Nursing in your State !!!!!!!

Sunshine55 · Mar 30, 2001

Am still awaiting my application for license transfer from the State of Florida Board of Nursing so can't comment on LPN positions in Florida.

In New York, my first position was in a county hospital without emergency services. LPN's worked on all units, which included: Acute(LPN's were trained to participate on Blue 100 team responsible for the entire hospital) Rehabilitation (CVA's, TBI, etc.), Skilled Nursing, Health Related, Infectious Disease, Pediatric, Young Adult, and Alzheimer's. Once was floated to a 60 bed health related unit encompassing two floors as the only nurse on Thanksgiving during a flu quarantine knowing none of the patients!

Worked for New York State Developmental Disabilities in various group home settings which included children and young adults, behavioral homes with high functioning residents which included sexual offenders and had received sign language training prior to the opening of a new group home exclusively for deaf women with behavior problems. I loved these challenging positions. Lots of resident teaching, participating in team care plans and implementation, planned recreational activities and participated in outings, transported individuals to school, appointments,etc., passed medications, made and/or assisted residents with preparation of lunches, breakfasts, and dinners, ADL's, tube feedings, replaced G-tubes, phone orders and transcription. Lots of seizure disorders, pica, inappropriate behaviors such as biting, kicking, hair pulling, throwing items from regurgitated stomach contents to wheelchairs, public masturbation, etc. Emergency interventions due to certain seizure disorders, wounds requiring sutures, bites, high Carbon Monoxide level one night requiring total evacuation, resident who swallowed part of their sweatshirt (endoscopy also revealed part of a backpack). My only injury was a broken nose. But was called in to takeover when a coworker sliced parts of his fingers off in a blender - beyond description how much blood needed to be cleaned off the ceiling, walls, cupboards, etc. Was sent to Children's Hospital for a week's inservicing on behavior modification.

OB/GYN nurse in large group practice. Some physicians saw up to 60 OB patients per day. Demagraphics, BP's and weights, urines, hematocrits, sterilizing equipment, assisting with in-office procedures, phone triage, shoulder to cry on, etc.

Home Health - meds, tube feedings, ADL's, comfort care, dressing changes, etc. Was not happy in this area especially working the night shift.

MD_Rn · Mar 30, 2001

Worked the first part of my career in NJ, now living in Maryland... The difference: I had more respect from pts, doctors and coworkers in NJ. I made more money in NJ (cost of living is about the same). I had more say in how I performed my job in NJ and I felt more secure in my position. I do not feel respected for my knowledge or practice in MD... I have worked at 3 different employers in MD and experienced the same thing. Never changed jobs in NJ.

theboss · Mar 30, 2001

thankyou sunshine55 for your input on new york !!!sounds like you have been fortunate to get some great experience and i commend you for it! not just anyone can do some of your (challenges)!! it takes a special nurse to be able to do them ! good for you !!!thanks and good luck in florida.

to MD_RN im sorry you have ran into that kind of treatment in MD..NJ sounds like a wonderful place for nurses , have you thought of maybe returning there or is this not an option for you??? remember the worst is happening so it can only get better!!! keep your head up and dont let them keep you down! im not saying MD is all bad there must be a nurse friendly place to work somewhere in MD you just havent found it yet. if there is anyone out there from MD that can help MD-RN lets here from you . thankyou and watch for some good news..

[This message has been edited by theboss (edited March 30, 2001).]

ornurse2001 · Mar 31, 2001

I worked as an LPN in 3 states before becoming an RN-First Illinois, then NC, then Mo.My-things really change state to state for LPN's !

In Illinois, they are very restrictive in what they allow in LPN practice.LPN's in Illinois from 1987-1991 while I practiced there could not do anything with an IV-couldn't start them, couldn't hang even NS, couldn't hang antibiodics.In some hospitals(a catholic hospital where I did clinical in LPN school)an LPN could not even give PO coumadin !

I moved from there to NC, where I was surprised at the difference-there, LPN's started IV's after taking an infusion course, hung everything and gave IVP drugs.I worked in ICU there for 3 years and LPN's were valuable there-they managed cardiac drips, obtained CVP and SWAN readings,hung blood and blood products etc; of course, there was always an RN in charge on the unit as a resource.LPN's in NC are catagorized as LPN I and LPN II, depending on whatever advanced training they obtained-such as infusion therapy courses, critical care courses etc.

In Missouri, LPN's can start IV's, hang all fluids and antibiodics, but not blood or blood products and cannot give any IVP drugs.

In all 3 states, LPN's could not do initial assessments upon admissions, but could and did take teams of patients and performed daily assessments.

My, how the states certainly do differ in their nurse practice laws.

In Missouri, LPN's can start and hang

Brownms46 · Mar 31, 2001

Originally posted by theboss:
hey i would like to hear more about the diffrences of all aspects of nursing in your state??? good or bad, fun or not what ever it is lets here it !!!hope to here some great responses!!!!!!thanks the boss

Jeeze, where do I start? First, I started out as an LVN in Texas, in an NICU, and cross trained in L&D. This was great experience. In the NICU, I did infant assessments, IV starts, gave meds through UVC, and obtained ABGs through UAC lines. Gave IV meds, OG/OJ fdgs, assisted MD, residents, with procedures, spun HCTs, care for level III babies on vents, and Step down LEVEL II, and LEVEL I normal newborns. I did initial admissions, and assessments on newborn infants. In Texas, LVNs admitted their own pts., started IVs, drew blood, hung blood, blood products, gave all meds, including IVP. ABG draws from Art lines. I have been in charge on med-surg units. Worked ICU,CCU, SICU,MICU, and Level I Trauma ER. Served as resource for new nurses, including RNs. I also worked as a supervisor for home health aides/homemakers in a United Way program, with my own office, and a great ADN boss. I was in charge of hiring, did inservices, evaluations, admissions, and discharge of pts, schedules, and sumitted their payroll, and monthly reports on my program. I developed, and put together a guide to assist families with finding nursing homes for their love ones.

I also helped develop a new admission form for psych pts., at the VA hospital in NY.

Alabama, worked home health, made medicare, medicaid visits, drew blood, inserted NGTs, supra pubic catheters, obtained orders from MDs, team lead a large area with at least 6-8 nurses depending on the prn we used. I assigned the nurses, including RNs, visits, Q&A their paper work, assisted with billing, maintained files, and did intake of referrals. I worked at a home care agency, as a supervisor of nurses, took call on a rotating basis, followed up on referrals from hospitals, visited pts., prior to D/C from the hospital, and admitted them to our service. Agency went out of business, but not before oweing many nurses money. Fortunately I was warned by an agency owner/friend of mine, just in time to get out with my money!

S. C. Worked ICU/CCU/MICU/NICU/Level I/II Trauma ER, L&D ( was offered Head Nurse position by the Head of OB at small hospital, that was opening a new OB unit, and had no experience OB nurses. They had trained some nurses at another hospital, but this OB doc, ate them on a regular basis! I filled in at a private school for CNAs, and was the clinical instructor. I loved the students, and it was a very enjoyable experience. The permenant instructor was going through chemo treatments. I worked outpt. surgery doing EKGs, IV starts, and preparing them for surgery, recovered them, and d/c'd them home. I did IV, blood draws from Central lines, EKGs, hemodynamics monitoring, and became ACLS, NALS, and PALS cert., and took a BTLS course. I hung blood, blood products, titrated cardiac drips, did physical assessments, admissions of Critical care pts, and Trauma ER admissions, and transfered pts. to Critical care units. Also learned how to access portal caths.

Washington..duh! Treated as an aide in most hospitals, in fact one place even had CNA after my name! Of course I never went back there again. There are a few hospitals, that do allow LPNs to start IVs, do IVPs, EKGs, and so on, but not many. Just started a new contract in a ER, and I'm back to being a nurse again. I can give drugs in a code, IVP meds, IV starts, the works. There is no division between nurses. There is a place for the doctor to place the chart when they write orders, and it just says "nurses orders"...period! If its something a tech can do, its put in their slot. Some hospitals in Washington, had at one time, got rid of LPNs. When they went to get them back, they couldn't find many with acute care or IV experience. So the hospitals used them as PCA/CNAs,...period.

I did a contract in one of these hospitals, and was allowed to start IVs, do IVPs, PCAs, but not blood hangs in a hospital, that on other floors, used LPNs as PCAs. Go figure!

That is why my website is devoted to encouraging LPNs to keep up their skills, and update their knowlege levels. http://homepages.about.com:8088/brownms46/travelnursinginformationforlpnvns/

Just because your job doesn't allow you to do something, don't allow your skills to go to waste. You never know when an opportunity will present itself!

Brownie

[This message has been edited by Brownms46 (edited March 31, 2001).]

theboss · Apr 1, 2001

thankyou for responding i love hearing about your lives. i hope to continue to obtain more knowledge as all of you have it is encouraging.. i love to learn..i feel it makes us all better people thanks again