LPN vs. RN

NamasteNurse, BSN, RN · Apr 9, 2012

When I was in nursing school one of my teachers said, "LPN's know what, RN's know why". Not sure I agree with that, but as an LPN I do almost everything an RN does. It depends on the facility. We can change care plans, but not initiate them. We conference with the doctors, make some assessments, and pass meds, do treatments, feed, toilet, wound care, chart, write orders, patient teaching, family counseling...everything!

MYself, I became an LPN because it was fast and cheap. In one year and with only a $10,000 investment, I now make $45,000 a year! That's more than I made as a teacher! Some of the nurses I work with have been LPN's for 20+ years. It's less stress, more patient contact and less contact with admin! At the end of the day we get to go home and not worry all that much. It's a decent living. And a great way to spend your working life, helping others. Why all the hating? Just stop it.

NamasteNurse, BSN, RN · Apr 10, 2012

"The only down-fall here, though, is that you get no recognition if you're an LPN and want to become an RN - they make you start the 4 years from scratch! "

NOT TRUE!

Depends on the state you live in. In NY your LPN counts greatly towards your RN. Most schools will let you "challenge" nursing one and two as an LPN, allowing you to go directly into nursing 3 if you pass. Also, online classes for RN require a clinical test at the end and former LPN's generally pass with flying colors as opposed to RN's who have no clinical experience coming out of the online RN program. Then there are many types of 'bridge' programs which allow LPN's to become RN's in one year. In NY, at least, LPN's are valued!

RN/Mom · Apr 10, 2012

I'm in CA and some of the above sound like facility restrictions. To clarify. In CA LVN's can assess we just can't do the initial admission assessment. The IV certification allows us to give any of the clear fluids AND to do blood infusions (although no facilities allow us to do legally we can) Verbal orders yes we can, same thing for patient teaching. We just can't do the care plan.
All of the above are skills that are vital to my job as a field hospice LVN. Our scope of practice is really not that bad considering the differences in the length of our education just be aware most of the restrictions on our scope of practice comes from the facility.

thethepointLVN, I am quite confused! Do you know if the BVNPT recently changed our scope of practice with regards to clear IV fluids and blood products? Four years ago, when I was in LVN school, we were taught that IV certified LVNs in CA may only give NS and nothing else. Now, however, it appears IV certified LVNs can administer "fluid solutions of electrolytes, nutrients, vitamins, blood and blood products" via peripheral lines:

http://www.bvnpt.ca.gov/pdf/vnregs.pdf

According to the practice act, LVNs can only do "basic assessment," which the board refers to as "data collection." Anything abnormal still needs to be reported to the RN.

I can't find anything in the practice act referring to verbal orders. What is your source that states LVNs in CA can take them? I actually wish we could take verbal and telephone orders because it would make my job a lot easier!

nurse_kirsten · Apr 10, 2012

added quote (still learning these forums)

nurse_kirsten · Apr 10, 2012

"The only down-fall here, though, is that you get no recognition if you're an LPN and want to become an RN - they make you start the 4 years from scratch! "
NOT TRUE!
Depends on the state you live in. In NY your LPN counts greatly towards your RN. Most schools will let you "challenge" nursing one and two as an LPN, allowing you to go directly into nursing 3 if you pass. Also, online classes for RN require a clinical test at the end and former LPN's generally pass with flying colors as opposed to RN's who have no clinical experience coming out of the online RN program. Then there are many types of 'bridge' programs which allow LPN's to become RN's in one year. In NY, at least, LPN's are valued!

I'm from Canada, not the US.

I'm not sure why they do this. There are a few distance programs that allow you to apply some of your courses, but they are still about 3 years long.

I'm also not sure about the rules in the states, but to become an RN here you must have a BScN degree, which is part of the reason for making them start over.

I never said LPN's aren't valued - it just seems they aren't here by our government.

tothepointeLVN, LVN · Apr 10, 2012

As far as I know there have been no recent changes I DO know a few years ago they had changed the scope so LVN's working in dialysis could push certain drugs applicable to their setting but that was quickly revoked.

I graduated, got licensed and took my IV certification in 09. When I was being certified for Blood Withdrawal and IV Certification learning to do blood transfusion was part of the course syllabus and this was a course only for LVN's. Our instructor told us no facility in our area would allow us to do so but that it was within our scope. I believe the hangup factor on that is that it still needs to be signed by 2 RN's so why have the LVN in the middle.

Basic assessment/data collection all just different names for the same thing IMHO so far as what I'm expected to do on the job.. From what my NCLEX reviewer told us about issue was the key difference is LVN's can't assess bowel sounds. For the NCLEX you call it data collection but in reality it's assessing.

For the verbal orders give me a few minutes to read through the practice act to see what I can find. What I was taught was that it's usually restricted by the facility but that there's nothing in the practice act saying we can't. The verbal/TO orders for one hospice company even has a section where it says RN/LVN.

A lot of the "restrictions" on LVN's are facility based. When you really get down to it the differences are small. What it boils down to it we can "do" things but we are not allowed to "think" anything about it.

Butterfliesnroses · Apr 10, 2012

I initially wanted to go for my RN. Then I was really not enjoying school. I almost didn't make it past summer qtr. I had a hard time comprehending and testing in the same week. I more enjoyed the previous 3 qtrs. where I could read the info over and over, mull over it, so to speak. Then I had a choice. I could work full time as a LPN, or be out of a job. Knowing that the hospitals don't hire LPN's, my only choices were other nursing homes. They weren't hiring. Also I was feeling mom guilt. I felt lik my mind was not with my daughter. We were together and hanging out, but I had school on my mind. So I dropped out of the 1st RN qtr. I dream of going back and will go back when my child (or children, if me and my hubby have more) are older and don't want/need me around so much. I make double what I did as a CNA. I pay my bills and we can even splurge. I'm pretty darn happy.

stronisgram · Apr 10, 2012

I've read everyone's comments here and agree with most - disagree with some. I began as an LPN (proudly) about 29 years ago. Worked in a LTC facility and took verbal orders, did treatments etc ---absolutely no IV anything. Moved on to ASN (again proudly) because I wanted to LEARN more about nursing and how to care for patients. I was also upset that I believed I could assess and do things the RNs were doing but wasn't allowed to in the hospital setting. All the while, taking care of the patient was priority for me and I wanted to learn. Fast forward to my BSN training. This, I MUST say, is a HUGE difference in what LPNs learned and can practice in Ohio. Though LPNs can take the IV certification course (and many are phenomenal), I must agree that there is a knowledge-based difference in many areas such as IV/vascular system/adverse reasctions etc. Not that the LPN is not smart (please don't take that the wrong way anyone), but I KNOW first-hand that amount of information I have received from LPN to BSN and it is enormous! The why and how behind the information is also further clarified. So the knowledge is definitely increased with more schooling (stands to reason). I have worked with many LPNs that are great and I would greatly trust - but I have to admit there IS indeed a HUGE difference in the practice standards between the LPN and RNs. States vary for sure. Now, I am three classes short of receiving my MSN!! Why?? Because I wanted to learn more - there are many, many sides to nursing and I wanted to learn more. Have I learned more anatomy/physiology in my MSN?? Nope - much more about laws, ethics, regulations, administration, leadership, statistics, research, public/community health ----how to help change outdated protocols and the absolute why behind it all!! Does it make me better?? NOPE! Does it make LPNs or other RNs less - NOPE!! What it does do is allow me to expand my practice, knowledge, skill, and career opportunities to help PATIENTS and their families. There is indeed differences in all levels of nursing - but these differences are necessary!! :)

tothepointeLVN, LVN · Apr 10, 2012

This, I MUST say, is a HUGE difference in what LPNs learned and can practice in Ohio. Though LPNs can take the IV certification course (and many are phenomenal), I must agree that there is a knowledge-based difference in many areas such as IV/vascular system/adverse reactions etc.

I absolutely agree with you and although I am IV certified I will not use it beyond monitoring the occasion PIV and CAD pump that I encounter out in the home setting. LVN's here don't get IV training as part of school. It's something that's added on afterwards and 20 hours of CEU and 3 live sticks does not a competent IV practitioner make. I'll have plenty of opportunities to do IV's once I'm an RN.

NsugaBuga · Apr 11, 2012

Right. But I do know some RNs (and a soon-to-be RN) that I work with..... that look at LPNs and speak to them as if they dont know anhything at all.

NsugaBuga · Apr 11, 2012

By standards, do you mean what is expected of an RN Vs. an LPN?

stronisgram · Apr 11, 2012

To NsugaBuga...my meaning of standards is what is expected of each level of nursing. All nurses have professional standards - no matter the degree one has - this is what makes us a caring profession. Standards of ethics and principles should be the same throughout all levels --- standards of practice in each level will vary however, basically because of the level of education and expectations at each level. For example, though all levels of nurses are expected to teach their patients, the higher the degree one goes - the more education is expected - and not just for the patient, but also the family, community, and to assist toward regulatory changes etc. Again, not that LPNs can not do the same; this is not what I mean. With each varying level of nursing expertise comes varying levels of expectations for that particular degree.

I am always so sad to hear of any nurse who thinks they are "better" than another. We should be embracing each other and our chosen profession and support each other - and not think that any nurse does not possess knowledge! Like I stated before, I went to LPN school and was a proud LPN for 11 years before returning to school. I knew I had the rigorous training as well and knew I had the knowledge. BUT restrictions then in the hospital setting wouldn't allow me to do more than the LPN practice act stated (of course); and I wanted more. No one is lesser - we all have knowledge and skills. We do need to pull together better as a profession and support each other MORE ....period....instead of fighting against each other!