LPNer

Until there is a group specific need, it would be difficult to define it. But one might think fo something akin to LPNs positions if it were decided to remove them from the acute care floors or benefits concerning continueing education. It really would be group specific so impossible to define here.

I don't remember anybody in this thread thinking that an LPN should be the same as an RN. As mentioned in your post, LPNs have two levels of IV certification. This is the type of certifications I am talking about. But it should not be limited to PIV and CIV. My own hospital does not add restrictions beyond what the BON restricts us to so I am very lucky in my position as an LPN. However, so many other hospitals have so many restrictions on LPNs that they do not even hire them anymore. What a waste of manpower. My thoughts are, if the state qualified LPNs for more through certifications, then certain hospitals would be more likely to hire LPNs. Pt acuity is higher than ever before and inexperienced LPNs should never enter the "units" and quite frankly, only select LPNs could ever be qualified to work there competantly. I do not want to make LPNs "like" RNs. We are a separate and proud class of nurses. We are qualified to work in med/surg, ortho, bariatrics, sub-acute care, hospices, etc. LPNs should be achnowledged for the training and abilities they do have and each individuals ability to build on that education to further his/her carreer with one quater or so classes that add to his/her resume proving competancy in certain areas, just as the IV certification does now.

I am not nearly as concerned about breaking the wafers by hand as I am counting them in front of the pt. This is, after all a Methadone Treatment Facility! I wouldn't want them to see any more than the one dose they are getting.

Oh, I see what you are saying now. I didnt susgest a separate bargaining unit, I asked her to find out how they are going to handle issues that pertain strictly to nurses. And that would be exactly what I would suggest to pharm techs, physical therapists, etc. How is this union prepared to address my groups specific needs. That is not the same thing as a separate bargaining unit. Do you understand unions?

I agree 100%! What I want to know is HOW? Everytime I suggest that LPNs be permitted to become certified in this or that, as in Colorado they have an advanced IV therepy permitting LPNs to work with CLines. This is what I am talking about, yet every time I mention it, I am attacked by RNs who insist that an LPN can not be an RN. I never suggested such. I never suggested challenging the NCLEX-RN or anything like that. I am simply asking nurses to stand together for the betterment of all nurses as well as pt care. It seems we want something that is not likely to happen with all the female back-biting, you can't have what I have or even a tiny part of it and I will take from you everything that I possibly can along the way attitude so prevelant among women. I wish I had the answer.

There has to be more to that guidline than stated here. Would you mind sharing your source with us?

Congratulations!

I'm watching it now. The movie is OK, How heroic of the folks who were really there. But now, it's just a movie, seen better, seen worse.

LPNs had a lot more carreer mobility when I became an LPN in the 70s. An LPN was the head nurse of the ER where I went to school. I was offered the charge nurse postiion in the ER of a small hospital in Ky in the early 80s. (I didn't want to work ER than or now.) I have been the charge nurse on a med/surg unit in a hospital. Yes, we did, at one time have a lot of carreer mobility with bascially the same scope of practice as we have now; minor changes have been made and THAT has taken our mobility away. LPNs at a lot of hospitals did not have "limited" IV responsiblitlies. We had the same IV responsibilities as our RN co-workers. The scope was changed and now I don't know the things I used to know! I am told that because I am onlyl an LPN I am not capable of learning anything new to expand my responsibilities unless I return to college. I don't have the abilities I used to have, where did that knowledge go? Oh I know, I don't have a degree to prove it! Please. LPNs have not always been treated as second class nurses. We have been whittled down by the BON (mostly RNs) to put us in our place and to prevent us form taking jobs that could better serve the professional status of RNs. How would the professional nurses insist on their value if technical nurses can are permitted to function to their full capacity in the hospital?

Been there done that! The cuff was quite long and it wrapped around until it wasa several layers thick around the arm, then inflate and take blood pressure as you do now with a stethescope. The whole thing did not inflate, I suppose being wrapped so many times around the arm didn't allow for inflation at the far end of the cuff.

Just because they do not reward nurses for education aquired in other ways than college credits does not mean this can not change! That's my who point! LPNs need to stand together and be seen! RNs have various ladder programs (their scope allows employees to do this, at present the LPNs scope does not) LPNs must stand together and work with the BON to allow this to become a reality for LPNs. The online bridge programs do make becoming an RN feasible for a lot of LPNs who could not do it otherwise but that is not an option for many of us and an in-house or even statewide "ladder" program or certification program would allow LPNs to remain LPNs AND advance in their chosen carreer! Laws and regulations CAN change, it's time LPNs banded together to facilitate those changes.

I've been hearing the same thing since the 70s! I understand NY has taken steps to do just that; however, I don't see the final date for "convertion" ever being met. As always, that date will keep getting set back. Even Kentucky, at one time, had said it was going to require all LPNs to get credits towards their RN as continueing education requirements. If that were the case, none of the LPNs I've been knowing for 20 years or more could possibly be practicing as LPNs now....surely, even just a class of two a year would have produced a degree by now! Many states have tried it and they all have found that LPNs are valuable nurses, LPNs are cost effective nurses, LPNs can never be replaced.

I sure miss having my cigarettes while I chart!

I do not remember anyone saying it does or should or could or anything else like that. Where did you get the idea that anyone has said that?

Most of the once a day meds can be spread out over less heavy med times thoughout the day. That would be the first step in managing the load. LTC facilities have long "ignored" this problem because it is a method of repremanding nurses who for whatever reason need to be gotten rid of and they don't want to make a big stink. Just let go because s/he can't handle the job. I have a very good, long time friend who is still DON at a LTC. She let me in on that hint many moons ago, it was when I was acting as her temporary ADON. Didn't want the job myself but did agree to help for awhile. I did, all done. Thank God!

There were a few metal IV needles available still in the 70s but angiocaths were also available. Seems they lasted just about as long as an angio does, some sites hold up while others fail pretty quick. In any event, none "last" past 3 days (except central lines.)

The hospital I am at now is not union. I am sure a union with other licensed personel would be better than grouped with non-licensed staff. But... I still worry that your particular needs as a staff nurse will not be met. When the hospital I did work at that was union decided to do away with LPNs they could not understand why we should object because a job that paid the same, offered the same benefits, etc was available. They had no concept how much nursing means to a nurse. Pharmacy techs count pills for a living. The emotional bonds to what we do are not there. PT could and very likely does feel the same way aobut their carreers as we do about ours, but there is not another level of PT who hsa been chomping at the bit for decades to do away with them so their needs can never be the same as the LPNs. You know, at one time, over 20 years ago, I came to within 1 quarter of having my ADN. My husband died and I was left with kids to raise alone etc etc etc so never did finish. Have to start all over again now and it isn't worth it. I have done so much in so many positions as an LPN that now I strive to help LPNs become the nurses that we are instead of the glorified CNAs many BONs are trying to make us. This is all a different story but I am getting to a point about the union.... Ask the union in a well drafted letter just how they intend to approach the subject should it arise in your hospital. Are they going to help bring LPNs, even non union members, in your state to approach the BON about these issues? I would want to know that they will be there for me should this happen. What are thier plans? How would they handle such a situation?

Actually I do undrestand. I have far more formal education than being a simple LPN indicates. When my first husband died, sorely underinsured, I had nearly completed the ADN program. In all these 20 years since I have continued to work as an LPN and care for my children and their educational needs. Everyone assumes I do not know what I am talking about. I do. And an RN is better educated, no argument there. I am simply stateing that as LPNs we should fight for ourselves and not sit down and roll over because we are not as educated as RNs. Just becasue an RN knows more, does not mean an LPN does not know enough. Get it?

Things need to change in nursing. RNs move to make changes in their scope of practice all the time, yet LPNs seem to think it's not possible and RNs continue to foster that misconception (job security)! We are not RNs, never said I think the wave of the future would be for all LPNs to go that route with or without additional formal education (if an LPN chooses to advance her pay substancially and increase job ops, then that is the way to go, but to remain a bedside nurses, we need advancement ops that do not require formal collegiate education at a costof $10,000.00 or so. I honestly believe LPNs short change themselves and their abilities! Were you not taught to assess your patients in LPN school? Were you not taught the rational behind that assessment? Maybe there are schools out there in some states that require nothing from their LPN students but that is not what I am hearing from so many of the students and experienced LPNs and it is certainly not the way it was when I was in school. Come on LPNs, tell us if you were or were not taught how to assess your patients and if you did or did not have to understand that assessment! LPNs do not have the education the RNs do, that will not change. But we are given a broad base to start our carreer with and it is up to the individual to build on that base, just as an RN can and often is rewarded for that same "building on the base of knowledge" she gained in school (many facilities call that a ladder program) the LPNs should be offered the same opportunities. Come on LPNs are you that insecure in your knowledge? Can we not stand together for our rights as licensed nurses? Why should RNs continue to gain in their scope while we sit and allow tham to "do away" with us?

I worked at a University Hosp where the RNs had their own union and the LPNs were in the union with most of the other staff, all of which were non-licensed personel! The needs of those personel who are not professionals, who are not licensed, are very different from licensed nurses, resp tx, physical tx, etc. It was a nightmare for LPNs when the hospital decided to phase out LPns in favor of an all RN staff. Nobody cared! The union did not understand the light of LPNs as they never dealt with licensed professionals before. The LPNs lost and were phased out. This is one of our biggest problems, it's not that we are not capable of working in acute care, (few nurses are right out of school, that's why RNs enjoy preceptor programs of up to 6 months duration!) we have no representation! We need to join together as a separate entity if the RNs in the facility do not want you to join their union. We do not need to lump ourselves into a group of non-licensed personel who can not understand our needs as far as compensation packages, job security, advancement ops, etc. Like I said have before, an LPN can never be an RN without additional formal education, but there is no reason why we can not build our own professional organization and ensure our advancement through certifications, etc. We need to be treated as entry level professionals, not ancillary personel!

Ancilliary personel! Run, stay away from them. They can not help the LPN in our particular crisis!

I did not mean that experience alone should allow a greater scope of practice but that the BON should institute a ladder that would allow LPNs to test and gain a rung on the ladder if passed. This would not make them RNs. They would still be LPNs with a broader scope of practice in that area. A system such as this would provide the health care system with nurses with the proven knowledge required, even though not achieved through acedamia, while allowing LPNs with many years of experience some mobility in their carreers.

The way I remember to cover my bases when doing a head to toe is to, of course, start at the head and think of each system in the area I am working with. Overall Appearance, grossly obese, emaciated, dirty, etc Odors, urine, stool, BO, fruity, etc What do they sound like? Or did they speak at all? Position/posture Skin color/texture Head CNS Auditory Vision Smell (their nose, not mine) condition of hair? very dry/oily (may or may not "be something" make a mental note) Neck condition of trach - midline? audible breathing sounds (not using steth for lung sounds) C/O (above for head too) pulses Torso: Chest lung sounds symetry on inspration/experation depth of resperation C/O etc etc etc all the way down [*]Abdomen [*]Back Perinium Upper Extremities Lower Extremities For each of the areas I inspect/assess I think of all the systems available for input into the system. With very little practice, it will come to you very quickly and you will start seeing abdomens as a wealth of information instead of just the GI tract. I havn't seen this outlined since nursing school nearly 30 years ago (much better outline than I gave you, I left you with lots of blanks to fill in, but I didn't think I needed to write it because you know what to look at) and since then I have developed an excellent assessment strategy.

My school required that back in the mid 70s. Alas, the hospital they were attached to has closed, so did they.

And I had to have experience in hospital vent care before I could work in home care vent. LOL Just shows you the difference from one state/organization to the other. I also think any nurse who is now an RN, even if she has maintained her LPN license is no longer an LPN...Just a thought, don't know if that has anything to do with the poster I was responding to, but I thought of it and decided to toss it in here. No reflection on the post I responed to in my first paragraph.