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Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?



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No. 20
from whodunit
Old Jan 17, 2009, 01:00 PM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
I don't even want to get into the RN vs LPN debate but there are major differences between the 2.I have worked with LPNS who have taught me soooomuch about the hands on care and hopefully they were able to learn about the whys or whynots from me.I agree that they should be given preference to get into RN school but there is no way their training is equal to merging with us.
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No. 21
from Jules A
Old Jan 17, 2009, 01:40 PM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
Originally Posted by psychRNinNY View Post
It is illegal and out of the scope of practice for any LPN in any setting in any state to ASSESS that is not a state by state thing. The supervising RNs are putting their licenses at risk by allowing this to occur, as the RNs are responsible for the LPNs and if he or she allows that LPN to practice outside of the legal scope of practice it is the the RN who will be in trouble and at risk of losing his or her licence. Many facilities ask LPNs to do this and they can get in trouble as well. Just because a facility is not following the law does not make this law non existant.
I don't understand how LPNs would care for patients without assessing them. At my facility the LPNs are not allowed to do the initial intake assessment but after that they absolutely do assess and report their findings on each patient as part of their job.
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No. 22
Old Jan 17, 2009, 02:00 PM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
Originally Posted by psychRNinNY View Post
It is illegal and out of the scope of practice for any LPN in any setting in any state to ASSESS that is not a state by state thing. The supervising RNs are putting their licenses at risk by allowing this to occur, as the RNs are responsible for the LPNs and if he or she allows that LPN to practice outside of the legal scope of practice it is the the RN who will be in trouble and at risk of losing his or her licence. Many facilities ask LPNs to do this and they can get in trouble as well. Just because a facility is not following the law does not make this law non existant.
an LPN, in many states, such as my home state of FL and my temporary state of NC, can perform "data collection" and "ongoing evaluation". so if you put that into real world terms, ongoing assessment of the patient. you are being very silly by thinking that i, as an LPN working in an acute care setting, give my pt medications, call physicians, monitor heart rate/rhythm, start and maintain IV's, etc and do not perform an ongoing assessment. yes, i work with RN's who sign off my admission assessment, but i, myself, the LPN, have eyes, ears and nursing skills, and am obviously trusted by the RN's who sign off my initial assessment.

i do work for a comparably less amount of money and technically, like tweety said, function in the same role at the bedside. i am the go-to person for IV's, even for the anesthesiologists. the RN's call me to "come look at this". i am a member of the facility wide rapid response and code team. i am still a nurse with a license who is responsible for my own actions, judgements and mistakes.

relax.
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No. 23
Old Jan 17, 2009, 02:12 PM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
See, this is a big prolem, though. Of COURSE as an LPN I assessed all the time - but I was out of my scope and, as a new nurse, sometimes out of my depth - not that the LTC cared so long as they had a license with a pulse.

But for LPN's to find work now they are often required to work "beyond" their scope, certainly not their abilities. And for cheap.

I'm rambling.
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No. 24
Old Jan 17, 2009, 05:44 PM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
I was not meaning to say that LPNs are INCAPABLE of assessing.....I too have worked with some wonderful and very smart LPNs.....I was just stating the LAW.....hell we all know how many times we as nurses could DIAGNOSE seeing the same things again and again but we all know only an MD (or NP/PA) can do that!!!! talking the law here not ability so please know I was not trying to offend anyone. I have written a letter to the state who tried to pull an LPNs licence--- to defend her and stand up for her. We are all on the same team here and we need to focus on what's important.....we are all nurses of any level for one reason.....we love people and taking care of them. We need to stick together!
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No. 25
from pawashrn
Old Jan 18, 2009, 11:04 PM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
the titles are based on education. aide-LPN-RN-CRNP-Doctor-specialist---these titles may integrate with one another but they are separate entities and have defined lines of responsibilities and decision making skills based on education
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No. 26
from RN_Canada
Old Jan 18, 2009, 11:17 PM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
The roles seem similar but are not equal. The reason they are not equal is that the RN has a broader knowledge base. The extra years of study in a more in-depth program is what distinguishes the RN from the LPN.
Just the Canadian perspective on this discussion

With the RN preparation now a mandatory university degree the lines are not blurred!

RN's have university education and LPN's have between one and 2 years of education. For anyone to suggest that they "do the same thing" is a bit naive.

Research has shown that the people who understand this the least are the working LPN's and the people who understand it the best are the RN's who started out as LPN's and went on to complete their university education to be a RN.

As much as I can understand here is the difference (and this is not well understood in Canada...we have a lot of work to do)

Although self regulating the LPN does not work in an independent role and must be part of a team or work in partnership or under supervision . They cannot enter into a relationship with a client unless that client is already being cared for by another health care provider that can establish a plan of care.

A Registered Nurse can enter into a relationship with a client independently without the client having an established plan of care or being cared for by another health care provider such as a doctor.

The Canadian Association of LPN's describes the LPN scope of practice as a "partnership" so I think I am on the right track here .....
I know that the situation is different in the US but thought you might like the Canadian persepective.
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No. 27
from mcknis
Old Jan 19, 2009, 10:59 AM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
paycheck, education, etc. all make a difference to me!
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No. 28
from Seishiro
Old Jan 20, 2009, 08:55 PM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
No. LPNs have a different scope of practice than that of RNs. The level and degree of education is different. This argument can also be made for those seeking DNPs (Doctorate of Nursing Practice) against those with MD degrees. While I believe both should/could be called Doctor, one is still a nurse caring for patients and the other is a doctor treating patients for their disease process.

LPNs work with RNs underneath their supervision to care for clients.

If I have worked 3-4 years for an Associates in nursing, I'm going to be a little more than a little nonplussed about a nurse who has only gone to school full time for a year, or two years receiving the same credit. Granted I'm sure there are a lot of LPNs who can teach many RNs out there a thing or two about a thing or two, but what it all boils down to is the level of education, IMHO.

PS I am currently a LPN student.
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No. 29
Old Jan 20, 2009, 08:58 PM

Default Re: Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?
Originally Posted by Seishiro View Post
LPNs work with RNs underneath their supervision to care for clients.


i do not need a chaperone at all times. thanks.
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