The 'De-Skilling' Of Nursing - page 13

by TheCommuter 33,589 Views | 240 Comments Senior Moderator

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. 1
    Quote from BrandonLPN
    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.
    They can here in Arizona, but they have not.
    lindarn likes this.
  2. 0
    Quote from Asystole RN
    Lower level nursing? Are you implying that the work performed by LPNs is somehow below the level of work performed by RNs
    Of course it is. No one ever said LPNs and RNs are the same.we DO provide a lower, less acute level of care. Doesn't mean we're not really nurses, or that our role isn't needed.
  3. 0
    Quote from BrandonLPN
    Of course it is. No one ever said LPNs and RNs are the same.we DO provide a lower, less acute level of care. Doesn't mean we're not really nurses, or that our role isn't needed.
    I am confused by Aystole RN's comment too.
  4. 2
    Quote from Asystole RN
    They can here in Arizona, but they have not.
    Thats because federal law still mandates that a facility licensed as a nursing home MUST have a licensed nurse on site 24/7. Get rid of that law, and I'm sure many SNF's would revert to an assisted living model where NO nurse is present on off shifts and the med tech (or whoever) can just call the nurse "on call" if he needs to.
    gummi bear and lindarn like this.
  5. 4
    Hmmm...interesting although i fail to see why requiring entry level Nurse to have a BSN should not be a requirement. Besides you work with physicians that have been to school for minimum 12yrs just college education most have done research or participated in several, pharmacists in my hospital are all doctorate levels, even PT now is asking for a masters degree. Yet Nursing wants to be respected by their colleagues with minimal education no research, no scholarly articles. I say please give me a break!...i prefer my meds especially i.v to be mixed by a pharmacist for infection control issues unless its a STAT required drug. I like my CNA to check my patients call lights and assist in ADLs we have classes for CNAs and educate them to recognize subtle things. I also want my wound care consult to change dressings as i ordered and collaborate with me. As for RRT yes i know the vent settings and how to change them but when i am busy titrating drugs or stuck in patients room for a procedure our enroute to CT, MRI or whatever procedure then i appreciate them giving treatments. BTW only Nurses and Physicians can put in orders in my hospital and charge. After all you never see a cardiologist doing am endoscopy. What Nurses to recognize is that they have the power to command higher salaries, but you can't do that without proving you are on the same level of education as the people commanding the high pay. Til them we can complain til we drop!....and yes i started as a CNA went to Nursing school and almost done with my MSN and i definitely can see the difference in how i have evolved as a professional.
    jm2c...
    VanLpn, Cold Stethoscope, lindarn, and 1 other like this.
  6. 1
    Quote from BrandonLPN
    Of course it is. No one ever said LPNs and RNs are the same.we DO provide a lower, less acute level of care. Doesn't mean we're not really nurses, or that our role isn't needed.
    I will remember that you said this the next time there is a LPN v. RN thread where LPNs are claiming they do the same things RNs do and that the only difference are some fluff classes.

    I do not see LPNs as a lesser nurse. I see LPNs as an entirely separate, but related, occupation that has it's own unique features and it's own unique role within healthcare.

    Just as I see sub-acute healthcare, it is not a lesser form of healthcare when compared to acute care but rather a separate, but related, form of care that has its own unique features and it's own unique role within healthcare.

    I do not believe that LPNs should be relegated to a lower acuity level of care either, I think that they can fulfill a unique roll within all the levels of care.
    lindarn likes this.
  7. 0
    Quote from BrandonLPN
    Thats because federal law still mandates that a facility licensed as a nursing home MUST have a licensed nurse on site 24/7. Get rid of that law, and I'm sure many SNF's would revert to an assisted living model where NO nurse is present on off shifts and the med tech (or whoever) can just call the nurse "on call" if he needs to.
    I am unaware of any federal law that states that a nurse has to be on site, I know of laws that state a nurse has to be on call or available at all times however. Please feel free to correct me if I am wrong. And if this is a Medicare directive then that definitely does not apply to the non Medicare facilities, I know of several here in Arizona alone.

    There are several facilities in Arizona that utilize medication aides, they are utilized along with LPNs and RNs on the floor.
  8. 4
    So often the argument for requiring the entry to nursing to be the BSN is that it will get us more respect from the doctors and pharmacists and other professionals. Why is that so important to people. Why do you care? Besides, we all know most doctors don't give a rat's a** whether you're a ADN or a BSN.
  9. 2
    Quote from BrandonLPN
    So often the argument for requiring the entry to nursing to be the BSN is that it will get us more respect from the doctors and pharmacists and other professionals. Why is that so important to people. Why do you care? Besides, we all know most doctors don't give a rat's a** whether you're a ADN or a BSN.
    It is about the professionalization of the occupation.
    VanLpn and lindarn like this.
  10. 1
    Quote from Asystole RN
    I will remember that you said this the next time there is a LPN v. RN thread where LPNs are claiming they do the same things RNs do and that the only difference are some fluff classes.
    I've never said that. I HAVE said that when both RNs and LPNs work as floor nurses in LTC they do essentially the same job. I stand by that. I've also said that it's silly to say that LPNs "don't assess" when we do, every shift of every day. I've also went on record here as saying that a LPN should not take a pt assignment in acute care. In that setting we should be doing the "tasky" stuff like getting vitals, meds, dressings, etc. thus freeing the RN to, y'know, actually be a team leader and stuff like all that extra training prepared you for.
    mc3 likes this.


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