waves

If this is true, then what do you interpret as the team nursing "legal scenario"? If an RN and LVN team have 9 patients in Surgical Acute, is the hospital out of compliance? Or is it allowable because of the term licensed (and subsequent definition that includes LVNs) in the original draft of the law regarding patient ratios in CA? (In regards to spacenurse post #14)

You sound like a thorough nurse. Please do not blame LVNs only for doing poor assessments. I have worked with RNs who chart assessments on the wrong patient chart (and never notice), and who also chart WNL when they are obviously not. I won't go into the RNs who thought D5W and D5NS were the same thing, that a UA specimen could be taken from a long hanging foley bag, or that Lovenox could be given in the arm. One of our instructors used to chuckle that WNL meant We Never Looked.

I went to these website links and found nothing r/t LVN assignmnets. There was in the FAQ section of one a Q/A Heading regarding same, but the actual Q/A seems to have been removed. It is a very confusing business as the hospital I am at uses an RN-LVN team to cover up to 9 mixed surgical acute patients. The administration is hoping to have the RNs share the paperwork load with the LVNs as well as the direct patient care. They stress that the LVNs are trained in assessments, care planning, etc. It seems some of the long-time LVNs have no interest in adding paperwork to their burden. Some of the new LVNs have a different outlook and want the added responsibility. I do think that LVNs could be assessing POD #2 or #3 and beyond, provided the patient is recovering as expected, and no change of condition has been noted. The problem seems to be in the way pts are assigned. If the patients are assigned to an RN-LVN team, isn't the RN always responsible for delegating and follow-up? If, as in rural hospitals, the LVNs receive a patient assignment with an RN to cover a scattered IV ABX, who is overseeing the LVN? It still seems very interpretation and pint of view driven.

yes, finding out i had passed was quick. the way my school did the application process was flawed so approval to test was slow. the issuance of the license after receiving the pass letter is also variable by admission of the BVNPT office. due to budget cuts they are often under staffed and sometimes have seasonal help when a large influx of candidate information is expected.

bambou- hey there. i'm not sure if you are from california. i am and i will speak to my experience in earning a nursing license here. choosing nursing was one of the best decisions i have ever made. the nursing program that will be best for depends to some degree on how much education you already have, how much support you have financially and for child care etc. if you are already a parent. the non-degree program i attended for an lvn was through a local adult education program. there are not very many of these in california. more programs are offered thru junior/community colleges in cali. some have RN and some have LVN and some have both. the RN programs usually are awarded along with an associates degree. there are of course many RN/BSN nursing programs at colleges and universities across the state which are mostly geared toward high school graduates who plan to attend college full time directly out of high school with the intent of earning a nursing degree. some schools promise the classes will be done in 4 years. this promise is made, because it often takes students at larger institutions 5 years to complete the degree. the community colleges will advertise a two year RN program with an associates degree. the two years are once you have entered the official nursing program. to gain entry into this program you need to take pre-requisite classes in things such as anatomy, physiology, biology, chemistry, etc. this is where i ran into trouble. i had a hard time registering for the pre-requisite classes due to the large number of students who had priority over me in the registration process. i can't even guess how many years it would have taken me to complete the pre-reqs if i had continued at that jc. if you do not already have a large number of college credits, you shouldn't have the same problem. i strongly advise you talk to someone from the counseling and nursing departments to help you organize your scedule. many schools offer certain classes only in the spring or fall, etc. the lvn is not the same as the rn. i earned an lvn first because i needed to get myself into the workforce. in my area lvn's can make about $20/hour at a skilled nursing facility (SNF), $11-19/hr at hospitals, and $11-16/hr at doctor's offices. i personally am on the longest possible road to becoming an RN, because i went to the adult education program. none of my classes from the program were college accredited, so i am retaking anatomy, etc. to get into an LVN to RN bridge program or an LVN to BSN/RN program. but, i needed to start earning money and it was the quickest option to get me trained and into the work force. i must add, i work full time in a hospital right now. the experience i am earning as an lvn is the best training i could ever receive. i happen to be in an area with limited opportunity to take the classes i need, so it will be 3-4 years from receiving my lvn to being able to apply for an RN program. in mind it is worth it. one reason i chose the lvn over the rn initially, was that i didn't want to spend 5 years in school to find out it wasn't for me. i was in my late 30's when i began my transition into healthcare. nursing is a wonderful profession in that it can take you in many directions... there is direct patient care, specialized positions, home health, doctor's offices, clinics, management (with advanced training and/or experience). you will be able to change your career as you grow as a person. the nclex is the nationally recognized test. the nclex for the LVN(LPN) is different than the nclex for the RN. if i have any other questions, please feel free to ask. good luck. one last suggestion is to train as a CNA to get some experience in health care. the training programs are less than 9 months ususally. they are offered by skilled nursing facilities and other community agencies as well as some community colleges. CNAs in my area make $9 to $15/hr. And a word to the wise...if the job description of a cna doesn't appeal to you, well...everyone in nursing does those tasks along with the more advanced ones.

Thanks so much for your very complete answer. What do you mean by window pane the wound?

As for waiting for results... for my class, those that heard within two weeks from the state via a letter, were those that passed. Those that waited 4-6 weeks for initial results did not pass. Getting the letter from the state.... you are asked to send a check for $100 back to the state for license processing. Depending on the back log of incoming mail, it can be another 4 weeks to get the actual license. I wish someone had told me that! You do have the option of walking into the BVNPT office in Sacramento with your letter and check. You will be handed a temporary license. You'll get your license (not paper, but something like a credit card) a couple weeks later. You can work on your temporary license for 45 or 60 days. It will not have the same issue number as your actual license. You can verify your own licensing on-line sometime between when the receive that $100 check and when you get the plastic card. I was told it varies depending on work load at the office and number of staff. Good luck!

the first drug program i downloaded was epocrates. the free part is a very basic drug book. when you first download it, they provide you with advanced features that will magically disappear in 30-60 days or so. then to get the extra features, you pay as a nursing student, i found the pt teaching, nursing considerations, IV considerations, etc. very helpful in the NDH drug program. but, the hard copy drug book i am most likely to grab is the NDH too. being able to access by brand names and chemical names is quick!

I have Tungsten E from palm. I have a 128MB expansion card too. On the expansion card I have a drug "book", a book about diagnostic tests, and a book of nursing interventions and plans. I purchased all of the books from skyscape. I chose the option to do a trial download before purchasing each. I liked the features. I liked the drug book (I'll list it below) because it is geared toward nurses and has subsections for each drug on patient teaching, nursing considerations, and effects on lab results...as well as all the other things you'd expect in a drug book. I like my test/diagnostic program becasue it explains what is required before, during and after every procedure, as well as why it might be ordered and what results may indicate. I have referred to it many times in answering questions for patients about what to expect during a procedure. The nursing interventions is the hardest to use, but I don't like the nursing intervention that much. I have used it though to help decide what subjective and objective things might apply to my particular patient...and what I might expect to see. The programs are listed as follows: NDH05 by LWW (drug book) RnDxTests by FAD (test/diagnostics book) RnDx_Int by FAD (nursing interventions) the three programs link between each other, though I probably haven't used that feature to my full advantage. I love my extra tungsten brain though! good luck

in cali- iv cert means blood and saline but no K. the rationale is that the K requires the RN training to recognize issues...due to cardiac, ie. possible death, effects.

i know what you mean about 5 years to get the 2 year degree. i started taking my pre-reqs at SRJC. it became clear very quickly that i would not be able to get into classes i needed. i met people in the summer biology class that had taken some classes 3-4 times...at least they started them. there was a strategy to sign up for several classes and drop the ones you are not doing well in. and they didn't lose any priority status. i heard rumors the school was going to do some additional filtering of students who were doing this, like they lose their priority for that class registration on their third try. i ended up checking out other schools further north, mendo and college of the redwoods. there is less problems getting classes at these schools. mendo is just developing its ADN, but CoR is well established in eureka. keep in mind that pre-reqs are pretty much the same, but not exactly...you may have a suprise in store for you if you don't stay in contact with any school you want to take the ADN at.

it is definitely tougher to find the stuff in print about keeping LVNs aboard...if you have an lvn under you, how many patients would you be willing to take on? or do you prefer not to even delegate bedbaths, dressing changes, etc.? in your opinion is the whole ratio thing of 1:5 based on the notion that an LVN and CNA would help provide the total care...or that the RN would do it all? just very curious as i've never seen an RN do a bedbath outside of ICU.

Having my head deep in the textbooks for the last year as an lvn student, I was believing what the dir. of nursing at the hospital and our instructor was telling us about not being able to hire lvns due to the state law. now that i try to find more info, i see that it is the rn union that is pushing hard to eliminate the lvn from the picture. the hospital where i do my clinicals had lots of traveler RNs in Jan. some of them seemed questionable in their ability to provide care. now the hospital has more lvns on night shifts in med/surg. i don't know if the hospital filed for a waiver due to the rural location though. one of the other students works at another hospital as a CNA. she confirmed the hospital is reducing its CNA staff...punishment for RNs who demand ratios to be able to provide "total patient care". i guess folks need to be careful what they wish for!

depends on where you are in cali. if you are in the bigger cities/urban areas there are urgent cares clinics, large hospitals, rehab centers, and the usual nursing home/doctor's office stuff. a lot of california is rural. folks don't think so from watching tv, but it is true. there are plenty of rural areas in northern california that need LVNs (what LPNs are called in texas and california). most of the work will be snf/nursing home. the state is currently trying to work out the rnurse-patient ratios in hospitals. they way it stands now, most aren't hiring many new LVNs. depends on how many sub-acute beds, etc. there was a law passed and ruled on by a court that only RNs could be used in figuring the ratio in acute care. so hospitals are desperate for RNs. i'm a bettin' man. there is no way health care will be affordable with 5:1 ratios that only count RNs, else there will be no health care. things will shift soon...either law will be revoked/changed...or more sub-acute/rehab type centers will be used. depends on whether you want to work on school to be n RN...work in geriatrics, etc. good luck