RPN/LPN/RNA all the same???

Well, the CRNE is written at the level that diploma RN graduates can write it alongside BScNs, so I think the issue of whether a diploma or certificate PN writing the same exam should be considered moot.

I work active/acute treatment in Alberta. I work under my own license and carry my own malpractice insurance. No RN supervises my work or my fellow LPNs work who work in dialysis, the OR, the orthopedic clinic, public health, or homecare. My assessments are made without the requirement of having an RN "sign-off" on it.

I may never be charge in my hospital, but with the changes in my scope of practice in the last five years, I wouldn't be surprized if I'm piercing the TPN or blood bag within the next five.

The diploma PN has basically become the diploma RN in the province of Alberta and Ontario. As each province requires the two year diploma, it will become more and more apparent.

It's interesting this whole business of which clients are too unstable for an RPN to care for, it seems to be a very grey area. I had an interview once for a home care position and I asked the interviewer what types of training and orientation would be available, also what types of patients would I be caring for and about transferring care to an RN. Her response to the last question was that, in a perfect world, only stable patients would be given to RPN's but that was just not todays reality in home care.

There are only 3 types regulated nursing professions in Canada

RPN = Registered Psychiatric nurse
LPN = Licensed Practical Nurse or Registered Practical Nurse
RN = Registered Nurse

All are self regulating professions but self regulation does not mean independent practice. Regulations seem to be different across the country yet every LPN writes the same exam hmmmm.........

I have been unable to locate the scope of practice statement for LPN's in Alberta that articulates the limits and conditions on practice or restricted activities. This is very clearly defined in the legislation in BC so I am waiting on the College of LPNs Alberta for some clarification.

Just an update on my investigations regarding scope of practice

In BC LPN scope of practice states specifically that the LPN works under supervision of an RN. This does not mean direct supervision but there must be an RN available and who is assigned to that patient as well as the LPN.
This is not well understood by many employers and indeed by LPN's and RN's alike.
This does not mean that the LPN is not an independent slef regulating profession..they are. An LPN is responsible for their own practice but should be practicing within their legislated scope of practice which stipulates "under supervision".

I still have not finished my investigation on this issue but for now I know for sure this is not the case in all provinces.

IN Alberta for instance "under supervision of an RN" is not stipulated in the legislated scope of practice however, the act does restrict certain activities. Even after training for that skill, if an LPN performs this restricted activity then there must be a professional who can legally perform that activity within their scope of practice available for consultation.

I wonder if it is different in different provinces. I am an RPN and I carry my own assignment, no RN is assigned to my pts and they do not supervise my work. Of course they are available if I have a question about anything.

As I said ....it is different in every province.

I think a major contributing factor to the situation in BC is that the LPN course is ONLY 1 year in length. (actually less than 52 weeks)

these graduates write the same exam as the LPN's who go to school for much longer and they pass at the same rate.

Which only proves that an exam does not measure everything we need to measure.

Exams are written so that those with the basic education can pass them. Like the diploma RNs write the same exam as a BScN grad.

BC educated LPNs used to have to upgrade their basic education in several areas when they moved provinces. I know that the A&P they received did not CLPNA standards and a few modules were required (they were issued a restricted licence) to practice.

I've worked in both provinces and there is a difference in what a new grad in BC understands from what I was expected to know as a new grad. Differences in assessments, drug knowledge.

Some provinces just require a more indepth knowledge base to practice.

It really does sound like BC has differing RPN requirements than Ontario and Alberta. I was on a college website and this college is requiring that any RPN's who want to upgrade from certificate status to diploma status must be working to full scope of diploma practice which would be a medical or surgical area in a hospital. It makes me curious as to what the motivation behind this is. That's just Ontario though, I am guessing other provinces do things differently.

Alberta is just grandfathering us. Our employers and CLPNA have provided us with education to meet the changing scope of practice over the years. Many PNs here already had the university transfer credits that are now included in the diploma.

http://www.health.gov.bc.ca/leg/hpc/...rse.html#IIIA1

the current scope of practice for LPN's in BC is being reviewed and under this review the government has examined all LPN scope of practice statements which are listed at this link.

From reading this it appears that the practical nurse scope of practice is under direction from another health care professional in all provinces.

I am going to examine this further but that is the what I got from my first reading.

This does not mean that the LPN is not self regulating, however, it does mean that the LPN ( or whatever the designation is in the particular province) does not provide care for patient independently.

An RN or Registered Psychiatric Nurse can provide nursing services to a patient who is not under the care of a physician. They can enter into a therapeutic relationship with the client and provide nursing services without a medical plan in place and without any other permission other than the informed consent of the patient.

Many (registered) nurses do this when providing family therapy, drug and alcohol counseling and other services.

LPN's however, (at least from what I read here) must have the patient care either delegated to them or work under the supervision of the RN or some other health care provider. Either that or the scope of practice is one of assistance to another professional.

Is that the way you interpret this?