What would you do?

Nurseinthemaking · Jul 22, 2005

Oh, one more thing, when I ask is it worth it, I mean, is it worth risking my license, being a new nurse with these High risk patients?

Marie_LPN, RN, LPN, RN · Jul 22, 2005

I would not say this is a good idea for a new grad. While it would be an awesome experience, i could see burnout happening at a fast rate, from what you've described.

It also sounds like a crapload of responsibility for the pay. I think there's also a snake under the woodpile somewhere, too.

With a job that could be that stressful, would you even physically feel like going to school to go for your RN?

The questions to ask yourself is: are you even ready to do something like this, or does this sound like a job that you'd like?

Marie_LPN, RN, LPN, RN · Jul 22, 2005

Oh, one more thing, when I ask is it worth it, I mean, is it worth risking my license, being a new nurse with these High risk patients?

Everyone has to make decisions that are best for them, but if i were the one presented with it, i would say no. Just too much for me.

angie1982 · Jul 22, 2005

I would think very long and hard before taking this position. It sounds like they are expecting you to practice outside of the LPN scope of practice. Very risky, and you could end up losing your license. This is an ICU and they have a 4:1 ratio? scary. I'm a brand new RN and this sounds scary to me. Ultimatly it is your decision, but if I were u I would look elsewhere before accepting this job.

pricklypear · Jul 23, 2005

Doesn't make any sense. Are you sure it's a PICU? I mean Peds ICU? Or some kind of step-down unit. Stents are one thing, but fresh CABG is another. LVNs pushing cardiac meds?? Better check your state regs. Even our IV certified LPN IIs can't push meds. Sounds to me like they're desperate for help - which isn't a good thing for you. You may be asked to do way more than you're comfortable with, much sooner than you think. If you can make 7$ more at a nursing home, I would start there instead of risking your license.

Nurseinthemaking · Jul 23, 2005

Doesn't make any sense. Are you sure it's a PICU? I mean Peds ICU? Or some kind of step-down unit. Stents are one thing, but fresh CABG is another. LVNs pushing cardiac meds?? Better check your state regs. Even our IV certified LPN IIs can't push meds. Sounds to me like they're desperate for help - which isn't a good thing for you. You may be asked to do way more than you're comfortable with, much sooner than you think. If you can make 7$ more at a nursing home, I would start there instead of risking your license.

It is a pulmonary ICU. These are fresh out of surgery patients.

underwatergirl · Jul 23, 2005

I do agree with Marie_LPN...It would be an awesome experience but the jeopardy to you being burned out or loosing your license is too great. PICU, is tough even for some experienced nurses, whether that be LPN or RN, as an LPN for 5 years (working on RN, experience in nursing home, med/surg, ER, ICU, clinic and surgery) I do not find it appropriate for us LPN's to give cardiac IV meds, mainly due to too much liability and possible mistakes. I am sorry if I offend anyone but this is coming from an LPN, I just feel RN's have a more indepth knowledge of the body and of clinical assessment tools...please don't be offended. I am not saying RN's are better, I am saying they are offered the capability to handle it with hight education. After all, they are making the money for the liability, why should an LPN take on the same roles/liability as a RN?

To me some of those patients appear to be out of the scope of practice for an LPN. Ok so we know there are 2 CNA's, 4-1 nurse ratio...what is the real breakdown, meaning how many patients is an RN supervising the nursing care by LPN's. That is another concern. Lets say that ratio is 4 patients per LPN and 8 patients per RN, I don't think the needed support is present for you.

In conclusion, I do not recommend Nursing home either, I made a big mistake as a new LPN jumping into nursing home work...again the liability is hard, the pt. load is hard as a new nurse. I will never go back to nursing home work, mainly due to my poor experience in one and the fact that it in my opinion isn't fair to the residents...I feel as if their care is diminished and I don't suppor that.

I also don't recommend clinic work immediately either...due to the fact it isn't enough variety or experience for a new grad for them to fully develop his/her nursing skills.

What I would recommend is find a good med/surg position. Hospitals and NM on med/surg are outstanding at slowly brining new grads into nursing...because honestly what you do in school is less than 10% of your knowledge and ability as you gain in your first year. In addition to that med/surg will offer you a wide variety of pt. The time to develop your skills and managing pt. load. It will also be an outstanding asset as you are continueing for your RN. Honestly this is where I think all new grads should go.

Just my .02

Good Luck,

Annette

Nurseinthemaking · Jul 23, 2005

I do agree with Marie_LPN...It would be an awesome experience but the jeopardy to you being burned out or loosing your license is too great. PICU, is tough even for some experienced nurses, whether that be LPN or RN, as an LPN for 5 years (working on RN, experience in nursing home, med/surg, ER, ICU, clinic and surgery) I do not find it appropriate for us LPN's to give cardiac IV meds, mainly due to too much liability and possible mistakes. I am sorry if I offend anyone but this is coming from an LPN, I just feel RN's have a more indepth knowledge of the body and of clinical assessment tools...please don't be offended. I am not saying RN's are better, I am saying they are offered the capability to handle it with hight education. After all, they are making the money for the liability, why should an LPN take on the same roles/liability as a RN?
To me some of those patients appear to be out of the scope of practice for an LPN. Ok so we know there are 2 CNA's, 4-1 nurse ratio...what is the real breakdown, meaning how many patients is an RN supervising the nursing care by LPN's. That is another concern. Lets say that ratio is 4 patients per LPN and 8 patients per RN, I don't think the needed support is present for you.
In conclusion, I do not recommend Nursing home either, I made a big mistake as a new LPN jumping into nursing home work...again the liability is hard, the pt. load is hard as a new nurse. I will never go back to nursing home work, mainly due to my poor experience in one and the fact that it in my opinion isn't fair to the residents...I feel as if their care is diminished and I don't suppor that.
I also don't recommend clinic work immediately either...due to the fact it isn't enough variety or experience for a new grad for them to fully develop his/her nursing skills.
What I would recommend is find a good med/surg position. Hospitals and NM on med/surg are outstanding at slowly brining new grads into nursing...because honestly what you do in school is less than 10% of your knowledge and ability as you gain in your first year. In addition to that med/surg will offer you a wide variety of pt. The time to develop your skills and managing pt. load. It will also be an outstanding asset as you are continueing for your RN. Honestly this is where I think all new grads should go.
Just my .02
Good Luck,
Annette

Med Surge is where I have wanted to work the whole time, but right now there are no hospitals currently hiring LVN's. Well there is one, but they have no positions.

What about working at a Emergency Clinic?

pricklypear · Jul 23, 2005

I've never heard of a pulmonary ICU! That's interesting. There seem to be ICUs for just about everything these days! I agree with everybody else. That hospital is asking you to take on a RN responsibility at LVN wage. I apologize for being cynical, but if something happened, they won't stand behind you.

I think some kind of urgent care clinic, or same day surgery would be great for you.

underwatergirl · Jul 23, 2005

Is it flow blow emergency clinic or is it an urgent care???

I think urgent care would be good, but realize it will push you with your skills as a new grad. It has enough variety, my only concern is the orientation they would offer you. With new grads that is really what it comes down to...a REALLY REALLY GOOD orientation. In my opinion.

But I think it is a way better choice than a nursing home...where I came from...now this may be different in other areas...Generally a nurse had a pt. load of about 30-1...you pass meds generally twice a shift, sometimes a third time if a pt. has an different time dose. You had 2 hours to get all the meds out..meaning if it is scheduled at 8am...you started med pass at 7am and end at 9am. Generally the second med pass of the day was a little lighter but the first one is a big load, you can barely get done in time. I say this because you may have pt.s that require, oral meds crushed up, need inhalers, patch changes, Dig(required apical pulse), eye drops, injections, and a topical ointments. So you can figure about 3-4 hours of your shift is passing meds..now the other 4 hours is your assessments, generally I had about 10 assessments a shift, remember we are talking elderly here, several disease processes going on, several in depth assessments. So you figure about 15 min to 20 min for total assessments, that ranges to about another 2-4 hours of your work...so there is almost your entire day your talking 5-8 hours we are upto. Now mind you, there is more yet. Helping to feed pt. helping to position pt. Checking BM's, supervising 3-5 CNA's. Now don't forget we have to get charting done. Now lets say someone falls on your shift or someone goes to the hospital or passess away...not only is sad but extrememly stressfull making sure you follow all protocals and policies. Nursing homes for good reason are monitored closely, there are several rules and regulations. Due to that monitoring, Nursing homes imploy several, I mean several policy and procedures which is a good thing. But straight out of school and for time after that, you are trying to remember what you learned to apply it to real life and now you throw all of that on it? Again I stand by my original statement, nursing homes are good for seasoned nurses, who have their technique down to a T and can focus on following what needs ot be done. The two nursing homes I worked at, there was not good team work and people would stab each other in the back, left and right...I just don't agree with that, I just don't think that is something a new grad. should learn how to cope with.

I would go for the emergency clinic, slight concern that it is an ER that you are either working under your skills or working above them. Remember for LPN's we walk a very fine line of what our scope of practice is...that is due to how it is wrote by the board and how it is interpreted by each facility. So we must error on the side of caution. I do think an urgent care wouldn't be bad, possibly good, as long as you were slowly brought into the role.

Good luck, Please ask anymore questions you have...

Annette

JAHJF · Jul 23, 2005

Just my 2 cents, but I would run as far as possible away from this offer.

I'm an RN in TN (only out of school 1yr) and I work on a Cardiac Step-down unit. I know in TN LPN's can't do a lot of things involving central lines and IV gtts and pushes. And at the hospital I work at the fresh CABGs (meaning straight from the OR) go to the surgical ICU and have 1:1 care for atleast the 1st 24hrs (d/t acuity) then if progressing well they come up to my unit.