Questions about LPN/LVN Jobs.

LPN1974, LPN · Apr 18, 2005

Hello,
My name is Josh and I am serving in the Navy as a Hospital Corpsman. We work on wards, ER's, the battle field and all other types of settings that require medical personnel. I mainly have experience working in family pactice clinincs and also have 1 years experience in an ER. A very slow ER that was more like an ACC. Well, I will be separating from the Navy in a few months and will be challenging the board to get my LVN license. I am not exactly sure what the scope of practice is for an LVN and I am a little nervous about going into this field. What exactly does an LVN do? I have seen lot's of job ads that ask for an IV cert. I am allowed to give IV's in the Navy but I don't know if that will allow me to give IV's in the civilian world. Who certifies LVN's to give IV's? I would also like to know what the typical salary is for an LVN in CA. I'm attracted to the pay offered at temp agencies but I'm not sure if I want to be thrown into different work settings each week when I'm not really even sure what my role will be. How can I make good money and get good experience in the Los Angeles area? Any help would be appreciated.
Thanks,
Josh from Los Angeles

Hello, and sorry no one has offered to answer your question.

I'll tell you what little bit I know and do.

I work in a facility that cares for Mentally and physically disabled people.

My main job function is administering medications. I have to know what I'm administering, the uses or indications of it, dosage range, adverse side effects.

I take orders off the charts, and start them when appropriate, check BS by glucometer/fingersticks and give insulin as ordered and on a sliding scale,

I put in foleys, do wound and skin care treatments, take care of lacerations, we do updraft treatments for people with respiratory problems, assess someone to see if they need further evaluation by a physician, and send them to the emergency room if necessary.

Due to the nature of our type of people we care for, we get fractures quite often, and they can't always tell you where they hurt, so we have to assess for pain, swelling, etc, for possible FX's.

In alot of facilities LPNs can start IVs. We don't do IVs where I work, but alot of nursing homes do give IVs. If our people, where I work, are sick enough for IVs they have to go to the hospital.

In some facilities LPNs/LVNs work in surgery as scrub nurses assisting the physician with surgery.

We do alot of administering meds and alot of basic bedside nursing care to sum it up.

Your state board of nursing can give you specifics for the state you live in, as to what the scope of an LVNs practice is where you live.

LPNs/LVNs generally work under the direction of an RN or a physician and alot of what they can do depends on where you live and the facility you work in.

Also, alot of places are trying to phase out LPNs, but I don't think we will ever completely get phased out. Nursing homes and places like where I work do not want to pay for an all RN staff, so I think LPNs will always be needed in certain areas.

Hope this answers some of your questions. I based my answers on my own job, and it's been years since I've been in a hospital.

HisAlone · Apr 18, 2005

Hi Josh,

I'm just up north from you in the Ventura area. You can go to http://www.bvnpt.ca.gov/provlist.htm to find lists of those who are authorized by the State Board to provide IV Therapy and Blood Withdrawal. Some can only offer IV, others can offer both. There are lots of places in the LA area. I went ahead and got both and am really glad I did. IV cert usually means at least $1-2 more per hour to start. The class I took also did a good job of deepening my understanding of a lot of fundamental issues that are really important in nursing (i.e. F&E and acid-base imbalances, fluid types, TPN, IV complications, etc.) I can't imagine trying to work as a nurse without being absolutely solid in these areas.

Starting pay ranges up here vary from $15.00 to $18.00/hr for days, higher for night shifts. Some facilities have sign-on bonuses: my hospital pays $3,000 for days, $5,000 for nights. Surprisingly, the non-union shop pays more than the union shops in my county. This info is specific to acute hospitals - I'm not sure what can be expected at area LTCs. Most of the home care and temp agencies that I've spoken to want you to have at least a year on the floor before they'll hire you. I'd have to agree with them on that issue. It's really important to have the experience on the floor putting you through your paces on skills before going into a field that requires a high degree of independence. Most home care agencies will not allow LVNs to be case managers, so you generally just make runs for the RNs. But you are still treated as a valuable member of the interdisciplinary team.

As far as duties, we do most of what is considered bedside care. We can hang IV fluids (including blood) with nutrients, vitamins and electrolyes - but no meds (unless you are in a hemodialysis, pheresis or blood bank setting). We cannot do IV pushes. The hospital you work for usually has its own limitations (i.e. LVNs can hang no more than 20 mEq of KCL in our facility). Of course, we work under the supervision of RNs, so the RN will also have her own idea of what you can or cannot do - which is fair because it's her licence on the line.

Each hospital has its own policy regarding the use of LVNs. One hospital uses LVNs in ER, Postpartm (Mother-Baby), and even NICU. Other hospitals use them only on medsurg floors and geriatric units. My hospital uses LVNs in both Telemetry, DOU, and Oncology. Most hositals will not hire LVNs in areas of extreme acuity like ICU or PACU. You'll see alot of variety in this area, so if you have a particular area of interest you have to shop around. Up here, I'm actually seeing a trend of MORE LVNs, as opposed to cutting back on them. I wouldn't recommend a facility that strictly limits the duties and areas of opportunities for LVNs because that kind of implies an institutional attitude that may not be positive and may even lead to an eventual scale-back. We have one hospital that only uses LVNs for their auxillary facility that serves LTCs, not in their main Regional facility, for example. Make sure you talk to as many people as you can - some facilities (and RNs) LOVE LVNs, some don't.

I would definitely recommend that you take your time and chose carefully - your first position is extremely important in terms of building your confidence level and setting the tone of your career. Once you get in, work your buns off to prove your worth to the RNs on your unit. Do everything you can to make your RN's life easier. I've seen a few LVNs get cocky with the RNs and they paid for it. I think you may be disappointed at the differences between the military and the civilian world. Out here we are extremely valuable, but we are not RNs, and need to keep BOTH of these points in mind. You have to be both assertive and very skilled at diplomacy - at least until you have proven yourself (which takes time).

Start getting your prereqs done so you can continue on to become an RN at some point in the future. That's not to say LVN isn't a great career choice, I just can't imagine why anyone would not keep going on up the ladder. It also shows your employer that you have initiative. Whether you are an RN or an LVN, the education never ends, so why not direct it toward a higher pay rate and more opportunity?

Good luck! Yer gonna LUV it!

jt8493 · Apr 19, 2005

Thank You for the replies. I really appreciate the help and advice. I think I'll do just fine because I do already have a fair amount of experience in patient care. I just hope I can adapt to a whole new set of rules. Any more advice or comments from anyone else would be greatly appreciated.

Thanks Again!