director about that specific unit.

[Burnt Out, ASN, RN]

Sadly, we do not have many LPNs left in our hospital as our DON has and is phasing them out. We miss them and they were valuable personnel in our hospital.

And yes, depending on the state you are in and what that state's BON has for the LPN scope of practice, it does create some additional work for the RNs. For example, with shift assessments, we had to sign behind the LPNs-they would do "problem area assessments" but we had to do full head to toe. We also had to give all IV pushes, both scheduled and prns. If the patient had a PICC or CV line, we had to flush all the lumens and do tubing changes. We also had to hang all TPN. We also had to initiate blood transfusions but per our hospital policy, the LPN could monitor after the initial 15 minutes and end the transfusion, but many refused to do this. All RNs also had to do a full assessment on a new admission. That is a lot to do when a RN already has a heavy load.