LPN's Role in the ICU?

[Nurse-o-Matic]

I am an RN in a 24-bed ICU. Currently, we have 1-2 LPN's scheduled per shift. Our policy is no more than 2 patients per RN unless you have an LPN working along with you, in which case you may have 3 patients. My experience with LPN's in citical care is that they seem to want to step outside of thier role-for example, push meds or draw off picc lines. Also, when the patient is crashing and I'm starting a new drip, calling the doc, etc., they will sometimes go off on break?!? Because RN's are paid more, some they feel they shouldn't do as much work and will bring a book to read while I run around at the end of the shift getting I&O's, restocking, or boosting patients.

I have worked in other departments with LPN's where each of us did our role and got the job done. In ICU it's different because our LPN's do have additional skills and want to function at a higher level. 10 years ago our ICU had LPN's taking care of thier own patients including IV pushes, IV's, and calling docs. There are a few of these LPN's left who practiced under those conditions and are now bitter to the rules. They feel they are stepping backwards in thier profession, but don't wish to pursue the RN degree.

Does your ICU employ LPN's?

[Kate28]

I'm a new member here, I just recently started LVN school here in Texas. I came to the forums to see what kind of wonderful advice I could get from fellow LVN/RN's on how to make my year go a bit easier. I've been here 5 minutes and I have already been offended beyond words. It pains me that I have to read about how horrible LVNs are on the floor, how they jack around or how they don't do their jobs. Of course there are going to be those out there, I understand that. But I REFUSE to be looked down upon simply because I don't have the time or money to go to school for 2 additional years. Critical care is where I want to go. Unfortunately most of the larger CC units in the Texas Medical Center are "wanting" to phase out LVNs. Who knows if it will happen, I don't know. I understand that LVNs can't do certain things. I know that we have to be monitored by a RN. That's fine with me. But when you go throwing your weight around by stereotyping all LVNs, subliminally saying that we aren't as good as RNs, that is going too far. The number one job of the nurse is to be the patient's advocate. Take care of the patient, do anything in your power to protect them. It sounds like the majority of those criticizing are more concerned with their power trip than taking care of the patient. I wont be coming back here, I already have too much to worry about rather than to listen to ignorance. I may not be an RN, but once I get my LVN degree, I will be proud as hell.

[Dalzac, LPN, LVN, RN]

I have to say I am just flabbergasted at the comments that have been in this thread!!!!! I am a LPN and I have worked in ccu/icu for 27 yrs. Before that I was a CCU Tech. and knew when I got my lpn I was going to work in CCU. I have worked in Oklahoma City hospitals ,5 of them, and always in CCU or ER. My bos whom I have worked with 13 yrs calls me her cost effective RN. She trusts me, period. When she was given the chance to open a new chest pain center she called me the first day and assk me to work in this new unit.

When I went to nursing school my instructors knew I was going to work in critical units and they made my assignments and they were not easy patients. They were tough tough tough patients. I am just amzed at the lack of knowledge some of these posters have spewed out.

We are in an age of such nursing shortages that any help would be grateful and wanted. I have to say though, I would never want to work with some of these nurses and their frame of mind. I want to be where i am wanted and appreciated. The one good thing about where I work I am wanted and appreciated.

Oh yeah the only things I can't do is hang blood and that is pretty much it.

[RN34TX]

I'm a new member here, I just recently started LVN school here in Texas. I came to the forums to see what kind of wonderful advice I could get from fellow LVN/RN's on how to make my year go a bit easier. I've been here 5 minutes and I have already been offended beyond words. It pains me that I have to read about how horrible LVNs are on the floor, how they jack around or how they don't do their jobs. Of course there are going to be those out there, I understand that. But I REFUSE to be looked down upon simply because I don't have the time or money to go to school for 2 additional years. Critical care is where I want to go. Unfortunately most of the larger CC units in the Texas Medical Center are "wanting" to phase out LVNs. Who knows if it will happen, I don't know. I understand that LVNs can't do certain things. I know that we have to be monitored by a RN. That's fine with me. But when you go throwing your weight around by stereotyping all LVNs, subliminally saying that we aren't as good as RNs, that is going too far. The number one job of the nurse is to be the patient's advocate. Take care of the patient, do anything in your power to protect them. It sounds like the majority of those criticizing are more concerned with their power trip than taking care of the patient. I wont be coming back here, I already have too much to worry about rather than to listen to ignorance. I may not be an RN, but once I get my LVN degree, I will be proud as hell.

I know it gets ugly in here, esp. for someone new and impressionable to nursing. Just a word of advice:

ICU and ER jobs for LVN's are out there in TX but not all that plentiful and they generally will want someone experienced rather than a new grad.

My advice to you upon graduation is to go straight to Telemetry.

It's a great place to start for someone wanting to move eventually to ICU and there are plenty of telemetry units in TX who hire LVN's.

[Kate28]

I know it gets ugly in here, esp. for someone new and impressionable to nursing. Just a word of advice:

ICU and ER jobs for LVN's are out there in TX but not all that plentiful and they generally will want someone experienced rather than a new grad.

My advice to you upon graduation is to go straight to Telemetry.

It's a great place to start for someone wanting to move eventually to ICU and there are plenty of telemetry units in TX who hire LVN's.

hmm i didn't even think of that. thank you so much for your advice!

[lindarn]

The hospital where I used to work and one of the largest here in Washington, laid off ALL OF THIER LPNS TWO YEARS, AS HAVE OTHER HOSPITALS. California hardly uses them in the hospital. Here in Spokane, jobs for LPNs are pretty much just in Nuraing homes and Assisted Living Facilities.

I have ony worked with LPNs/LVNs in NY. I have worked ICU for years, and I don;t know anyone who uses LPN/LVNs in ICU. LPNs and LVNs don't belong in ICU due to the knowledge base that is needed to work ther safely. I don;t care who says that they can "run rings around the RNs". The RNs are responsible for what you do or don't do, and there is too much in ICU, that you can't. I do not want to be responsible for someone elses work in the ICU. I am too busy with my own one or two patients, to want to be responsible for someone elses' one or two patients. If there are nurses who are stupid enough to take on that responsibility, what can I say. It is not my license.

But wait, this is Texas, where workers have no unions and no rights. And the nurses will lose their jobs, if they refuse to work with LVNs in the ICU. And be reported to Group One, and blacklisted from every job that they apply for. JMHO, and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

[RN34TX]

The hospital where I used to work and one of the largest here in Washington, laid off ALL OF THIER LPNS TWO YEARS, AS HAVE OTHER HOSPITALS. California hardly uses them in the hospital. Here in Spokane, jobs for LPNs are pretty much just in Nuraing homes and Assisted Living Facilities.

I have ony worked with LPNs/LVNs in NY. I have worked ICU for years, and I don;t know anyone who uses LPN/LVNs in ICU. LPNs and LVNs don't belong in ICU due to the knowledge base that is needed to work ther safely. I don;t care who says that they can "run rings around the RNs". The RNs are responsible for what you do or don't do, and there is too much in ICU, that you can't. I do not want to be responsible for someone elses work in the ICU. I am too busy with my own one or two patients, to want to be responsible for someone elses' one or two patients. If there are nurses who are stupid enough to take on that responsibility, what can I say. It is not my license.

But wait, this is Texas, where workers have no unions and no rights. And the nurses will lose their jobs, if they refuse to work with LVNs in the ICU. And be reported to Group One, and blacklisted from every job that they apply for. JMHO, and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

I'd agree with some of your statements, however....

This is also the same Texas that has the good sense to actually utilize LVN's to their fullest potential rather than employ them to be little more than glorified CNA's who can pass pills and insert foleys.

Talk about a wasted resource for a hospital with a tight budget.

I also think you're being a little dramatic in your painting a picture of TX RN's being forced to work with LVN's in the ICU or be blacklisted.

The RN's I worked with back when I was an LVN were not resistant to the idea and were certainly not forced to work with me. They more than welcomed me.

The recurring theme here is that the RN's in this discussion who are the most resisitant to the idea are the same ones who have little or no experience actually working with LVN's in the ICU.

Many RN's who go to work in specialty areas where there is little or no LVN presence rely on old ideologies and outdated information about LVN practice that they recall from years ago in their RN programs.

[toadie]

the state i live in allows lpn's only to hang ivf and some antibiotics. no ivp meds. they are not allowed to take verbal orders from md or allowed to do assessments. they are not allowed to titrate drips either. they may not initiate an iv infusion but may hang a new bag of ivf if it is empty. i don't think they are allowed to access any type of central lines either. my hospital doesn't have lpn's in our icu. the truth is i think they would be very bored to be there.

while in nursing school i worked on med-surg and found the lpn's to be more knowledgeable about many things than some of the rn's. i think it doesn't have so much to do with your degrees or certifications, rather your own states practice act and what things are within your scope of practice that determines where you can and should work. just my 2 cents.

[lady2]

I think this is a waste of time because, it is not going to change things, actually there should only be one entry level and we would not have to debate about who can work where! If the LPN's were RN's they could work where ever!

[HazelLPN, LPN]

The hospital where I used to work and one of the largest here in Washington, laid off ALL OF THIER LPNS TWO YEARS, AS HAVE OTHER HOSPITALS. California hardly uses them in the hospital. Here in Spokane, jobs for LPNs are pretty much just in Nuraing homes and Assisted Living Facilities.

I have ony worked with LPNs/LVNs in NY. I have worked ICU for years, and I don;t know anyone who uses LPN/LVNs in ICU. LPNs and LVNs don't belong in ICU due to the knowledge base that is needed to work ther safely. I don;t care who says that they can "run rings around the RNs". The RNs are responsible for what you do or don't do, and there is too much in ICU, that you can't. I do not want to be responsible for someone elses work in the ICU. I am too busy with my own one or two patients, to want to be responsible for someone elses' one or two patients. If there are nurses who are stupid enough to take on that responsibility, what can I say. It is not my license.

But wait, this is Texas, where workers have no unions and no rights. And the nurses will lose their jobs, if they refuse to work with LVNs in the ICU. And be reported to Group One, and blacklisted from every job that they apply for. JMHO, and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

My License can be lost just as easily as an RNs can.

LPNs lack the knowledge base to work in critcal care? My LPN program was a 2 year long hospital based diploma program. RNs went 3 years. I'm not sure what kind of magic knowledge base that extra year would have brought me. My critical care knowledge came from doing, researching, and learning on my own. Experience is the best teacher.

[Geeg]

LVN/LPN have no place in an ICU.

[Princess74]

Wow, no wonder that there are so many nurses not in the profession anymore. Some of y'all need to get off of your high horse and settle down. With your bad attitudes toward your fellow nurses, I really wonder how you treat your patients. I would not want a nurse with a "GOD" Complex taking care of me or my loved ones. Some of you are acting like a Doctor with an I know it all and I'm better than you attitude. GROW UP!! (Not trying to put Doctors down but you all know what I am talking about. Every hospital has atleast one).

Now, get off the RN vs LPN/LVN thing. None of us want to hear it!!

[pedinurse05]

My License can be lost just as easily as an RNs can.

LPNs lack the knowledge base to work in critcal care? My LPN program was a 2 year long hospital based diploma program. RNs went 3 years. I'm not sure what kind of magic knowledge base that extra year would have brought me. My critical care knowledge came from doing, researching, and learning on my own. Experience is the best teacher.

Hazel--

You are absolutely right...the very best teacher is experience. I am sure with your many years critical care experience that you are a capable as well as mentor!