Eliminating LPNs - are hospitals doing this?

  1. Hello All,

    My mother is an LPN at a major women's and children's medical center in Honolulu. Recently the hospital announced that it may eliminate the LPN position throughout the hopsital in the next 12 months. My understanding is that they will supplement this loss by hiring additional CNAs.

    My question to you all is if you have any experience with this. Do you work at a hospital that has done this? Was it a good choice? Was it a bad choice? And what's your personal opinion? Do you think it's a good idea or a bad idea?

    While I'm certainly biased for my mother's position, I am honestly curious what others in the field think of this major decision.

    Thanks for your time.
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  2. 86 Comments

  3. by   cna on her way
    I am not really sure how to answer this question. I am planning on doing the LPN thing first so of course I want to disagree with the discussion. However, I can see why some hospitals choose to do so. Hiring CNAs is quite a bit cheaper for a hospital. But the nurse to patient ratio for RNs is going to dramatically increase and theres only so much a CNA can assist them with. At least with a LPN, meds can be given and paperwork can be done. Its a no win situation either way. I think that hospitals should try to work towards a happy medium. I wish your mom the best. They can't just let her go anyhow. There should be some type of grandfather clause in effect for the LPNs that are already working.
  4. by   Marie_LPN, RN
    They can pay CNA's less so it's seen as a moneysaver, but who winds up suffering? Wonder how their RN shortage is going?

    Majority of the float pool at the hospital i work at are LPN. About ten years ago they tried to eliminate LPN's from our hospital. The result was a huge nursing shortage and several complaints when the RN's were worked to death and asked to work 24 hrs shifts (yes that's illegal). Their LPN elimination lasted 6 months. Not only did they hired back the LPN's they laid off, they wound up paying MORE money.

    Even if i weren't an LPN student i'd still see it as a bad idea. I see a short-handed staff of nurses.
  5. by   ktwlpn
    Originally posted by kalaith
    Hello All,

    My mother is an LPN at a major women's and children's medical center in Honolulu. Recently the hospital announced that it may eliminate the LPN position throughout the hopsital in the next 12 months. My understanding is that they will supplement this loss by hiring additional CNAs.

    My question to you all is if you have any experience with this. Do you work at a hospital that has done this? Was it a good choice? Was it a bad choice? And what's your personal opinion? Do you think it's a good idea or a bad idea?

    While I'm certainly biased for my mother's position, I am honestly curious what others in the field think of this major decision.

    Thanks for your time.
    I was laid off from a small local community hospital.They eliminated most of the LPN's in the house.Sadly due to the shortage of RN's it has resulted in unsafe RN to patient ratios.They trained the cna's to do tasks such as finger sticks,ekg's....Maybe they saved some dough-many of the nurses had close to 20 yrs in and were at the top of the pay scale.Things have gotten better-they have been able to attract some new young rn's and retain them......Many acute facilities have followed suit-I think it all depends on each state's practice act.There is alot I can't do in acute care-but I'll always have a job somewhere.Good luck to your mom....
  6. by   purplemania
    It may be perfectly legal to eliminate all LPN positions, as no one could claim discrimination. We have not hired any in 2+ years because, in our state, all LPNs (LVN in Texas) work under RN license, which means I am ultimately responsible for all assessments, re-assessments, blood transfusions, IV infusions and other things. I agree there should be some "happy medium", but I do not have the answer.
  7. by   kalaith
    Thanks for your post cna on her way. I had a similar reaction when I first heard the news. On one hand CNAs are much cheaper than LPNs but on the other hand there is a lot they're not trained to do that LPNs can do.

    The hospitals position seems to be this. If you're willing to become an RN, we'll keep you. If not, we can help you find a job within one of the clinics or another hospital we own. (It's only the LPNs at the women's and children's hospital that are in danger of losing their jobs.)

    My mother is in her late 50's and will be retiring in 5 - 10 years. She's not sure she'd want to go back to school just to work a few years as an RN.
  8. by   Tweety
    There's such a shortage of RNs here my hospital couldn't do it even if they wanted to.
  9. by   kalaith
    Wow. Thanks for all of your posts. I wish I could reply individually. It's a tough situation all around. There has been talk in this hospital in Honolulu of the inability of hiring and retaining good RNs. Eliminating LPNs seems like a bad move. Of course, there is also talk of reorganizing their floor for high-risk patients. (My mother works post-partem or what they now call "mother baby coupling care")
  10. by   ktwlpn
    Originally posted by cna on her way
    They can't just let her go anyhow. There should be some type of grandfather clause in effect for the LPNs that are already working.
    Sure they can...Here in Pa we are a right to work state.When they eliminated our positions on the med surg unit they took us into the office one by one going from the LPN with the most seniority on down...They eliminated 10 positions-kept 2-the LPN's with the most seniority were offered those psotions and accepted them...We were handed a package with the paperwork we needed to file for un-employment and were each given severance-1 week of pay for each yr of service...We had to sign a statement saying we would keep the arrangement confidential or risk loosing it all.I got around that-it only called for us to keep the details of the severance package to ourselves.The next day when the local papers came out they all quoted the admin as saying that "no bedside nurses were lost" I made a few calls and set that straight-so I guess I'll never work in that org again....Unless you are in a union the man can pretty much do whatever they want to........
  11. by   luv-my-dal
    .....so.....do CNAs administer meds., monitor IVs, do pt. assessments and ongoing care....???

    I don't know what the scope of practice is for a CNA.....
  12. by   llg
    I currently work in (and in the past have worked in) hospitals that hire LPN's for some units, but not for others -- which is, perhaps, that "happy medium" that some of you have talked about.

    The reasoning is this: On some units, the level of acuity is such that LPN's can do very little of the care and need so much supervision and back-up from the RN that their role on those units ends up being much like that of a nursing assistant. Also, having 3 levels of nursing care providers (RN, LPN, and CNA) makes it very confusing for the RN to organize and supervise the team -- particularly the new grads. On those units, they therefore chose to go with the RN plus CNA combination only and eliminated the mid-level LPN positions. That leaves just 2 levels of providers -- and RN who can legally do everything for the patient and a nursing assistant to help.

    I hope you can see that the elimination of the LPN positions on those floors was not due to a lack of respect or appreciation for the individual LPN's. It was just too confusing to have 3 levels of providers all looking after the same high-acuty patients -- and there were almost no patients whose acuity was sufficiently low to assign to the LPN without significant RN involvement.

    On other units, there were/are a sufficient number of patients who can be handled by the LPN's with minimal RN assistance. Those units have retained some of the LPN positions.

    llg
  13. by   kimmicoobug
    The facility I work at is doing away with the LPN position. They are doing this by not replacing the current LPNs as they leave. The ones that are still there do not really do the bedside stuff, but act as med-nurses. Although, recently up in OB they had float LPNs provide care to patients. These patients were post-partum with no IVs or a few days post surgery with no IV.
  14. by   Dayray
    This happens from time to time at hospitals. the reason behind it is a combination of 2 things.

    #1 hospitals want to save money.
    #2 ignorance about what an LPN is and does.

    I was an LPN before I graduated this may. becoming an RN has made me realize that their are some very serious differences between RN and LPN (watch it here it comes) <<<<BUT>>>>

    LPNs are not interchangeable with CNA's a CNA cannot and should not be expected to assess this is what LPNs are for they care for patients, assess and report. As an LPN I didn't always know what to do for every problem but I had the training and skills to figure out when I need to get an RN in the room to tell me how to fix the problem. CNA's cant do this, I was also a CNA so I'm not belittling them and yes some would catch things as well as an LPN but not many.

    One of the hospitals I worked at had phased out LPNs and failed miserably, RNs were over worked and patients didn't get good care.

    As nurses we need to be careful it's easy to compare RN to LPN and yes Rn's have allot more responsibility and hopefully more skill and knowledge then the average LPN but when we take it too far and start thinking LPNs aren't necessary and even worse suggest to management that they be eliminated we only hurt the patients and our selves. the Suites will jump at a chance to save bucks by firring skilled labor and bringing in people off the street and calling them techs or assistants and then you know who really gets the shaft? the RN who is expected to do the work they did before + the work of the LPN.

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