Lvn = working w/stable pts??

Nurses LPN/LVN

Published

As an lvn which type of patients will I be most likely to work with?? What will the environment be like? The reason I ask is because this is why I chose to become an lvn and not a RN due to the fact that I don't like the idea of working/caring/treating very ill patients instead I prefer more stable patients that need not much intensive care but rather some type of rehab services ....is this true?? Can anybody clarify this for me what the lvn most commonly work environment/patients look like??

Up Vote Up Vote ×
Specializes in Med/Surg, LTACH, LTC, Home Health.

Putting it bluntly, but honestly, if you want rehab patients, get a job in rehab. If you want critical care patients, get a job in ICU, if you want stable patients, get a job in home health and a very carefully-selected nursing home.

In either one of these environments, you cannot be afraid of what's going on with the patient. Stable patients crash! YOU, the nurse (LPN or RN), will be part of the determining factor as to whether they live or die if that happens on your shift. You cannot freeze up!

Nurses, very often than not, are the first responders in that it is the nurse (and the CNA) that first recognize that there had been a change in the patient's baseline condition. When that change occurs, no matter the environment, the person in charge of the patient MUST do something to manage that patient until help arrives.

My dear friend's husband was discharged from inpatient to rehab in March after having been hospitalized since the turn of the year. While in rehab, he crashed twice. Each time, he was recognized early and sent out to an acute care hospital. Each time he was placed on the vent. But the second time, he did not recover. The funeral is this coming Friday (the 12th). Had those rehab nurses not recognized the change in condition, the funeral would have been a couple of months back.

Do not be afraid to LEARN how to be a nurse. These episodes are frightening. But the patients and their families are depending on you, trusting you, to help them land safely instead of burning when they crash.

All if that being said, I had been an LPN for maybe 2 years when a nursing home patient started to crash. She was 89, but still a full code. Scared me to death!!! But another nurse and I did CPR until EMS arrived and took over.

The second time was in home health 10 years later with a throat cancer/trach patient. As my luck would have it, the tumor ruptured (as anticipated), clogged the opening to the trach's inner cannula, and after unsuccessful attempts at suctioning, I called 9-1-1, and literally watched that man suffocate.

He was a DNR, but that was the worst moment of my professional life! The interview with the county coroner was a nightmare. Answering his questions were more like an interrogation! I finally blurted out, "I didn't kill him; he died!" The coroner showed me his questionnaire and tried his best to reassure me....didn't help!

For 3 months straight, I was in the house before dark because I literally jumped at when lights cast the shadow of my own body. But don't YOU be afraid. (I know, right).

That last experience, after I recovered from it, was the beginning of my 'let's REALLY see what's up in this field' days. I took the blinders off and my eyes have been wide open since.

Sorry for the long answer to such a short question. Not trying to frighten you, but as a nurse, you will have your turn. The good news is that there tends to be safety in numbers.:up:

Up Vote Up Vote ×
Specializes in Acute Care, Rehab, Palliative.

In theory we only care for stable patients. In reality that's not always true depending on where you work.

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Most textbooks in the US will inform the reader that LPNs/LVNs provide nursing care to "stable patients with predictable outcomes."

However, keep in mind that a stable patient in rehab, a clinic, nursing home, group home, jail, prison, or home care setting can become unstable at any time.

Up Vote Up Vote ×

In NCLEX world. LVNs are given stable, "easy" patients. In real life, from what I've seen, that's not what happens. They're just divided up and everyone gets what they get.

Up Vote Up Vote ×

I think as a new grad LVN, which I am assuming your are, you will be happy, lucky, to take any job you can get

I have worked with LVN's in ICU???? I never knew LVN's were supposed to provide nursing care to stable patients with predictable out comes?

When I was a new RN, scared stiff to take care of any patient no matter how stable, the employee entrance was down the hallway that passed the ICU/CCU. I used to mentally tiptoe past the doorway thinking "I will NEVER work ICU." Five years later I was an ICU nurse.

Up Vote Up Vote ×
Specializes in Acute Care, Rehab, Palliative.

A number of times I have juggled a tricky patient for a shift and then at the end they decide to send them to ICU!

Up Vote Up Vote ×

Wow thanks for all your stories and input..at this point this all I need pure honesty about what its really like out there as a nurse period regardless of any title/degree...which I have no doubt its true! My mom herself was a stable patient with a severe fever few days after a surgery and passed in a 30 min lapse....well hopefully school plays an important role in preparing me for such scenarios if not clinicals??? Or By watching other codes? God just thinking about it gives me the chills..

Up Vote Up Vote ×
Specializes in Acute Care, Rehab, Palliative.

There's no guarantee that your patients will be stable. I have had patients code and/or die.

Up Vote Up Vote ×
Specializes in ER, Med-surg.

No matter what area of nursing you work in, even if you typically are assigned stable patients, there will always be the possibility for patients to destabilize, and identifying and intervening when that happens is part of the nurse's job description.

It makes nearly everyone nervous, especially at first, but it is something you become more skilled with and comfortable with over time- ESPECIALLY if you don't actively try to avoid unstable patients.

Up Vote Up Vote ×
YOU, the nurse (LPN or RN), will be part of the determining factor as to whether they live or die if that happens on your shift. You cannot freeze up!

Very intense BSNbeDONE..but my question is, what if you do freeze up? Being a new grad. I am forever scared that I won't handle situations like these correctly!

Up Vote Up Vote ×
Specializes in Clinical Documentation Specialist, LTC.

As a LPN of 20+ years, I have had many, many skilled nursing home patients go "bad" on me. Taught me how to think on my feet and with experience I learned how to care for critically ill patients. Now as a Clinical Documentation Specialist and still a LPN, I am REQUIRED to critically think and know all about ABGs, how to "see" sepsis and acute renal failure (Just two examples) just by looking at labs. Don't be afraid of taking care of critically ill patients. It can be very rewarding.

Up Vote Up Vote ×
+ Add a Comment