http://work.chron.com/lvn-do-4238.html
Duties
A licensed vocational nurse's duties revolve around basic patient care. LVNs monitor their patients' vital signs and keep their charts up to date. They assist patients in basic hygiene and personal care, including bathing and dressing them and helping them eat if necessary.
They can give injections,
monitor catheters, change bandages and help bring down fevers with alcohol rubs. In some states, vocational nurses can administer prescription medications or start an IV if needed. They also provide emotional support for their patients, helping them cope with the stresses of the clinical environment. LVNs always work under the supervision of a doctor or registered nurse.
Well, not exactly. In California at least, they can't give injections, cannot administer medications (and IVs and IV fluids are meds, according to the "rules"), bandage changes are not usually assigned to LVNs due to the assessment needed from an RN as to the wound beneath.
Basically, how it breaks down (again, at least in California) is that the LVN can do "anything" that does NOT require any judgment/assessment. Meaning, taking a set of vitals is fine; interpreting them for a medication administration is not (e.g does the patient need to get their "as needed" blood pressure meds NOW because of a high reading? LVNs can't make that call; only an RN can. Same with pain meds - because the nurse needs to assess the levels and quality of pain before and after pain med administration, as well as monitor BP for issues that go along with narcotics).
They most certainly cannot do anything considered "invasive", meaning anything that is 'put into the body' in any respect other than assisting a patient to eat.
And, I stress this point in this situation...
they cannot suction.
That being said...
A good LVN is worth their weight in gold. I have had the incredible pleasure of knowing some very accomplished LVNs, and have relied on their support not only as a student nurse, but as a patient myself and as the daughter of a terminal father, and now while my mother is hospitalized.
A good LVN, one with experience and with a decent head on their shoulders, can see things coming and get the RN ahead of issues becoming overwhelming; can be a huge help to the RN they're supporting, by doing a lot of those very important things (like bathing a patient, or interacting with the family, or helping the patient in many ways) that increases a patient's comfort and sense security. And while they're indeed "lower" on the "totem pole", they are needed, necessary, and relied upon in a great many areas.
A poor LVN, however, is a huge burden to the responsible RN.
A note about the "totem pole": it goes like this (education in parenthesis)...
Certified Nurse's Assistent (programs range from 6-10 weeks long)
Licensed Vocational Nurse (6-9 months program)
Registered Nurse (AA) (2-3 yrs prereq's, 2 yrs hospital training/lectures)
Registered Nurse (BS) (same prereq's as AA, 4 yrs total hospital/lectures)
Registered Nurse (Masters/Doctorate) (more than the above, but not sure how much)
And, additionally, it really, really matters which program/hospital one trains at. I trained at Los Angeles County/USC, one of the best schools in the nation. I was given an incredible education, and by the time I had completed the hospital training, I had seen more than most other nurses had in 5 years as a nurse (my first death was a bleed out, 6 weeks into my training. Second death was about 12 weeks into my training, cancer but died of cardiac arrest due to systemic infection. I've known nurses who have been working for 10 years and not experienced either of those types of death...).
In regards to LVN training, most are done at places like "American Career College" or "Kaplan" or "Concorde Career College". These are considered "trade schools", rather than colleges in the traditional sense.
Again, I'm not denigrating LVNs...I've had the pleasure to work with many outstanding ones, all of whom taught me a lot about different things. However, LVNs are in no way comparable to RNs, as RNs must be trained in judgment and assessment and patient planning, as well as many other areas that LVNs are not trained for, including invasive procedures.
I hope this helps a little bit to clarify the differences in the levels of training...there is a huge difference. And the prerequisite training is part of why G'mother may not understand the difference between coma and brain death, as they are not required to take the same courses an RN would...nor be able to assess adequately the body's response, even on such a detailed scale as the Glasgow Coma scale (and would also explain why she doesn't understand the difference between voluntary and involuntary muscle movements, nor how the body can move independently of the brain [the spinal cord stimulus]).
If the Grandmother is an LVN and suctioned...well...to me, that could very easily have been one of the biggest issues in this whole tragic event. I would not wish the guilt on anyone that she must be experiencing.
Best-
Herding Cats
lease:
