HazelLPN

It seems you missed the main point of my post which was that teachers and school nurses who work in states where they have the right to collectively bargain make significantly more money than in states where they do not. Texas is a state where they do not...and I live in a state where they do.

Texas is a right to work for less state and unions that represent teachers and school nurses have little to no power. In the district where I recently served as a substitute assistant school nurse, a teacher with a PhD and 20 years of experience makes over $100K and school RNs are on the same pay schedule as the teachers. The LPNs in the district are considered classified employees and make an hourly wage. When I was an LPN in the ICU at a large teaching hospital I made much more money, but it was much less than my RN coworkers.

I became an LPN because in my day, an LPN was a nurse who took care of the patient without having to worry about any administrative roles. In those days, an LPN could work anywhere in the hospital ...and we all trained in the hospital. These days, opportunities for LPNs are often limited to LTC and ambulatory settings. Neither of these jobs would have ever appealed to me...and I would rather go into a non nursing area than serve in these roles. No disrespect to the nurses who work there...I was good with one or two very sick patients that I could focus on....I couldn't do a med pass for 20 patients...I would lose my license by the end of the shift. Getting your RN will give you the most opportunities and you never know what you might like to do later on in life. In my case, I think I would have done well in my middle years as a CRNA or a certified school RN in my Indian Summer. I have no regrets because I had a great career as an LPN, but if I were young again I wouldn't become an LPN in this day and age...I would get a BSN straight out of high school. That's what I tell all young people who are interested in nursing. I also point out that it not not make them any better than the veteran LPN they work alongside. Many made that mistake working with me, but they rued the day they did. Best to you, Mrs H.

What an insult to the LPN used as a unit clerk. I hope she received LPN pay.

We had a high school student who ran in front of a car outside the school on a dark rainy morning right before school started. The school RN had just parked her car and noticed a crowd outside the school and she knew something had happened. She sent a teacher into the school to get the AED and began CPR. She knew he was already gone when she started compressions, but continued until EMS arrived. She followed the ambulance to the hospital with the principal and was with the family when the student was pronounced. She then came back to school and charted the incident, went home and changed her clothes, and came back to work. After school, the principal called an emergency staff meeting and the school RN debriefed the staff not only about the incident, but also spoke about grief, trauma, and guilt after such incidents. She was model of professionalism. I was working in the MH unit at that school which is self contained and located in its own wing. I didn't know what happened until the meeting. I had recently retired from a long career in critical care nursing and I don't think that any of my experiences could have prepared me if I had been the first one on the scene.

Find a job with tuition reimbursement! I worked for a large teaching hospital that paid for my school when I was working on my RN ( I never finished ,another story).

In my day, nearly everyone started on Med/surg before transferring to ICU. I myself started there right out of school because believe it or not...we didn't have ICUs when I graduated. Once it opened, I transferred to work down there within months. It is more common now to hire new grads in critical care, but I am still from the old school that if you can do med/surg...you can go anywhere. Why don' t you try and make some human connections? Maybe contact the nurse manager and see if it is possible for you could cross train in the ICU at the hospital where you work and pick up contingent hours. We had several floor nurses who floated down to us who eventually got cross trained so that they would be more comfortable working with vents. They generally didn't take patients who required critical care drugs ...if they had a drip that needed titrated one of us would handle it. However, it was great to have float nurses who could handle sicker patients and a few made the switch where they worked with us full time and moonlighted in med/surg. Best to you, Mrs H.

Absolute nonsense.

We need more men in nursing period! I have been retired from critical care nursing for ten years so I hope things are better now. My last job in the hospital was working contingent in the PICU and would float to NICU as needed. We had a 45 bed NICU (combined with step down) and a 30 bed PICU. There were no male nurses in the NICU and I think there were only 4 in the PICU. Back when I was an MICU nurse (this is now bordering on ancient history...1960s-early 2000s) most of the men I worked with put their time in and then went onto CRNA school. We had very few who stayed bedside nurses. Its been so long since I worked there that I don't think I know a single nurse I worked with to call to ask. Up until last year, I worked as a substitute assistant school nurse a few days a month. (still on the role but doubt if I'll go back for anything more than helping with screenings in the fall and then hang up the cap for good....the ole gray mare just aint' what she used to be...). We have only ONE male school RN...and I love working with him so much. He's an ex army nurse with a no nonsense attitude and a wicked since of humor who is so much fun to work with. My best friends at work were always the men.

I once had a nightmare after working an evening shift where I had four feeder growers that I forgot to feed one the entire shift. It was so real and vivid that I actually called the unit in the middle of the night to make sure I didn't make any mistakes. I've been retired from critical care for nearly ten years now. When I dream of the hospital its usually a good dream. The rare bad dream I have is when I walk into the nurses station in the NICU and they say "four feeder growers and one chronic that never sleeps.....thanks for taking one for the team" and my nursing license vanishes before my eyes.....

I have a challenge with your statement that"everyone thinks (teachers) are poor but we (LPNs) make big bucks." Considering many people laugh that LPN stands for "Lesser Paid Nurse"...I think that your assessment that everyone thinks that LPNs make big bucks is mistaken. Many people don't even know what an LPN is. I personally believe that most fair minded people agree that teachers and nurses are hard working professionals who are underpaid. You can't compare a teacher to an LPN. It would be better to compare teachers to an RN as educational requirements are more similar. After I retired from critical care nursing, I came out of retirement to work as a substitute assistant school nurse in the public schools. As an LPN, I couldn't serve as the actual school nurse...they were BSN educated RNs who also held a state license from the department of education to work as a school RN. They were on the same pay scale as the teachers and had their own bargaining unit within the teachers union. School RNs work VERY hard and earn every penny. As an LPN assistant school nurse, my pay was so low that I considered myself to be a volunteer. However, I didn't do it for the money. I did it because I still loved nursing but was no longer physically able to work in critical care. If you want to make a lot of money as a nurse, then the first thing you need to do is to find a bridge program and get your RN. The highest paid nurses are APNs of course...with CRNAs probably making the most. Best to you, Mrs. H.

One of my the weirdest family incidents occurred when I was taking care of a fairly routine s/p crain in the PICU. The mom and dad of course were very relieved I told them "we are just waiting for a bed upstairs...he doesn't need ICU anymore." The mom said "oh thank you....we are going back to the hotel now to have oral sex." I was so shocked I dropped my pen on my flow sheet. When I called report to the floor nurse I said "um...yes.....the parents are.....ah....getting some ice cream....they will be back later tonight."

I am a retired LPN and in my day, it wasn't at all uncommon for LPNs to work in the ICU. Though its not common these days, it does still happen. The ICU from which I retired still has LPNs working. Most of these places that use LPNs in the ICU are states and facilities that allow an LPN to have a broad scope of practice. It is important to remember that the LPN does not work under the RN license. The LPN is responsible for care under her own license. What is outside of the LPNs scope is the responsibility of the supervising RN. This could be very little in states and facilities that allow LPNs a broad scope of practice or it could put so much additional work on the RN that it probably wouldn't be practical for an LPN to work in the ICU.

You could do it either way. I worked in adult ICU for years and years before I started doing PICU. However, most of the nurses that I worked with in the PICU started out at other units at the Childrens' hospital.....infectious disease, hem/onc, ER, NICU, burn, pulmonary, neurosurg....even inpatient rehab. We also had our share of new grads that went through the hospital's NA program where they worked in the PICU as NAs part time before becoming RNs where they were able to learn quite a bit about critical care that they would never normally learn in school. I was in the minority starting out with adult critical care. I don't think it makes a difference as to were you start as long as you are intelligent, willing to learn, and love what you are doing. The biggest challenge I had was getting used to everything done by weight....and that kids compensate very well before they crash vs adults will usually look like hell long before their moment of glory. It didn't long me long though. Now getting used to NICU is another story..... PICU was my favorite kind of nursing that I did...hands down. I especially liked the great variety that you see in the PICU that you don't see in other kinds of nursing. You can take care of a burn one day and bad wheezer the next and then help admit the open heart the third. It keeps you on your toes and it keeps the mind sharp because technology is always changing, there are always new things to learn and something you've never seen. Its also much less physically demanding than adult ICU as the size of the patients are much more manageable (in general of course). I ruined my knee in adult ICU...and even after replacement it will never quite be the same. Critical care can be learned. I've seen it. Peds can be learned. I did it. What can not be learned is inborn talent and passion...that you must possess inside of you. Either route can send you on the path in which you desire. Best to you in your career, Mrs. H.

The great Bette Davis, one of my favorite actresses when I was a little girl, said once "Getting old ain't for sissies!" There's nothing good about getting old once you realize that you can't do what you used to do as well as you used to do it. You get to the point where you know that you can't do the job as well as you used to. I worked in the ICU for over 40 years before I bowed out. In my case, it was my knee that was the problem. I didn't move as fast as I used to. I began dreading when I had to travel off unit with a patient to CT or MRI with a bunch of pumps.... or even transferring them to the floor with very little. I am happy to say that my care never suffered, right up to the end but I knew that If I continued for much longer that my care would not be up to MY standards. Facing knee replacement surgery and a long recovery period...not to mention that I was 75 years old at the time...I knew I wouldn't be back after my surgery. They all said I would be back...I'm not sure if they really thought that or they wanted me to feel good about myself. When I went in for my last shift I said to myself "This is it....soon it will be finished." I feel for your coworker. However, I don't think it was that she lacked critical thinking. You don't work in ICU 30 years without being good at it. She has some kind of problem. Heath problem, family problem, burn out problem....we don't know. That's why she's leaving....not because she simply lacks "critical thinking." I'll be you anything she knew there was a problem long before anyone else did. That's how it usually happens. In time, she will learn that there is life after critical care nursing. After I retired, I immediately had my knee replaced. I still have to walk with a cane occasionally when I go up stairs or when I have to walk a long way...so I could never return to the hospital again. However, I am STILL active as an LPN. Not in the ICU or a hospital...but as a substitute assistant school nurse caring for special needs students. I love it. I work very little but am glad that I can still work at an age when some people can't even tie their own shoes. I hope she loves her job in the clinic and finds happiness in nursing again and whatever ails her will be taken away from her. Best to you both, Mrs H.

Doesn't sound like she was cut out for med/surg either......or any kind of nursing that is.

Do you like better staffing ratios and better pay for nurses?

Same thing I wore in the hospital. White uniform AND my cap....proudly.

I worked in a hospital for 54 years...most of that time in critical care...before I came out of retirement to became a substitute assistant school nurse. I'm not the actual school nurse....I mainly work with medically fragile or special needs students that the regular school RN would not have time to care for with everything else she /he must deal with. I used to joke that I wanted to be a school nurse when I had a difficult PICU shift and give out ice packs and band aids...other nurses did too. Little did I know how much responsibility the school nurse has. IMHO, because the school nurse is highly autonomous, I don't think that one year is enough to prepare one for school nursing. You have to have excellent assessment skills. I work in a high poverty district, and the school RN is often times the only health care professional that our students see on a regular basis. Many of our school nurses have many years in acute care peds before coming to school nursing. One my favorite coworkers is a former flight nurse with the US air military. He won't tell you the job is easy either. When we had inexperienced nurses in the various ICUs like yourself, we made sure that they were given appropriate assignments. When we didn't have great assignments to give them, they were given a lot of support from the veteran nurses. You simply don't have that luxury as a school nurse as you work alone. Best to you, Mrs H.

I am also a former PICU nurse turned school nurse (although I'm only an assistant school nurse..and a substitute at that....working mainly with special needs units and medically fragile students that the regular school RN wouldn't have time to manage with everything else she/he must do). It seems like many of our school nurses in my district are former critical care nurses. Our school RNs are on the same salary schedule as the teachers. With advanced degrees and experience, they can do pretty well. I think they max out in the $90K range with 30 years with an MSN/MEd...even higher with a PhD. The school RNs have their own bargaining unit within the teachers unit represented by the NEA. When I was still working in critical care I would joke that I wanted to be a school nurse and give ice packs and band aids. Little did I know how much responsible and autonomy the school nurse has...and there is no attending, resident, intern, charge nurse, house supervisor or colleague working with you. YOU are pretty much on your own and the expert of all things medical. Staff members will tell you all about their medical problems. I can't tell you how many times I've said "oh, you should call your family doctor about that" or "Let's call you doctor right now" in some cases. I remember feeling naked when I started working thinking "where is the drug box?" and then remember "wait....I don't do that anymore.....I call 911 and EMS will arrive to do the rest. Your experience as a PICU nurse surely will help you with the many medical fragile children we are getting in our schools these days. They are very lucky to have you. Best to you in your new career, Mrs H.

I had ACLS, PALS, and NRP before I retired from critical care nursing. It is unusual for LPNs to work in critical care these days but the ones who are left earn these certifications as well as their RN colleagues. However, one must still follow the LPN scope of practice for the state where she/he practices as well as follow hospital guidelines for the LPN job description. I was able to push code drugs IV, yet one state over, an LPN could not give any IV medication...ACLS certified or not.

Back in my day, an LPN could work anywhere in the hospital including L&D. Back in the 1980s where I worked, there was a push for the LPNs who were working in specialty units (ER, critical care, L&D) to go get their RN and the hospital offered tuition reimbursement. At the time, they were told they would no longer have jobs in these places and would be reassigned to a regular floor if they chose to remain LPNs. In the end, they were allowed to remain LPNs and nobody was forced out. However, they were replaced with an RN when they retired or quit. Many LPNs took advantage of this opportunity, some chose to remain LPNs. If I recall, at the hospital where I worked, L&D had an LPN back in the early 2000s and when she retired, she was replaced by an RN. This was in a hospital and state where LPNs were used to the fullest extent of their training. I would imagine that there are still LPNs out there in L&D but it is the exception to the rule. The LPNs who are still employed in L&D are probably veteran nurses who have been grandfathered in due to their experience and will be replaced by an RN when they retire. If you wish to work in L&D your best bet is to go get your RN. However, it doesn't hurt to call up the nurse manager of the L&D unit to show your interest in such a position. It may be possible that they use LPNs in some capacity. At the very least, it may give you an advantage when it comes to finding an RN position. Best to you, Mrs H.

I did NICU myself before I retired and then spent my final years in nursing as a substitute assistant school nurse. Many school nurses in my district it seems are former critical care and ER nurses. Your NICU experience will be great for the amount of OB that you do. I had several kiddos that I took care of in the NICU as students that I took care of...one of which was one of the sickest babies I ever had....a meconium aspiration who ended up on ECMO and then a terrible surgical wound infection and probably spent 4 months in the hospital. 15 years later, she had asthma and anger management problems but did better than anyone thought she would. Best wishes to you on your new and rewarding career....you'll do great! Mrs. H.

My first paycheck was so long ago that I probably used it for something nice to decorate my log cabin.

I was told "don't touch me you old ass (insert N word) b_ _ _ h" by a high school student who had been in a fight. The regular school RN was busy with the other kid and they didn't want them together so I had this kid in a conference room just off the main office. I happen to be a white lady. Lilly white in fact. Northern European heritage. I get sunburned walking to my mailbox. The student was also white. Not as white as me, but white none the less. I was taken aback as I've NEVER been disrespected by a student like that before. I was also very confused because I knew that word to discriminate against black people. I was horrified that I had a racist on my hands...and there's nothing more that I hate than a racist. I wondered if his vision was affected because he had a black eye. I called his grandma to come pick him up and I said he would need to see his pediatrician or go to the ER right away. When she arrived to pick him up I told him he what he called me when I tried to look at his wounds. She looked at him and said "Did you say that to the NURSE?" He said "no, she's lying" She looked at me, then looked at him, looked at me again, then looked at him and all the while she started to turn bright red and breath hard and her eyes got really big. I was ready to run for the AED just in case. She looked at him again (at this point she reminded me of one of those cartoon characters you used to see on television who were red with steam coming out of their ears) and said "YOU LIEEEEEEE!!!!!!" and smacked him so hard that he fell off his stool and into the copy machine. The principal, the police officer, the school RN all came out of their office to see what was going on. Next week, I was given an apology letter from the student explaining that he wasn't raised to use those words and he hoped I would give him a second chance.