The 'De-Skilling' Of Nursing - page 15

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. 3
    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?

    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.
    As I said before I'm not in the acute care setting trying to pretend I'm just as good. So not implying stating. My job is more hands on less technical less demanding but still nursing. Community based nursing requires critical thinking but usually one patient at a time so that's obviously easier. It's rewarding and not too stressful but I can't imagine wanting to do it once I have my BSN certainly not at LVN rates. So economics will have to be considered. I became a LVN once most of the shift into less acute areas had already occurred so I'm not chasing something that's not coming back.
    Fiona59, lindarn, and BrandonLPN like this.

    Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  2. 3
    Quote from BrandonLPN
    I get the desire for standardization, but there's benefits of having a multi tiered system. I actually think there is some merit to the idea of *forcing* nursing to be a career taken on a step by step basis. A requirement to get into a LPN program is having worked for a year first as a CNA. A requirement to get into a RN program is having worked for a year as a LPN. Thus no new RN could possibly step into a RN job without already having solid nursing experience. Nursing schools do such a pi** poor job of preparing nurses for the real world, some real world experience could only help.
    I have thought this for a long time, and thank you for articulating it so clearly. It's like the ancient Greek system, actually. Also, like training for the NP role was originally conceived. Nursing and patient care would exist on a continuum, with knowledge and skills building on each other, in such a system.
    Fiona59, lindarn, and BrandonLPN like this.
  3. 4
    I am displeased with the actions of the delegates of the ANA..... because honestly..... at this point I AM thinking what delegates?....they have the name but no action....How many of them are addressing the facts hundreds of new/old graduates RN are being turned away from working everyday as R.N's and LPN /LVN's. How about the fact that many health care facilities prefer to hire 12 cna or techs or care companions as oppose to nurses....How have they address this concern? How about meds being administered via med tech...how have they addressed this? How about ECG being performed by EKG tech or cna.....how about vitals signs being done by cna......and the nurse has to go back and check it again.....how about cultures being done tech or cna .....and we have to take it again because it was done wrong....how about blood being taken by phlebotomist.......How about in some hospital or other health care facilities in the OR there NO RN's just surgical tech.....the scrub nurse is only there when JACHO is visiting.....I could go on and on? ...Where are the regulations? Where is the tone? . These ANA people in my opinion are NOT representing my interest.....When was the last time you went on the ANA website? ..... no offense somethings are outdated and they are on their website. The governance structure does not use its power to advance the nurse. It makes rules and regulation for nurses, but no follow up.It DOES NOT organize us nurses rather it divides because it does not include LPN/LVN. It has not organized us as NURSES to make political stands. Imagine if it was important for who ever was running for office to get a our support as NURSES.....we could take a stand as one united body. However, they have never tapped into their ability to create UNITY.....
    mc3, Fiona59, lindarn, and 1 other like this.
  4. 1
    Quote from Asystole RN
    I predict that the future of nursing will have the BSN nurse finally become the standard of entry to be a registered nurse and LPNs will be left but required to have an associates degree. I would not be surprised if the two forms of nursing completely split into entirely separate professions with different educational pathways and different regulating bodies.
    Honestly that sounds like a fine idea and similar to something I suggested except mine was phase out the LPN's. Make the ADN then entry level nurse and make the BSN Nurse + with the expectation that having a BSN mean you already had experience and thus could benefit from the added education.

    When it comes down to it my view point as a nurse is I just want to be utilized appropriately. I would embrace a clearly defined role even if it was a little restricted. Though this embrace for me would be fleeting as I'm actively working on transitioning but still.
    Fiona59 likes this.
  5. 1
    Doesn't the UK instead of having RN and enrolled nurses have First Level and Second Level? And bands like band 6 etc.
    Fiona59 likes this.
  6. 2
    Quote from Asystole RN
    I have worked in sub-acute care for most of my career, and still do PRN. I would agree that there needs to be multiple levels of care. I predict that the future of nursing will have the BSN nurse finally become the standard of entry to be a registered nurse and LPNs will be left but required to have an associates degree. I would not be surprised if the two forms of nursing completely split into entirely separate professions with differenteducational pathways and different regulating bodies.
    I'll agree with this. I went to a
    vocational school, and I stand by my abilities as a nurse. But, at that school, I *did* witness some of the stupidest people I've ever met get "babied" through to protect the school's graduation statistics. That's scary. Making the LPN an associates
    program makes sense. Thus you would have two year degreed nurses practicing "practical nursing" and four year degreed nurses practicing "professional nursing".

    Of course, the pickle is then what happens to the ADN? Do we merge them with the LPN, which practicing ADNs would understandably see as a slap in the face? Or do we grandfather them into the new "professional nurse" role, which kind of seems to defeat the purpose...
    Fiona59 and lindarn like this.
  7. 0
    Quote from luv2
    I am displeased with the actions of the delegates of the ANA..... because honestly..... at this point I AM thinking what delegates?....they have the name but no action....How many of them are addressing the facts hundreds of new/old graduates RN are being turned away from working everyday as R.N's and LPN /LVN's. How about the fact that many health care facilities prefer to hire 12 cna or techs or care companions as oppose to nurses....How have they address this concern? How about meds being administered via med tech...how have they addressed this? How about ECG being performed by EKG tech or cna.....how about vitals signs being done by cna......and the nurse has to go back and check it again.....how about cultures being done tech or cna .....and we have to take it again because it was done wrong....how about blood being taken by phlebotomist.......How about in some hospital or other health care facilities in the OR there NO RN's just surgical tech.....the scrub nurse is only there when JACHO is visiting.....I could go on and on? ...Where are the regulations? Where is the tone? . These ANA people in my opinion are NOT representing my interest.....When was the last time you went on the ANA website? ..... no offense somethings are outdated and they are on their website. The governance structure does not use its power to advance the nurse. It makes rules and regulation for nurses, but no follow up.It DOES NOT organize us nurses rather it divides because it does not include LPN/LVN. It has not organized us as NURSES to make political stands. Imagine if it was important for who ever was running for office to get a our support as NURSES.....we could take a stand as one united body. However, they have never tapped into their ability to create UNITY.....
    You should read their lobbying efforts and find out exactly what action they took. They are not all-powerful and can only lobby for the causes that were voted upon.

    You think that nursing is the only profession with problems?

    Many of the problems you stated firmly lay with the state legislature, not with ANA or your local chapter. Your local chapter can lobby but I can guarantee you that they are no where near the influence of your local teamsters or AFL-CIO union.

    I was on their website about two hours ago.

    Just because something is not as powerful or follows your ideology 100% does not make it garbage. I hate ANA's liberal stance but hope that others like me will moderate them.
  8. 0
    Quote from BrandonLPN
    I'll agree with this. I went to a vocational school, and I stand by my abilities as a nurse. But, at that school, I *did* witness some of the stupidest people I've ever met get "babied" through to protect the school's graduation statistics. That's scary. Making the LPN an associates program makes sense. Of course, the pickle is then what happens to the ADN? Do we merge them with the LPN, which practicing ADNs would understandably see as a slap in the face? Or do we grandfather them into the new "professional nurse" role, which kind of seems to defeat the purpose...
    The ADN registered nurses would be grandfathered and merged into the rest of registered nursing. The professionalization of nursing is not something calculated in years or decades, it is something calculated in lifetimes.

    Look at Diploma nurses, as those nurses retire their form of nursing is going extinct. (although there are still a couple of programs left in the United States)
  9. 1
    Quote from tothepointeLVN
    Honestly that sounds like a fine idea and similar to something I suggested except mine was phase out the LPN's. Make the ADN then entry level nurse and make the BSN Nurse + with the expectation that having a BSN mean you already had experience and thus could benefit from the added education.

    When it comes down to it my view point as a nurse is I just want to be utilized appropriately. I would embrace a clearly defined role even if it was a little restricted. Though this embrace for me would be fleeting as I'm actively working on transitioning but still.
    As a LPN you advocate the destruction of LPNs?

    I am a BSN-RN and even I do not want the complete elimination of LPNs.

    You are right though, there needs to be clearly defined roles for all the various forms of nurses.
    lindarn likes this.
  10. 0
    If it'll bring peace yes. When it comes down to it its just a bunch of letters especially since LVN/LPN/RPN isn't a consistent title anyways. I advocate for maintain that level of nurse though whether its called practical nurse, enrolled nurse, level 2 nurse etc. And I DO think RN with high levels of education should get some recognition on the level of their license.

    Whatever system we have it needs to be clear to the public and others what each level means. How often are we having these THIS vs THAT fights when one side doesn't even know what the other can do.

    We ALL should be expected to think critically though thats the only thing really seperates us from the techs since we can make caring a license only thing.


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

A Big Thank You To Our Sponsors
Top