Dixiedi

We do have to take an IV therapy course before we can do anything more than regulate flow. We start PIVs, hang NS, LR, D5, 1/2NS or any combination of them We start antibiotics For PIVs with MVI, K, etc in them, an RN must hang the first bag but we do hang subsiquent bags. We also do restarts...but that goes along with starting. In Ohio we can not hang blood, but as always, we do monitor and stop. We also can not give any IVP meds. The only thing we can do with PICC or other CIVs is monitor/adjust flow rate. I work with several RNs who think the PICC/CIV rules are just rediculous. Nobody could act fast enough, RN, LPN or even MD to make a difference in the maybe 10 or 12 seconds difference in time to reach circulation up the arm. And to think it's becuase of the postion and possibilities of infection, bleeding, etc. Well, CNAs and PCAs provide care and they are just as likely if not more likely to run into a disconnected line. The rationale just doesn't follow through. It's like the BON decided they have to keep LPNs from being 100% useful to med-surg and other non-critical areas of the hospital by restricting procedures that just don't make sense to restrict. Oh well...there I go again.

Cincinati, Ohio Long list so I will try to make it orderly: personal care of course foleys and st caths trach care (including changing if needed) G-tube care and feed, flush, sx, asp, etc. NG just as G-tube Drains (nurses do not remove chest tubes but do care for them) dressings (no restriction as to packing, meds, etc) sutures (though it's rare that one of our ortho pts has any and the staples stay in past discharge) Meds PIV solutions and antibiotics (Ohio has a rather lengthy, odd IV and LPN policy) CIV "simple" solutions only. Treatments - I can't think of any treatment that LPNs are not allowed to provide to their pts. (this does not include some "unit" treatments/procedures that are not performed by any nurse on the floor.) Update the care plan. Pt. Teaching (on my floor, it's usually anticoagulant tx, pain control and reinforcing PT teaching, walker walking with new hip/knee, etc.) With the exception of CIV and IV push and of course "charge duty" the LPNs in my hospital care for their pts and accept total responsibility for our pts just as the RN staff nurses do. Just as I would answer a call light and give pain med PO or IM to one of my co-workers pts, my co-workers will give my pts IVP meds for me. Now, if Ohio will just catch up with Colorado and others and expand the LPNs role in IV therepy to include CIVs and IVPs. Ohio is soooo slow to catch on and they will never give LPNs credit for what we really are worth! We are not be RNs, but the average pt (not in one of the special care units) can be cared for quite competantly by most LPNs. Oh, but that's my soap box and I'm not going to go to that here.

Cincinnati here! I work in a small hospital on the orthopedic floor. Sports medicine, joint replacement. Love my job! Oh, I am an LPN for some 30 years.

Excellent answer. I hear so many younguns say you CAN find an RN program that will work for you. Yep, I suppose there's one out there someplace, but darned if I can find it. Get a loan? Excuse me, loans have to be repaid. for the 5$ more on the hour that I would make, it's not worth the effort just to hang blood and be a "charge nurse" in my hospital. I graduated LPN school in 1977 when there was far less diference between LPN and RN (the hospital where i went to LPN school had an LPN head nurse in the ER). Now, hanging blood and being in charge just aren't worth repaying a large loan and taking high school and nursing fundamental classes all over again because it's been so long since I graduated. I love my job, what more could a person ask for in this life?

I don't know any personally but would love to hear about your duties.

Unfortunately it sounds to me as if you are letting her get away with it. This you can not do. She is being insubordinate and disrespectful to not only you, she is being disrepectful to your pts. Remind her of this and that her behavior must change or their will have to be corrective action.

I have seen that happen before, twice. The staff should have prepared you. Nurses are just humans. It's very emotional for the staff when they have to "turn somebody off". It's a very different perspective from what the family feels but does remain very difficult. Most pts who are vent dependant just stop breathing and their heart follows within a couple of minutes. Your grandfather, as you said, was non-responsive when on the vent. Maybe he didn't know he was vent dependant. This does not mean there were no other brain functions working so when the vent was discontinued, he became frightened and this fear elicited the response you and your family witnessed. It is no indication that he might have survived if he had remained on the vent. It only indicates his basic survival instincts were intact. I believe every pt, even those who are non-responsive should be talked to, they should be told what is going on. He should have been told what was going to happen. I find fault with the nursing staff for not preparing you or your grandfather. But again, nurses are only human and so many these days get so involved with "gadgetry" that they forget there is a human being on the other side of the machines and bodily functions they are so proud they know all about. It's very difficult for all nurses and when you are new it will be even more so. You will learn and "get used to it". Remember, do not become emotionally involved; remain empathetic but not sympathetic. Keep an emotional distance while being supportive and understanding. And above all, always talk to your pts, even those who never respond, we just don't know enough about the brain to know how aware they are what's going on around them. And last but not least, inform families of as much as possible, they are not in the way, they are your pts best hope for an excellent outcome, even if that outcome is death.

LTC LPN - Don't you change tubes? I was suprised when I read they have to go to hosp for tube replacement. Earle 58 - We always keep spare g-tubes or buttons just for replacement for damage or age. Usually damage, they never seem to last long enough to have to be replaced because of age with all the pulling and tugging so many kids seem to be able to "give" their tubes.

hehehe... When I read your post my imediate thought was "close to wonderful states like Kentucky, Tenn, West Va... totally the other direction!

Finding LPNs who want to work in the hospital is not a problem. Finding RNs who is another story. There are more LPNs wanting hospital work then their are postitions available so they will not advertise. On the other hand, there are not as many RNs looking as there are positions, so they advertise. It's true many hospitals do not hire LPNs these days, but really now. Would you want to be in one of those hospitals? Not me, the administration is more interested in appearances (we have the best trained staff) than in quality nursing care. Not that RNs do not give quality care, they do. It's that you can hire more LPNs, thus providing better care simply because no two nurses can care for as many pts as 3 nurses can.. There are many who would disagree with me, but that is how I see it.

Back up your calls with email if possible. Be sure to mention "as per our telephone conversation" so as to back you up on it. Phone calls can so easily be forgotten and there's no proof they ever did. And, as the last poster said, please watch your back!

I am returning to acute care in August and one of the hospitals I am interviewing at does offer 12 hours weekend shifts, I am not sure about the other two. hehehe I am hoping the hospital of choice does but it's one of the two I don't know about yet. I'll find out Tues when I go for my interview. Most hospitals around here require 3 days, not two. Usually every Fri, Sat, Sun.

I too am in Ohio and around here, the schools with special needs kids will use an agency LPN (who works with some of the kids during off school hours) when the regular school nurse is off. Of course, this is not a regular school nurse job but it is a foot in the door if that's the way you want to go. Can't hurt to ask your school district of somebody "in the know" in your area.

Foul language in front of pts/families is not a nitpicking complaint. Respect of your pts and their families is most important. A nurse can be sharp as a tack, but if she verbally comes off like a street walker, then she doesn't leave a very good impression. Making fun of others, well, that is simply immaturity and has nothing to do with age. It's not just in nursing either, it's running rampant all over this country in all walks of life. No solution to offer unfortunately.

That's one person's opinion and just reading through the threads here, you will see there are a lot of nurses who feel differently. Anyone with a license can get a job. Maybe not what they thought they were going to get, but a job they can get. It's up to them to make the best of it instead of the worst.