ornurse2001

OK-This is an old thread, but I am reading it for the first time.I was referred to a dentist one time in Murphy,NC named Dr. Harry Dickey-no kidding, and his daughter operated an ice-cream parlor next door to his office called "Thw Sweet Tooth".

Sue D-We have a variety of practice laws in this country that are not standardized nationwide;rather each state's board of nursing determines what is acceptable practice for different levels of nursing education.I'm sure that this is confusing for people not practicing or new to practice here in the good ole' USA-it is often confusing for us the practicing nurses.Nursing assistants(sometimes called PCA(patient care assistants)can take a certification course that varies some in duration but is basic to learning things such as giving bed baths, taking VS, feeding techniques, preventive skin care(such as turning and repositioning), etc.Some states have levels of nursing assistants that can do additional things such as insert foley catheters, set up oxygen, and add formula to existing TF bags.LPN's are further educated with an increased focus in the clinical realm to perform duties such as inserting feeding tubes, foley catheters, giving medications, documenting in the patient record....again-LPN practice varies state to state.Education for an LPN is usually a very intense FT training program lasting 10 months to 2 yrs in some states.They are also referred to as Licensed Vocational Nurses since education at this level is ua=sually obtained in a vocation school, rather than a college.There are various different practice models used in various facilities.In some facilities for instance; they may practice team nursing where which an RN would oversee the care performed by LPN and CNA(PCA)'s with the RN serving as a supervisor and coordintaor of care( and in some states all the IV therapy), the LPN passing medications, performing fingerstick Blood sugar checks, documenting nursing care in the chart...etc., and the CNA would obtain VS, give bed baths,etc.In the ideal situation these roles should meld and function as a team assisting one another where able and within the scope of their education and training to provide the highest quality care possible to a group of patients.*smile*I hope this helps.

I enjoy my job well when there is something to do.I work in a small, rural hospital that is struggling to stay alive.I work in Surgery, but today for instance , we have one lap-chole and 2 LPN's and 3 RN's with which to do it.BORING.I am leaving this position soon to take a travel assignment and really excited about working in new places-seeing new people and learning new things.We'll see!

I enjoy my job well when there is something to do.I work in a small, rural hospital that is struggling to stay alive.I work in Surgery, but today for instance , we have one lap-chole and 2 LPN's and 3 RN's with which to do it.BORING.I am leaving this position soon to take a travel assignment and really excited about working in new places-seeing new people and learning new things.We'll see!

Hi Jami ! I had a simialr experience as an LPN when I moved from Illinois to NC back in 1991.In Illinois, LPN's are very limited-could not even hang plain, non-medicated IV fluids, much less do piggy backs or pushes.An LPN could not even start an IV there back then.I moved from there to NC and LPN's were catagorized as level I and level II, the latter having taken an in house IV training program.As an LPN II after your hospital's training program, you could start IV's, give IV push drugs with no exclusions, hang blood and blood products, manage cardiac drips etc.(of course under supervision of an RN charge nurse on the unit).I worked in a general ICU there and we typically had LPN's as the majority doing the assigned patient load, and sometimes had only one RN in the unit as a charge person whom would oversee the patient care and had no patient care assignments.The experience I gained in that position was invaluable to me when I later became an RN.Take all the opportunity for learning experiences that you can, it will definatly make you a more marketable resource!

I can't direct you to any resources but can give you my own experience.I am not sure if you mean prioritizing patients vs. paperwork -? The patients are always my first priority.I carry a paper with me that I have all of my patient information on and write myself notes to document from after all of my patient care is caught up. any help?Simple concept-not sure that this was what you wanted......

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

Thanks for responding.We do have those things available-maybe I just need to chill a little.

Hi-Thanks for responding-thought i should clarify that we never administer these meds in these doses without a physician present, in fact, they usually give the first dose.

Thanks for responding-In our facility we have CRNA's that do all the epidural boluses in OB-I think our OB nurses monitor the infusion, and a few select nurses that feel compfortable remove them.(Just tid bits-I think its interesting to learn how other places do things in comparison to what becomes commonplace for us in our current jobs) Thanks again !

1&2)LPN/12 years - RN/6mos. 3)Misery; also known as Missouri 4)pay is OK, would welcome more of course 5)lousy insurance,otherwise OK 6)8 hr shifts/mon-fri-6am to 2:30pm, but may switch to 10 hr shifts 4 days/week-no week-ends 7)no 8)sometimes 9)yes, but inservice education for employess is nil right now-small community supported hospital-much community education going on-poor medicaid/medicare reimbursement, you know...... 10)love being a nurse 11)OT discouraged 12)sometimes too many 13 & 14)I work Mon-Fri.6am-2:30pm-about 10-12 days of 24 hour surgery call per month-don't usually work holidays unless an emergency surgery while on-call 15 & 16) no desire for a union here, but understand why other places may need one 17)In reading these other posts, I think I will delay that prospective job change ! ------------------

I work in a surgery dept. with an endoscopy lab, and we give alot of sedative medications during endoscopic procedures.We usually use Versed in combination with either fentanyl or demerol.We have one Physician in particular that wants us to give as much as 14mg of versed and 100mcg of fentanyl during an EGD for instance.My question is-Does anybody else do conscious sedation for endoscopic procedures at their facility that can enlighten me on how much medication they typically give during these procedures???I am just wondering 1) How much is too much for an RN to administer and monitor without an anesthetist and 2) Is there a point when we should say something to the doc like "You are aware the patient has already had XXX.... amounts of these drugs" in order to CYA should; God forbid, respiratory arrest or some other unfortunate incident occur. Also, if you do endoscopic procedures do you have 2 nurses or more present for the procedure and if there is 2, which one does the biopsies(ie:get the forceps, pass them , open/close them and handle/mark specimin).We had been in the practice of the nurse assisting with holding the scope continue to hold the scope in place while the dr. manipulates the forceps thru the biopsy channell, and the RN administering conscious sedation was doing the biopsies & handling the specimins.We have recently had some controversy in our dept.regarding the possible lack of close monitoring during conscious sedation while handling the biopsies.All input appreciated!Thanks! ------------------

I have been in nursing for 20 years-first a nurse assistant, then an LPN for 12 years, now I am an RN(AAS)I became pregnant at age 13, and dropped out of school in the eighth grade to get married and have this baby.I proceeded to have 2 other children before age 19 for a total of 3 children.When I started looking at going to school after getting a GED, I was very disappointed to learn that I needed a great deal of general education classes in order to become an RN, since I missed these by not going to high school.Becoming an LPN first allowed me a stepping stone into a higher income brackett to support my children, and gave me an acedemic basis to work from.I was able to support my family rather well with an LPN salary, and held a variety of positions giving me varied experience-I worked in a hospital float pool, ER, OB, Newborn Nursery, ICU, CCU,OR, was a patient care coordinator in a long term care facility and was ACLS and PALS certified back when ACLS was a difficult feat to accomplish- all while being an LPN.I never had any difficulty obtaining positions that afforded me opportunity to use my practical skills and earn a fair living.Once locked into satisfying positions, I found it difficult to make going back to school a priority until my sons became teenagers, at which time I did become an RN, because getting there was always my long term goal.I am making more money, and there are broader job opportunities for RN's than LPN's, but would not trade the years of experiences I obtained as an LPN, and I believe that there are varied reasons why each of us choose our separate paths to what we feel is our acedemic success.There is a place for all of us in the health care arena, and every job is important.Also, there was discussion about "phasing out" LPN's back when I went to school, and it hasn't happened yet.With the current media attention to the worldwide nursing shortages in various areas-I feel it is unlikely, and even if it were to happen, I think there would be a "grandfathering" system that would maintain our currently practicing LPN's-which I feel would be appropriate.