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MAGNET STATUS - LPNs - defined roles

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Hello to all,

I'm on a mission. The health care system I work for in Georgia does not have defined roles for LPNs. Georgia state also does not have a Scope of Practice, per se, you go by your hospital's rules, pretty much. Which means, we are lumped together with NCAs on the staffing grid. We can team lead partnered with an NCA with up to 6 patients or we can have 3 to 4 patients by ourselves. The charge RN must co-sign all assessments and care plans. We can do all the things an RN does except - hang k-runs, push IV cardiac meds, hang blood (however we can witness and monitor the patient while blood is going). Some days we come in and we are the vital sign, accu checker, ADLs , pass no meds person:angryfire

Our hospital is seeking Magnet status and must have defined roles for LPNs. I'm extremely happy to be involved with helping to define the roles. I am on an information gathering mission. Here are some questions:

1. Who works in Georgia as LPNs, how are you set up? Do you have your own team? Do you always work as a nurse or do you get switched around from one day to the next?

2. Anybody in Georgia working at a magnet hospital? Do you have LPNs and are you being phased out? If your are being phased out, are you given the opportunity to go back to school? At who's expense? Does your hospital even hire LPNs?

3. Anybody in any other state work for a magnet hospital? How are your roles defined?

Thanks for your efforts and time in helping me out. I'm trying to make a better workplace for my fellow LPNs.

Thanks,

Lucy:uhoh3:

kstec, LPN

Specializes in Geriatrics/Family Practice. Has 1 years experience.

First I must stay I support your advocacy for LPN's. All three of our hospitals in Illinois where I live are trying to get magnet status and by doing that they have gotten rid of all LPN's. From what I gather magnet status was started by RN's (predominately BSN's and up) and means a hospital is staffed with all RN's, not LPN's. I may be wrong, but that is what I got out of the information I looked up. Here where I live we (LPN's) are clinic and nursing home nurses only. I wish there was someway that LPN's could somehow get there scope of practice of LPN's defined and of course somehow get us utilized more throughout the U.S. From what I gather this is just another round of phasing out LPN's, but eventually the hospitals will want us again, and of course they can kiss my b_tt. And from the RN's who I work with in the clinic say the hospital isn't all it's cracked up to be, that's why they took the paycuts and came to work in the clinic.

pagandeva2000, LPN

Specializes in Community Health, Med-Surg, Home Health.

I work in a municipal hospital in New York, and Magnet just left our hospital two weeks ago. They are definitely pro-RN, specifically BSN. It was interesting, because, while I was asked by some of the RNs to greet them, they really had nothing to say to LPNs as if we are close to nothing. In fact, one of them said to me; "You WILL be going to school to become an RN, WON'T you?" And, for the first time, I was highly insulted. I said "Yes" so that I would not be targeted by my backwards administration. They were also insulting to our PCAs (nurse techs). One of them is very knowledgable, and she joined in on the interview. The first thing that one of the surveyors said to her was "Are YOU in SCHOOL?" and she said that she is attending school for computer science. The surveyor says "Oh, and NOT NURSING??? My advice to YOU is that you should get your BSN and then go into nursing informatics. This way, we can add more to our profession". I can tell that our bright eyed PCA was basically HURT, because, she stated privately that computers is her passion, and that she never considered nursing. She felt that she was not being appreciated for her personal goals and I agreed with her.

It may be hard to get rid of LPNs immediately, because this is a city hospital with unions. But, what I did notice was that the day before Magnet arrived, they placed positions for close to 90 nurses, most with BSN or working for them in the near future. I can see that if our hospital does obtain magnet, they may reduce LPNs by attrition, or harass us to go back to school.

What was also interesting is that many of the RNs did not really know how to answer the tough questions that magnet asked of us. Not bragging, but I introjected a few times to clear the air for them to at least move on to another subject. One thing I believe is that raising the bar for entry level nurses to BSN will not help the nursing shortage, because most of them do not remain at the bedside for that long...a few years at best and they move on due to the horrendous circumstances we all work under and to get office positions in case management and such.

I am currently observing the trends to get prepared. I don't want to become an RN, but, I will move on to other places that would better appreciate LPNs if it comes down to it. At this time, we still have plenty of opportunities, but I do anticipate them shrinking within the next 10 years, or unless there is another phase. About 15 years ago (before I started working there), they laid off LPNs and brought them back in three months. Then, they had a massive lay off of RNs. You can never tell with these things. But, it is disrespectful of how LPNs are basically blown off. My attitude is this; let the RNs be the RNs (those that think little of us, I mean). Those that think we have nothing to contribute usually have their tails between their legs at some point. We all need each other.

txspadequeenRN, BSN, RN

Specializes in ICU, PICC Nurse, Nursing Supervisor. Has 20 years experience.

i thought if a hospital had magnet status then they were all rn.

Edited by txspadequeenRN

elizabells, BSN, RN

Specializes in NICU.

I'm working at an NYC hospital that's gearing up to apply for Magnet status (not the same one as pagandeva, I don't think). We have one LPN on my unit. Her official job is "ICU tech" and she does almost no patient care. She's like the boss of our NAs, who do absolutely zero patient care other than assisting with transports; I don't think they're technically allowed to touch the babies. She also organizes parent education. As far as I've observed, her only patient contact is assisting in CVL dressing changes. This is pretty stupid, in my opinion. I think she used to have much more involvement, and then the hospital changed its policies regarding LPNs.

pagandeva2000, LPN

Specializes in Community Health, Med-Surg, Home Health.

I work for a city hospital, and I think it is a bit harder to get rid of titles out of the blue; not impossible, but harder. They would have to find something else for us to do within the same salary scale as we are currently accustomed to. Anything can happen, though.

ohmeowzer RN, RN

Specializes in ob/gyn med /surg.

yes magnet hospitals are staffed by RN's only. they do prefer BSN's but if you are a RN they will hire you.my cousin works in a magnet hospital and she is a ADN and they told her they would like her to get her BSN in the future , but okay as long as she's a RN. they donot hire LPN's at all.

elizabells, BSN, RN

Specializes in NICU.

I would be willing to bet that at any union hospital if management really tried to get rid of the LPNs they would have a helluva fight on their hands.

yes magnet hospitals are staffed by RN's only. they do prefer BSN's but if you are a RN they will hire you.my cousin works in a magnet hospital and she is a ADN and they told her they would like her to get her BSN in the future , but okay as long as she's a RN. they donot hire LPN's at all.

The hospital I worked at was a Magnet hospital and employed LPNs. My co-worker who is also an LPN got a job offer in their pedi e d last year. There are still LPNs who work on the floor I used to work on. They give meds, draw blood, ekgs, etc.

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 28 years experience.

i thought if a hospital had magnet status then they were all rn.

not true. magnet hospitals must meet high standards for excellence, which can certainly be achieved with lpns on board don't you think?

my hospital had magnet and we have lots of lpns. (i say "had" because we lost it by not showing improvement in certain areas. guess you can't be the sameo sameo but must constantly grow and improve.)

Lucid Vital Nurse, BSN, RN

Specializes in M/S, Tel, ER, Onc, Clinic, MH, Corrections, CC.

Whoops! error.... CA LVN's can not put in Jejunostomy feeding tubes, we can only hang the feedings. We can also hang Lipids (Fat Emulsions), perform Perotineal Dialysis (with antibiotics instilled), Continuous Bladder Irrigations ( with antibiotics instilled), Flush Nephrostomies, and replace PEG Tubes that have come out.

pagandeva2000, LPN

Specializes in Community Health, Med-Surg, Home Health.

Hope this helps, Lucy....

I am a Correctional LVN who recently quit from a Magnet Hospital (in California). My role as an LVN is governed by my State Nurse Practice Act/Board of Vocational Nursing and at the hospital where I worked. When the Magnet Program was introduced, we (LVN's) were told that only RN's could work at a Magnet Hospital and the Vocational Nursing staff would be indisriminately let go a little at a time.....So much for that; not enough licensed nurses to staff the hospital to begin with! Anyhow here are what LVN's can do at this magnet hospital and according to state law 1. give meds (including all narcotics): PO/SL/IM/SC/PR/ID/VIA EARS/VIA NARES 2. Secondary assessments/data collection 3. Team Nursing (LVN's not allowed to have their own patients except in Peds) 4. Basic Nursing (CNA work) 5. Insertion of G-Tube/NGT/Jejunostomy feedings/suction 6.Sterile/non-sterile procedures (catheterization, etc)/dressing changes, 7. Charting/Medication reconciliation/Can only add to Care Plans 8. Accu Checks 9. Teaching 10. We can Discharge patients but only help the RN's with admits 11. Calling MD's /Taking and carrying out MD orders 12. EKG's 13. HHN Treatments 14. Unit Secretary work 15. Blood Withdrawl (if certified) 16. IV's (if certified): Start peripheral lines, (No messing with Central Lines; No IV Push Meds; No piggybacks [either antibiotic or with medication i.e.: Iron, Cardizem or Chemo; although we can mix IV medications in ER for the RN's]; No Intrathecal Meds; No PCA's). We can hang: ALL Electrolytes/IVF's: except Hypertonic Saline. We can hang: PPN without Regular Insulin in it (Peripheral TPN), Albumin, Blood and all Blood Products, MVI's, (Magnesium, Calcium Chloride/Gluconate, Potassium [up to 60 MEq's]) 17. Can only apply restraints after an RN has done so 18. Pyxis Narc Count 19. Specimen Collection (Sterile/Non-sterile). 20. Basic Life Support 21. Sit as Telemetry Monitor Technicians

So, that is the majority of what an LVN can and can not do in CA and at this Magnet Hospital. ;)

Are you saying that the LPNs that remain at this Magnet Hospital are still performing these skills? What made you leave there? Thanks

kstec, LPN

Specializes in Geriatrics/Family Practice. Has 1 years experience.

I only wish that the hospitals around here would let us LPN's do the list above, but actually we aren't even allowed in the hospitals and we have three of them. With the constant rejection it almost makes me want to go back and get my RN, but because I'm one who doesn't let society dictate what I have to do, I'll stay a LPN for now and maybe forever. I don't want the added responsibility of being an RN. I just want to assist the RN, not be a RN. Until everyone can figure what we as LPN's can and can't do and do it across the board, then we will continue to be in limbo and have no place except LTC. Every state has different rules and every hospital has different rules and between the two they can't figure out where to put us, so they just boot us to the curb, atleast here in Illinois. Oh well, enough of being on my soapbox, I'll just continue to work my prn clinic and agency jobs and wait until they decide to go all RN. Until then I'm thankful for everyday that I get to interact and attempt to make a difference in my patients lives.

pagandeva2000, LPN

Specializes in Community Health, Med-Surg, Home Health.

I only wish that the hospitals around here would let us LPN's do the list above, but actually we aren't even allowed in the hospitals and we have three of them. With the constant rejection it almost makes me want to go back and get my RN, but because I'm one who doesn't let society dictate what I have to do, I'll stay a LPN for now and maybe forever. I don't want the added responsibility of being an RN. I just want to assist the RN, not be a RN. Until everyone can figure what we as LPN's can and can't do and do it across the board, then we will continue to be in limbo and have no place except LTC. Every state has different rules and every hospital has different rules and between the two they can't figure out where to put us, so they just boot us to the curb, atleast here in Illinois. Oh well, enough of being on my soapbox, I'll just continue to work my prn clinic and agency jobs and wait until they decide to go all RN. Until then I'm thankful for everyday that I get to interact and attempt to make a difference in my patients lives.

I have been the same way; I don't want anyone to dictate to me what my value and contribution is to life or nursing. I did have a moment where I said that I would attempt to go back for the RN, and interestingly enough, one of my closet friends, who is an RN asked me "Is this what you really want?" and my answer was "no". I don't see much to desire being an RN...I really don't. Those responsibilities are a complete pain in the rear to me, and my only interest is really basic nursing. I would actually be unhappy becoming an RN because I would have felt forced to. And, truthfully, I don't see any of them being any happier or content. I am actually thinking of going to school for something else. If in case, the walls really narrow down for me in my area (and at this time, it does not seem to be that way, yet), I would like to have another field to go into. But, RN...no way.

Lucid Vital Nurse, BSN, RN

Specializes in M/S, Tel, ER, Onc, Clinic, MH, Corrections, CC.

I think that it's sad how LPN's/LVN's are treated...more so in some states than others. I have had my fair share of people regard me as being other than a NURSE because I'm not an RN and put me down, especially a couple RN's...But that makes me try harder and push harder to prove those people wrong; and one day I did. I was dealing with a inmate/patient having a seizure...and while I was doing everything (starting an IV and running fluids, protecting his airway, taking vitals/Neuro Checks) and the RN was sitting at the desk waiting about 15 minutes for the doctor to call and one officer stated " I haven't seen that **** nurse [RN] do anything while that other nurse is taking care of the patient!" I have had other RN's go completely off of my assessment of a patient in the clinics and not write anything down before I would call the doc and have the patient sent out Code III to a hospital. But, most of all, my patient is my main concern...everything else is secondary at that point. That is why I became a nurse, to help and protect my patients and do what's best for them....Not to worry about what nurses with higher licensure do or think. Don't get me wrong, I have worked along side some lazy LVN's and I do love RN's...I have had the pleasure of working with great ones who have gone above and beyond to teach me things and allow me to do RN functions and are excellent Nurses. I am taking courses myself to become an RN. But I have had RN's treat me poorly because I am "an LVN", but not quite a nurse; or as one RN put it "an overpaid Nurses' Aide". Well, I am a very good NURSE. I have experience in: ER, Med-Surg, Oncology, Telemetry, Mental Health, LTC/Convalescent Hospital, DOU, Critical Care, Corrections, Clinics, TB Ward. I started as a CNA then RNA then Monitor Tech then Unit Secretary then LVN with multiple cert's and eventually an RN.....because of God's Grace and because I pushed myself, especially when i was put down...LVN's do a lot of work..more than we get credit or paid for...and sometimes we as LVN's let the negativity get to us, but just keep being the best nurses you can be, try harder and know that you make a difference! Don't let it discourage you though. Although it I think every RN should have been a CNA and LVN first to see what it's like in our shoes...We do have a hard job. This isn't meant to be negative, so please don't take offense! I'm not RN bashing by any means!..Just trying to show a point to LVN's/LPN's....................God Bless! (Or whatever you believe in).;)

Lucid Vital Nurse, BSN, RN

Specializes in M/S, Tel, ER, Onc, Clinic, MH, Corrections, CC.

Yes, the LVN's there are still performing these functions. I left because I got a job as a Contract Nurse with an agency working for the California Department of Corrections and Rehabilitation making $34.00/hour, with lots of overtime and double time. Plus I knew it would be an excellent learning opportunity, which I have learned a great deal.:monkeydance:

Lorie P.

Specializes in Med/Surge, Private Duty Peds.

this is the link to the gbon that states what a lpn is allowed to do in the state of ga.

also each facility in ga has it's own policies and procedures that specificly outlines the role of lpn for that facility.

just because one facility says an lpn can access picc lines, iv meds, doesn't mean it can be done at another facility.

i think it is great what you are doing for lpn's. just remember the above.

http://sos.georgia.gov/acrobat/plb/laws/13_lpn_43-26-30_to_43.pdf

I just spent an hour typing a huge response to this thread that I just happened upon during a google search, then accidentally hit the backspace button and here we are. Ill be brief this time. I am an RN, BSN who formerly worked at twice consecutively awarded Magnet Status Hospital.

ATTENTIONS RNs: You are not the LPNs boss. You are not more knowledgeable than the LPN. You are not more of a nurse than the LPN. You are not more important than the LPN. You get paid more than the LPN....that is it. Get over yourselves.

ATTENTION LPNs: You are undervalued. You are undermarketed. You are often overlooked. You are misunderstood. You are not a glorified tech (like I really needed to tell you that, huh?) You are as much of a nurse as any level RN (DUH).

POINT: Nurses are nurses, no matter if there are 3 letters after our name or 2. PERIOD.:yeah:

Oh, and "indiscriminately" ridding hospitals or LPNs is so much the stupidest idea Ive ever heard that Im laughing as I type it right now. Would love to expand on the topic (like my original post) but dont have the time...

:twocents:

Catch ya later,

C-Cam RN

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