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 able to replace them. Please don't think I am putting LPNS down, I am not. I was an LPN for four years before I was an RN, and I have a great deal of respect for them. The two that have come in to the unit are sweet wonderful girls with a lot of knowledge and they work very hard. The real problem is the limitations placed on them In our state LPNs are not allowed to give IV pushes, hang blood, or hang and titrate drips. They cannot measure hemodynamics, and cannot take verbal orders from a physician. So an RN must do all of these tasks for them, as well as take on a full patient load of her own. The LPNs get very frustrated too when they need something done for their patient and the RN who is supposed to be covering her can't get away from her own patient to handle a problem. We have tried to have an LPN and an RN share four patients, with the LPN doing meds and treatments, and the RN doing assessments, drips and the like, but this has not worked out either. To make matters worse, some of the RNs are hostile to the LPNs, and give them a hard time. Most of us have been supportive of them, but a small number of the RNs have made things difficult in numerous ways. Most of it is very subtle, and is difficult to take anything specific to our unit manager. A few of the docs have also expressed discomfort with the LPNs being in a critical care area. Again, I am not complaining about the LPNs, I am just looking for some feedback and advise on ways to organize care and make this situation a little easier on everyone.
I feel these little spats we have are mostly simple misunderstandings, and if we sit back and breathe we'll see that...
I think the root of the hurt feelings in this thread is the underlying tone of "it's no big deal' and 'why can't you just work together.....teamwork...and everything will be OK" in some poster's opinions. Then add a few LPN'swho have have become offended...even though this issue is NOT putting down LPN's at all! It's the HOSPITAL RNinICU is mad at!! Their lack of concern is appalling!!!
This is not one of those situations where 'if we all are team players we can do a great job'...PCA's, RN's, and limited LPN's...in the ICU...cannot save the day if there are insufficent competent folks there....
Our national AACN standard for critical care is 2:1 patient nurse ratio and this nurse is to be COMPETENT in critical care. RNinICU's hospital is fudging on the standard and endangering patients...by counting severely restricted LPN's in the staffing matrix to cover the hospital's sorry ass!! This has NOTHING to do with the LPN's being 'bad'...it has EVERYTHING to do with a dangerous situation.
Some RN's may have responded in surprise because of differences in LPN practice across the country. I really don't think anyone here has put down LPN's....but perhaps some here have never worked with a stong LPN! So... let's educate them! :)
Now I get my panties in a cyber wad once in awhile too...like everyone else...so let's all do a 'group unwad' now....altogether on 3....1-2-3.........AAAH!! :roll
Ahhhhh indeed! Seems like the right thing to do to feel better.
Should the opportunity arise I would certainly love to show some of these RN's what a strong LVN can do.(that's not to say that there aren't any here)
Nurses, do you notice, tend to beat themselves up over something that management initiated. Then when frustration occurs its because of a "bad attitude".
Have you had the chance lately to work with an educator, a recruiter or administrator on the floor? in ICU?
I've been told that it is a very, very scarey situation.
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!
again....(sighhhh) i never thought my idea (sighhh) was a solution. just an idea that could possibly be used. can you understand this?
I SWEAR I'm not trying to start a fight so please don't yell at me!
But as a new grad...yes Practical Nursing grad....you guys are scaring the heck out of me. Is this what I have to look forward to? I've seen so many of these RN vs LPN posts. I don't want to fight....I just want to go to work, do the job I was trained to do, and help my patients.
when did rninicu ever post any problems with having the lpns in that unit... except for their restrictions???
if you read her original post, she states many other rn's are hostile to them (lpns) and "a small number of the rns have made things difficult in numerous ways." isn't this a problem? no, there's no specific comment that having the lpn's in her unit was the problem. i didn't say it was either....so i'm lost on what you are trying to get at here.....
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!
now reverse this and stand in my shoes for a minute. how condesending is it to ask me to read a link that you obviously have already read? i t was humble of you to provide the link "to save time", but what was the point in looking up information that you wanted? i don't get it?
and the statement ....made me think...who the heck is us??? and this statement..
people who are reading this would be us. telling us what you learned is just that without taking it to another level. you stated "tell me how a lpn can give blood, but not abx?" i replied "you'll have to ask the state" then, you stated "i'll give you the link to help you out" now, i thought to myself i didn't want the information...you did. look it up!...you had the link! in retrospect, it may appear you merely wanted to get the blood transfussion/lpn info. but as i said before, your approach is as suttle as a bulldog bite with smiley faces attached. i understand its important in our field to be an "in your face" type of person, but it really wasn't necessary here, and tuned me a bit out. just my opinion.
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!
mattsmom81
4,516 Posts
I feel these little spats we have are mostly simple misunderstandings, and if we sit back and breathe we'll see that...
I think the root of the hurt feelings in this thread is the underlying tone of "it's no big deal' and 'why can't you just work together.....teamwork...and everything will be OK" in some poster's opinions. Then add a few LPN'swho have have become offended...even though this issue is NOT putting down LPN's at all! It's the HOSPITAL RNinICU is mad at!! Their lack of concern is appalling!!!
This is not one of those situations where 'if we all are team players we can do a great job'...PCA's, RN's, and limited LPN's...in the ICU...cannot save the day if there are insufficent competent folks there....
Our national AACN standard for critical care is 2:1 patient nurse ratio and this nurse is to be COMPETENT in critical care. RNinICU's hospital is fudging on the standard and endangering patients...by counting severely restricted LPN's in the staffing matrix to cover the hospital's sorry ass!! This has NOTHING to do with the LPN's being 'bad'...it has EVERYTHING to do with a dangerous situation.
Some RN's may have responded in surprise because of differences in LPN practice across the country. I really don't think anyone here has put down LPN's....but perhaps some here have never worked with a stong LPN! So... let's educate them! :)
Now I get my panties in a cyber wad once in awhile too...like everyone else...so let's all do a 'group unwad' now....altogether on 3....1-2-3.........AAAH!!
:roll