LPN v. RN? What's the diff?

  1. I vaguely know what the differences are, but technically what is the difference? I used to think that LPN's couldn't administer meds, but now that I work in a hospital...... our LPN's do adminster meds. Really, to the naked eye of a peon unit sec such as myself, I can't tell the difference...... Someone enlighten me.
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  2. 13 Comments

  3. by   fergus51
    It completey depends on where you go. There are educational differences everywhere. LPN courses are shorter than RN courses. And I have heard a lot of LPNs on this board say that they can't do assessments, but otherwise do what an RN does. At my facility the LPNs do more the job of a CNA (bedside care, washes, transfers, lifts, feeding, etc.). Also they can not work in ICU, L&D, OR, CCU, etc. in the facility I work in now. There is no simple way to explain the difference.
  4. by   BrandyBSN
    Scope of practice. That is the key, but it varies by state.

    Here in this area, LPNs can not do patient assessments, they have to be done by an RN. They can not start IVs, hang chemotherapy drugs (neither can pregnant RN- they are teratenogenic). They also can not do central lines, or central line dressing changes. In many areas they can not receive certifications, such as TNCC, or CEN, or practice in the OR, ICU, L&D, or ER. The ANA does not classify them as "professional nurses", and dont not allow them to join. The term "professional nurse" only applies to a RN. (No flaming! As this was taken from the Nursing Practice Act of Missouri).

    The best way to find out the differences is to get a copy of your state's Nursing Practice Act. Keep in mind that the practice acts state the "largest" scope of practice, but it can be limited further by the employing institution, but it can not be added to.

    Does that help?
    And I mean no offense to LPNs, as they work their butts off too, but there are legal differences.

    BrandyBSN
  5. by   ucavalpn
    Brandy , no offense taken . I think you answered this very well.
  6. by   rubyred13
    Quote from BrandyBSN
    Scope of practice. That is the key, but it varies by state.

    Here in this area, LPNs can not do patient assessments, they have to be done by an RN. They can not start IVs, hang chemotherapy drugs (neither can pregnant RN- they are teratenogenic). They also can not do central lines, or central line dressing changes. In many areas they can not receive certifications, such as TNCC, or CEN, or practice in the OR, ICU, L&D, or ER. The ANA does not classify them as "professional nurses", and dont not allow them to join. The term "professional nurse" only applies to a RN. (No flaming! As this was taken from the Nursing Practice Act of Missouri).

    The best way to find out the differences is to get a copy of your state's Nursing Practice Act. Keep in mind that the practice acts state the "largest" scope of practice, but it can be limited further by the employing institution, but it can not be added to.

    Does that help?
    And I mean no offense to LPNs, as they work their butts off too, but there are legal differences.

    BrandyBSN
    Yes they can start IV's in Missouri with IV certification.
  7. by   futureRNJaz
    Definitely scope of practice. As a BSN student, I've learned that in ADPIE (assessment, diagnosis, planning, intervention, and evaluation), all that I can delegate to LPNs is the intervention. RNs have to do the rest.
  8. by   cntrygrl_8_82
    I noticed that many people have said that LPNs cannot do assessments, this is not true. We can do assessments, just not the initial admission assessment without a RN signing off on it. As more than one person mentioned, it does vary state by state and also facility by facility. I have been an agency nurse for a little over two years now and each facility is sometimes different. ALWAYS follow the nurse practice act and use it as a guideline and reference. LPNs cannot administered anesthsia, not even for conscious sedation, that is nationwide according to the nurse practice act. We can however work in the ER, ICU, MICU, OB and many other areas just as RNs can, depending on the regulations of the facility, but there are certain medications that LPNs cannot give and certain things LPNs cannot do (such as check to see how dilated/effaced an OB patient is as that is outside the scope of practice, when I refer to working OB I mean postpartum not labor and delivery), again, refer to the nurse practice act. LPNs do not have college degrees but rather vocational degrees so the scope of practice and skill level will be different.
    Hope this helps.
  9. by   rubyred13
    Quote from cntrygrl_8_82
    I noticed that many people have said that LPNs cannot do assessments, this is not true. We can do assessments, just not the initial admission assessment without a RN signing off on it. As more than one person mentioned, it does vary state by state and also facility by facility. I have been an agency nurse for a little over two years now and each facility is sometimes different. ALWAYS follow the nurse practice act and use it as a guideline and reference. LPNs cannot administered anesthsia, not even for conscious sedation, that is nationwide according to the nurse practice act. We can however work in the ER, ICU, MICU, OB and many other areas just as RNs can, depending on the regulations of the facility, but there are certain medications that LPNs cannot give and certain things LPNs cannot do (such as check to see how dilated/effaced an OB patient is as that is outside the scope of practice, when I refer to working OB I mean postpartum not labor and delivery), again, refer to the nurse practice act. LPNs do not have college degrees but rather vocational degrees so the scope of practice and skill level will be different.
    Hope this helps.
    True. Lpn's can do assessments. I have worked in OB many years, in the delivery room when the newborn is delivered, give apgar score, give narcan and/or bag and /or chest compressions if necessary. Take the newborn to the nursery and complete my assessment. We also have an ICU bed in our nursery sometimes I have to use. I also have worked in ER. Now I am cross training in ICU. If the OB doctor tells me to check a patient, how much she is dilated I do so, and I have under the docs supervision given pitocin drip.
    I believe some of the RN's who have never been an LPN first do not really know what an LPN does. I know some who have never worked in the medical field who are in their second year of nursing school think an LPN cannot take patients and do cna work only. I am in class with some of them since I am bridging over, and I just laugh. I will be graduating in a few weeks. But it really cracks me up when they say an LPN can't do this and that. And like you said it is different everywhere.
  10. by   RossayRN
    Also keep in mind too that in alot of places people still do things they aren't supposed to do. Yesterday one of my LPN class mates refused doing IV push because it is not in her scope of practice here (in IL she is watching her license) but had it been another LPN maybe she/he would have done it. People don't always follow the laws and the only way they get caught is if something bad happens and it is brought into the open in which case the hospital or whatever is going to get rid of the lowest man on the totem pole to protect their own arsses. Know your states nurse practice act and cover your own butt. Another thing too is we are taught in the BSN Health Assessment class ( and this is a class full of LPNs, RN-ADNs, and Undergrad nursing students) that LPNs cannot do assessment, they do observations which is why the RN does the initial assessment and LPN monitors for changes etc.
    Last edit by RossayRN on Nov 1, '08
  11. by   rubyred13
    Quote from RossaysoonRN
    Also keep in mind too that in alot of places people still do things they aren't supposed to do. Yesterday one of my LPN class mates refused doing IV push because it is not in her scope of practice here (in IL she is watching her license) but had it been another LPN maybe she/he would have done it. People don't always follow the laws and the only way they get caught is if something bad happens and it is brought into the open in which case the hospital or whatever is going to get rid of the lowest man on the totem pole to protect their own arsses. Know your states nurse practice act and cover your own butt. Another thing too is we are taught in the BSN Health Assessment class ( and this is a class full of LPNs, RN-ADNs, and Undergrad nursing students) that LPNs cannot do assessment, they do observations which is why the RN does the initial assessment and LPN monitors for changes etc.
    You are right about that too. I would never do an IV push as an lpn unless under the doctors supervision in an emergency. And you are right about the scope of practice and hospital policy. If something does go wrong and it isn't in your scope of practice, you are in trouble. I agree.
  12. by   picurn10
    In my state LPN's can't do IV push, but definitely start IV's (we're taught in schoo, no special certificate), we can't do central lines, but do assessments (just not the admission assessment), some hospitals in my area have LPN's in ER, but I don't know that new LPN's can work in ICU's, CC, etc... It does vary by state. In some states, LPN's can basically only work in Dr. offices, LTC, and home health, but in my area you can just about work in any setting you like.
    My LPN program (I'm going to bridge straight into RN) is 11 straight mo., 5 day per week, 8hrs a day but the RN program is 4 semesters, 1 clinical per week, and only 3 half days a week of class time.
    I am surprised at how few differences there are because I myself was pretty ignorant about the scope of practice for an LPN until I started LPN school. I still think the best analogy I've seen was on here, someone said it's like the difference between enlisted and officer in the military. Both are soldiers, marines, airmen (or in our case nurses) there is just a different level of education and responsibility between the two. In each setting it's a bit different it seems.
  13. by   rubyred13
    Quote from april&em
    In my state LPN's can't do IV push, but definitely start IV's (we're taught in schoo, no special certificate), we can't do central lines, but do assessments (just not the admission assessment), some hospitals in my area have LPN's in ER, but I don't know that new LPN's can work in ICU's, CC, etc... It does vary by state. In some states, LPN's can basically only work in Dr. offices, LTC, and home health, but in my area you can just about work in any setting you like.
    My LPN program (I'm going to bridge straight into RN) is 11 straight mo., 5 day per week, 8hrs a day but the RN program is 4 semesters, 1 clinical per week, and only 3 half days a week of class time.
    I am surprised at how few differences there are because I myself was pretty ignorant about the scope of practice for an LPN until I started LPN school. I still think the best analogy I've seen was on here, someone said it's like the difference between enlisted and officer in the military. Both are soldiers, marines, airmen (or in our case nurses) there is just a different level of education and responsibility between the two. In each setting it's a bit different it seems.
    Yes, I remember LPN school. I graduated in 2000. Boy, brings back memories. Ours was 11 months, 5 days a week and 8 hours a day also. It was extremely hard. We had soooo many subjects and so many tests throughout the week whereas the most we have in the bridge program is 2 tests a week, and now down to one test a week. LPN school was much harder. We were constantly slammed with everything. I would spread out all my books on the dining room table with my papers and would not even look up for hours. Spent many nights up late. It was awful. If you can make it through LPN school, you can make it through RN school! Just get the college basics out of the way first. We have one class a week with 2 to 3 clinicals for 2 semesters and the one month bridge over class. I would suggest working prn or part time through RN school, or even better, none at all like in LPN school! And also, if you don't pass your boards the first time you will just have to work as an LPN, whereas if you are a fresh 2 year student, if you do not pass boards, you will have to work as a CNA until you do!
  14. by   picurn10
    Thanks for the encouragement! Yes, I have 5 exams this week and next, but I typically have at least 3, not including modules, papers, and other assignments :uhoh21: Thankfully, I have my pre-reqs done so once I finish my "leadership" clinicals in July, it's straight to RN for me I've been lucky to be able to quit my job a few weeks ago and hopefully won't do anything other than maybe a shift or two as an CNA/nurse tech while in RN school. I have a just-turned-4yr old as well so I'm just working like crazy to get through this year. I totally relate to the spreading out the books and not looking up for hours

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