I'm an LPN and I understand.

Not being phased out. But being forced back to our traditional role as Licensed Practical Nurse. This article addresses the LPNs role being phased out of acute care and what future LPNs should know about the practical nursing profession. Nurses LPN/LVN Article

I'm a new Nurse. I spend a lot of my time on a nursing home corridor behind a med cart, or more like a rolling Walgreens kiosk. I stay at work 1, 2 sometimes maybe 3 hours after shift change behind a nurses station. After 4pm , I function alone. I'm the one in charge. I'm the one who assesses residents, makes judgements, contacts physicians, contacts family members, sends residents to the hospital, it's all me. It's a big responsibility. It's a big job. I'm a NURSE. I'm the NURSE. But I am not an RN. I'm an LPN.

There's been much debate on not only this website, but around the country; about RNs and LPNs and what's the difference. It seems like around every corner you hear, don't become an LPN, or LPNs can't work in acute care. In my area LPNs can work in acute care and are growing strong in med-surg and ortho/rehab units in acute care. But that's not to be naive to the fact that in many parts of the country this is not the case. But I understand. I understand why LPNs have been phased out of ERs, OBs , ICUs, med surg in some areas, and it really does not come as a shock to me.

The current trend for LPNs is not new. LPNs came about ages ago to assist the RN by tending to stable patients with predictable outcomes. But with today's healthcare costs, and all other modern day alternatives to costly acute care like Rehab, LTAC, LTC/SNFs, Home Health, those patients with predictable outcomes just don't camp out on med surg like they used too.

Hospitals today house highly acute patients. And our skill sets as LPNs just aren't effective in this kind of environment. It does not make us any less of a Nurse, it's just not traditionally our role. Our role has moved with the times outside of hospitals. But that does not mean our role is gone. There's a Home Health Agency, Nursing Home, LTACH, Rehab Hospital hiring LPNs in bulk around every street corner.

So my question to all LPNs? Why would you work in a CNA capacity just to get hospital experience? All prospective LPN students need to understand that an LPN is not an RN. Just like a Podiatrist is not an MD. All are doctors. But different types. RNs and LPNs are both NURSES but different types. RNs are acute care nurses, and nurse managers, made for coding patients, and IV drips, and newborns in distress. As LPNs we are there for Accu Checks, PEG Tubes, Walkers, foleys. We LPNs are Nurses whose expertise is management of long term chronic illnesses. But we are Nurses.

Don't waste your time going through podiatry school if you want to be an MD. You'll be disappointed. Same thing if your dream is to be an RN on a busy NICU but you're sitting at clinicals at your local trade school in an LTC facility. We need to embrace the type of Nurse we are and our role as LPNs. Why go to school to be an LPN to work as a Tech on med surg, when you can use your Nurse smarts and leadership abilities in long term care.

I think the problem with LPN insecurities today is we LPNs try to be something we were traditionally not meant to be. It's not the magnet status talk or the BSN requirements. With shortages of Nurses in LTCs and tough budget cuts to federal programs paying a BSN RN to pass meds in a busy nursing home for $15-17$ dollars an hour is scheduled for the 31st of Never.

So let us embrace the LPN's role in nursing as the "chronic illness stable condition nurses". I'm proud to be a long term care nurse. I don't want to deal with critical drips , titrations, deteriorating newborns and such. I want to provide the best nursing care possible to people in need of long term management for chronic illnesses. If these jobs are outside the hospital, we have to follow them. We have to be proud of the Nurse we chose to be.

Again don't become a family medicine specialist if you want to be a neurosurgeon. Both are physicians both have similar knowledge. But the skills and individual knowledge they have match 2 different types of client populations. It's the same with LPNs and RNs. I know that in a perfect little world the LPN is an assistant to the RN and the RN delegates and supervises every little move and task that an LPN makes. Let's get real now. In small rural nursing homes where the DOC knows the Nurses on a first name basis, the LPN has more autonomy than MSN-RN in a large hospital.

Not knocking anybody's role. RNs have more acuity skills according to the BON, they have a better understanding of the big picture and i understand. But I have a role as a Nurse. I'm a long term care nurse. I manage chronic illnesses. It's what I signed up for. I would suggest anyone who wants to fly on helicopters, and start atropine drips in the ER, or care for an infant in the NICU, do yourself a favor and strive to be an RN. Because I do not have these hopes.

The elderly are a blessing and I'm doing what I love. I'm a NURSE. A long term care LPN and proud of it. It's what I do. You stick an ER RN in my job and it probably won't go well. You stick me in the ER, I know it wont go well! So please prospective LPNs. Consider our tradition. Accept it, or strive for your RN, beause we're not the same. And as an LPN I understand.

I also remind them that that BSN does NOT make you a better nurse than that veteran LPN, ADN or diploma RN who you end up working with.

Actually, in the long run, it does. Having a higher degree of education certainly prepares someone to be a better healthcare professional than someone with say a diploma. The ever reaching scope of practice that RN's take on is evidence that higher standards of education are required. So yes, a RN with a BSN will be a better nurse than someone with a diploma.

I'm not saying the LPN or diploma RN won't be very caring or good at some clinical skills, but that is not a "nurse." You can teach anyone to put in a cath or walk someone to the bathroom. Being a healthcare professional demands higher levels of education.

Specializes in Nursing Home.

Well , i was taught that the client population the LPN is to serve the stable client predictable outcomes! Wich has more patients with Predictable outcomes ! You say facility doesnt matter ? So i assume your are saying that LTC doesnt have more stable cliente with predictable outcomes?

Specializes in Nursing Home.

And your saying LPNs an ADN RNs are not Nurses ? Ok ! What alot of people fail to realize is the BON only recognizes one RN Licensure. And both BSNs and ADNs both hold the same one.

Specializes in Peds/outpatient FP,derm,allergy/private duty.
Well , i was taught that the client population the LPN is to serve the stable client predictable outcomes! Wich has more patients with Predictable outcomes ! You say facility doesnt matter ? So i assume your are saying that LTC doesnt have more stable cliente with predictable outcomes?

Not sure if you are talking to me, downsouthlaff but what I wanted to say was I really loved your article. Finding the right niche in nursing is something that some nurses of many years literally never do.

I don't agree that traditionally RNs worked in acute care and LPNs worked in long-term care. The course material is similar but gone with less depth in LPN/ LVN programs. People who disparage LPNs most likely have no idea what is mandated by law to be included in a curriculum for the school to be accredited

Obviously, a state is never going to mandate something they would then prevent the nurse from using in their practice. If you think about what is actually meant by "predictable outcome" these days it is not so easy to define.

Some people fail to understand who initiates changes in Scopes of Practice. if "patients are sicker" now that will affect nurses in LTC as well. Having vent-dependent residents in LTC/rehab units would be unheard of 20 years ago.

If your resident falls and hits their head they don't have a predictable outcome, and many patients in acute facilities are on protocols with very predictable outcomes.

Specializes in Public Health.
Actually, in the long run, it does. Having a higher degree of education certainly prepares someone to be a better healthcare professional than someone with say a diploma. The ever reaching scope of practice that RN's take on is evidence that higher standards of education are required. So yes, a RN with a BSN will be a better nurse than someone with a diploma.

I'm not saying the LPN or diploma RN won't be very caring or good at some clinical skills, but that is not a "nurse." You can teach anyone to put in a cath or walk someone to the bathroom. Being a healthcare professional demands higher levels of education.

Umm, they are still nurses.

Specializes in Geriatrics, Dialysis.
Actually, in the long run, it does. Having a higher degree of education certainly prepares someone to be a better healthcare professional than someone with say a diploma. The ever reaching scope of practice that RN's take on is evidence that higher standards of education are required. So yes, a RN with a BSN will be a better nurse than someone with a diploma.

I'm not saying the LPN or diploma RN won't be very caring or good at some clinical skills, but that is not a "nurse." You can teach anyone to put in a cath or walk someone to the bathroom. Being a healthcare professional demands higher levels of education.

well this isn't at all offensive to diploma nurses ...some of whose programs were longer. more well rounded and more in depth than current BSN programs. LPN's and diploma RN's only good for "some clinical skills?" nope, not at all offensive.

I believe that the general ADL's will be covered mostly by CNA's in the future. This will relieve the RN to accept more patients or discharge/admit more patients that earn the hospital more money. I'm sure there will be times you get to change a gown, wipe a mouth, hold a hand but they will not be the focus or your patient care. There are plenty of clinical skills you will complete that give you quality time with patient that require an RN. I have a bachelors of science in nursing, so yes, in a way we are "scientists" in our own right. The medical field has grown in technology and complexity exponentially in the last 40 years and is growing even more rapidly. I have worked with older MD's before that longed for a simpler time when Penicillin was the antibiotic for everything, they made house calls where the family cooked them dinner, nobody dared question their diagnosis or threaten to sue them. This time in history has passed. Nurses can long for the time of yesteryear but it's wiser to move forward with the rest of the field and learn to be an integral part of the future.

If a person absolutely doesn't want to do more than 6 months to 1 year post secondary education the option as a CNA is a noble one. Their primary focus will be ADL's and will change many gowns. Their use in the field is greatly appreciated!

Specializes in Adult ICU/PICU/NICU.
Actually, in the long run, it does. Having a higher degree of education certainly prepares someone to be a better healthcare professional than someone with say a diploma. The ever reaching scope of practice that RN's take on is evidence that higher standards of education are required. So yes, a RN with a BSN will be a better nurse than someone with a diploma.

I'm not saying the LPN or diploma RN won't be very caring or good at some clinical skills, but that is not a "nurse." You can teach anyone to put in a cath or walk someone to the bathroom. Being a healthcare professional demands higher levels of education.

You have some academic talking points, but with all due respect you sound like you have very little experience in the real world of nursing.

Education does not stop with your diploma or your degree. It continues for all of one's life. Experience is truly the best teacher. As for the old diploma schools, you have no idea what we went through to obtain our diplomas.

I've worked with many nurses over the years, and have found that your academic talking points that you repeat from textbooks or instructors are simply not true. My experience tells me that a good nurse will be a good nurse no matter what her/his formal education is. I have worked with BSNs who were truly awful nurses and some who were wonderful. The BSN didn't help the awful ones, they simply lacked the talent and/or the work ethic to do the job.

I found the line about "you can teach anyone to...walk someone to the bathroom" to be particularly misinformed and insulting to nurses from an earlier generation who paved the way for you. We certainly did learn critical reasoning in the old diploma schools and were constantly asked to justify what we were going to do and why. It was essentially an apprenticeship from day one. Class in the morning, clinical in the afternoon, and you worked as a student nurse in the evening. You slept at a dorm in the hospital, ate you meals there and lived and breathed nursing for 2 or 3 years.

I nearly completed my BSN nearly 25 years ago. I certainly learned new things, but it didn't change the way I did critical care nursing. That came from my years of experience. What I did learn from my BSN training was nursing research, and how bias and poor research design is very common even in the hard sciences, let alone in nursing and one must critically review any kind of research before taking it as gospel.

I have been in nursing for nearly 60 years. It is common for young people fresh out of school to have the attitude that you do, and I'm not blaming you for your youth and/or inexperience. We all start there. I found that the attitude changes once young people actually work alongside veteran nurses who may have less formal education, but have more knowledge about nursing in their little finger than the new grad does in their whole being.

Live and learn,

Mrs H.

You have some academic talking points, but with all due respect you sound like you have very little experience in the real world of nursing.

Education does not stop with your diploma or your degree. It continues for all of one's life. Experience is truly the best teacher. As for the old diploma schools, you have no idea what we went through to obtain our diplomas.

I've worked with many nurses over the years, and have found that your academic talking points that you repeat from textbooks or instructors are simply not true. My experience tells me that a good nurse will be a good nurse no matter what her/his formal education is. I have worked with BSNs who were truly awful nurses and some who were wonderful. The BSN didn't help the awful ones, they simply lacked the talent and/or the work ethic to do the job.

I found the line about "you can teach anyone to...walk someone to the bathroom" to be particularly misinformed and insulting to nurses from an earlier generation who paved the way for you. We certainly did learn critical reasoning in the old diploma schools and were constantly asked to justify what we were going to do and why. It was essentially an apprenticeship from day one. Class in the morning, clinical in the afternoon, and you worked as a student nurse in the evening. You slept at a dorm in the hospital, ate you meals there and lived and breathed nursing for 2 or 3 years.

I nearly completed my BSN nearly 25 years ago. I certainly learned new things, but it didn't change the way I did critical care nursing. That came from my years of experience. What I did learn from my BSN training was nursing research, and how bias and poor research design is very common even in the hard sciences, let alone in nursing and one must critically review any kind of research before taking it as gospel.

I have been in nursing for nearly 60 years. It is common for young people fresh out of school to have the attitude that you do, and I'm not blaming you for your youth and/or inexperience. We all start there. I found that the attitude changes once young people actually work alongside veteran nurses who may have less formal education, but have more knowledge about nursing in their little finger than the new grad does in their whole being.

Live and learn,

Mrs H.

I have not been a nurse as long as you ( only 38 years), I am a proud diploma nurse and feel my education was outstanding for its time. But I have a MSN now and nursing is not the same profession it was 40 years ago, new technology and advances in medicine have shaped nursing practice.

While experience is great is no replacement for formal education, where you learn to systematically think verses nursing tasks.

I have respect for all levels of nursing, have taught in the PN program and believe it is a vital place in the nursing profession, as well as ADN, BSN, etc. But experience does not replace formal education.

I

If a person absolutely doesn't want to do more than 6 months to 1 year post secondary education the option as a CNA is a noble one. Their primary focus will be ADL's and will change many gowns. Their use in the field is greatly appreciated!

You do know Cna's are not licensed nurses?

My lpn program was 12 months long.

Not sure why you added that anyone who does not want to go to school longer than 6 months to a year should become a Cna.

Specializes in Adult ICU/PICU/NICU.

First of all, congratulations for your 38 years in nursing. You are still a young thing. Oh to 50 again. Oh to be 60 again. Oh to be 70 again!

I mean no disrespect, but I don't understand how formal education would help me with new technology. For example, when I started in nursing, I took care of patients in iron lungs. I then learned the technology on the job as it developed as we understood more about how these wonderful machines called our bodies work and how to help it heal. When we started doing ECMO in the NICU, I learned about that technology from the perfusionists during class. Everything was learned on the job, which I consider informal education. I'm not sure if I finished the final semester to get my BSN would have made me a better critical care nurse, so I must very politely and respectfully disagree with you that experience and informal education certainly can compensate for lack of formal education.

I certainly hope that you don't think I was frozen in time all of these years. All of us, LPNs or RNs, are constantly learning new things, usually informally vs going back to school. I wouldn't has lasted in nursing this long if I remained frozen.

Best to you,

Mrs H.

I have to agree with Mrs. H. I firmly believe education does not replace experience. You that nurse intuition that some of us have? Well, a text book cannot teach me that, only experience can.