LPNs City VS. Rural

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Specializes in NRP, Pediatrics, Med-Surg, Orthopedics,.

Hello fellow Nurses,

I am a rural LPN and a good one at that. I work on a busy Labor and Delivery floor that also encompasses verious surgical and medical patients as well. I work to full scope and beyond as I am often team leading when the RN I work with must be in the back with a labor patient. I am often the only one looking after many patients including babies. While I dont feel like this is out of scope, I have to wonder, are rural nurses better then the city ones? I have nothing against the people that work in the city at all but I recently read in my CLPNA magazine that city LPNs are now hanging med bags and can take DR. orders over the phone in some locations. I have been doing this an ALOT more since I began working on this floor so the article about this made me chuckle. Up coming in January, the LPNs in this hospital will begin a pilot project of pushing IV meds and hanging PICC line meds. I have done NSTs, initiated IV and caught a baby or two myself (long stories). I am curious what city nurses would have to say about their roles within the hospitals they work in VS. us country pumpkins that do it all caus we have to?

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Specializes in Acute Care, Rehab, Palliative.

What province are you in? I have been able to hang meds and take phone orders since I graduated.I can take care of Picc lines as well.

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Specializes in Acute Care, Rehab, Palliative.

PNs start IVs all the time. Why are you making it out to be something special? Everyone does it. You are performing skills that PNs are taught in school.Why do you think nurses in other setting wouldn't be doing them as well?

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Specializes in AC, LTC, Community, Northern Nursing.

I live in ONtario and although certain things are in our scope some facilities may not utilize their PN's to their full scope. I know of some employers that do not allow PN's to take phone orders from MD's, some can't do IV's etc. At least in Ontario it is facility directed.

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Hello fellow Nurses,

I am a rural LPN and a good one at that. I work on a busy Labor and Delivery floor that also encompasses verious surgical and medical patients as well. I work to full scope and beyond as I am often team leading when the RN I work with must be in the back with a labor patient. I am often the only one looking after many patients including babies. While I dont feel like this is out of scope, I have to wonder, are rural nurses better then the city ones? I have nothing against the people that work in the city at all but I recently read in my CLPNA magazine that city LPNs are now hanging med bags and can take DR. orders over the phone in some locations. I have been doing this an ALOT more since I began working on this floor so the article about this made me chuckle. Up coming in January, the LPNs in this hospital will begin a pilot project of pushing IV meds and hanging PICC line meds. I have done NSTs, initiated IV and caught a baby or two myself (long stories). I am curious what city nurses would have to say about their roles within the hospitals they work in VS. us country pumpkins that do it all caus we have to?

OK, I'll bite. I'm also an Alberta LPN. Have been for over a decade and worked in several specialty areas.

I've been hanging med bags for at least the last five years and changing them before that. Legally, the only bags I can't hang are blood, travisol and certain chemo drugs (but seeing as I don't work Oncology, that isn't an issue).

I took order over the phone a decade ago in LTC.

IV push is currently practised in several urban hospital as PICC care (also by homecare LPNs).

As Trish pointed out, the LPN skill set is facility specific. Ultimately AHS (who appears to be our mutual employer) plans to have the skill set the same across the province. I'll believe that when I see it (it might even happen before I retire, lol). I know how to drop an NG but site restrictions prohibit me from doing so, and yes, I've "guided" more than one new RN through the procedure.

Every LPN I know has "accidently" hung PICC line meds because it needed to be done and it's faster than finding an RN, especially when your patient has been on the meds for several doses before hand. Nobody ever compiles an incident report on this "event".

I've worked in the busiest postpartum unit in the province and have no desire to work L&D. Two very different animals.

If you are working out of scope, beware, CLPNA will be contacted by an RN somewhere within your facility and report you. One unit was reported by an RN because the LPNs were piercing the travisol bag to get them ready for hanging. CLPNA came down like a ton of bricks on my hospital.

You may be content to work out of scope but ultimately it is your practice permit that is at risk.

Unoficially, we've all worked out of scope at one point in time due to patient acuity or workload. Usually the UM turns a blind eye to it because of our experience and skills (and the UMs all know who is good and who isn't). BUT and this is a big but, is all it takes is one new grad or one frenemy to turn you in and screw your career. Is it really worth it to be smug?

I work in the city and would never say my skills are better than my rural coworkers. I work with LPNs who were RN in their home countries, RNs who were physicians in their homelands. All I look at it their skills in the nursing roles they are performing now. Some are excellent nurses, others? I wouldn't want them looking after my worst enemy.:uhoh3:

Rather than trying to decide who is the "better" nurse, spend your time trying to sort out AUPE and the bargaining committee to ensure that we get a wage that pays us for our authorized skills.

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