The 'De-Skilling' Of Nursing - page 12

by TheCommuter Asst. Admin

32,674 Views | 240 Comments

What should be our greatest concern for the future of nursing? We must fear the day if (or when) registered nurses (RNs) and licensed practical nurses (LPNs) will be less needed in healthcare due to systematic de-skilling of the... Read More


  1. 0
    Quote from BrandonLPN
    I can't tell if you're being serious or facetious. Do you really think saying there's a difference between CNAs and LPNs is "splitting hairs"?
    The "just kidding" was not a clue as to my intentions?

    I 100% believe that you are practically a nurse.

  2. 1
    Quote from Asystole RN
    I could not agree more with the part I bolded. Nursing is far too complicated to be able to provide a truly adequate and quality hands-on experience within nursing education. I believe that nursing would do well to copy the physicianmodel of education where there is a theory part of the education and then a formal residency portion. Leaving residency up to the individual hospital to determine the length and quality provides formixed results.
    Wouldn't forcing applicants for a RN program to have been first a CNA, then a LPN be the best way to ensure all RNs begin practice with hands on experience under their belt?
    gummi bear likes this.
  3. 3
    Just a question that no one seems to answer. If for some reason the phase out of LPN's ADN's and diploma RN's was successful who would work at the nursing homes? or home health? Medication Aides? Long Term Care Technicians? Home Health Assistants? The problem with bringing the education level up is lower level nursing still needs to be done but nobody will want to do it if they are trained to do SO much more.
    tnmarie, gummi bear, and BrandonLPN like this.
  4. 0
    Quote from aquarius04
    i totally agree. PT doing wound care is really foreign to me. And for some reason I feel like with the concentration their schooling is directed towards, wouldn't wound care be out of their scope of practice? Of course they could incorporate it, but the thought their primary goal was to help rehabilitate the patient?
    Highly depends upon the various state laws and how they define, or lack thereof, what medical tasks licensed and unlicensed personnel can or cannot perform. Many of the allied professions have somewhat open SOPs.

    The tasks being performed as described by the OP occur, and may be common in a particular state, but are definitely not the national norm. Here in AZ RTs can place PICC lines but this is something that is definitely not normal.
  5. 0
    Actually Asystole, the MSN model seems to be similar to the physician model of education. Most MSN programs do the theory prior to the practicum. Usually, the practicum is done last in the MSN program. Generally, this practicum is a real world experience.
  6. 0
    Quote from tothepointeLVN
    Just a question that no one seems to answer. If for some reason the phase out of LPN's ADN's and diploma RN's was successful who would work at the nursing homes? or home health? Medication Aides? Long Term Care Technicians? Home Health Assistants? The problem with bringing the education level up is lower level nursing still needs to be done but nobody will want to do it if they are trained to do SO much more.
    Trust me, LTC facilities would loooove to replace LPNs with medication aides and techs if they legally could. This is the problem with raising the entry point to nursing to the BSN level. You wind up with the former practical nurse jobs being filled with grossly underqulified UAP. Or overqualified BSNs who will also likely be underpaid and will leave the job at the first opportunity.
  7. 1
    Been an ER patient a few times, was a medic, now a nursing student. I may be kind of biased, but I don't see a problem with having assisting staff as long as they are not displacing the staff. When I was going through medic school we gobbled up IVs and EKGs med admin(some things we could administer), ETTs, and defibs in the ER. But there was only one of us one at a given time and the nurses used us as assistants. We did not replace them. Same for the unit I'm on now. Even with the nursing students on we don't replace the nurses.

    During my last ER visit I had a tech come in and do an EKG and transport me to xray, but it was the nurse was the one who did everything else.

    So as long as they are not being completely replaced and still are able to perform those tasks numerous times per day I don't really see a problem with a little help. I think it becomes a problem when they flood you with help and take away a good part of your job, often because it is cheaper.
    gummi bear likes this.
  8. 0
    Quote from tothepointeLVN
    Just a question that no one seems to answer. If for some reason the phase out of LPN's ADN's and diploma RN's was successful who would work at the nursing homes? or home health? Medication Aides? Long Term Care Technicians? Home Health Assistants? The problem with bringing the education level up is lower level nursing still needs to be done but nobody will want to do it if they are trained to do SO much more.
    Lower level nursing? Are you implying that the work performed by LPNs is somehow below the level of work performed by RNs?

    I think the idea is that BSN nurses would fill the home health, SNF, and other sub acute positions.

    Although, just as LPNs often are overlooked by RNs, the sub acute healthcare scene is often overlooked by acute care. Since acute care RNs dominate the national political nursing scene they do not readily address non acute care issues.
  9. 0
    Quote from BrandonLPN
    Wouldn't forcing applicants for a RN program to have been first a CNA, then a LPN be the best way to ensure all RNs begin practice with hands on experience under their belt?
    Works in France and other EU countries where time spent as a nursing assistant is required before entry into a "BSN" program or as part of it. However as often pointed out to me the "us" versus "them" when it comes to content between BSN programs.
  10. 0
    Quote from BrandonLPN
    Wouldn't forcing applicants for a RN program to have been first a CNA, then a LPN be the best way to ensure all RNs begin practice with hands on experience under their belt?
    No. Although experiences at those levels may introduce the student to healthcare and even provide some help to future RNs, CNA and LPN experience is not RN experience. An LPN needs an LPN residency and a RN needs a RN residency.


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