Quote from GrnTea
Well, as I am fond of saying, anecdote is not the singular of data. I'll see your tales of mahvelous crusty old LPNs bailing the resident or the new RN out one dark and stormy night, and raise you a dozen truly horrifying anecdotes about situations that were mis-read and mishandled by LPNs whose ignorance of physiology, assessment, and intervention was truly breathtaking
What I learned of LPNs in my first year out of school from the ones I worked with was that they were completely task-oriented, felt empowered to be mean to patients whose demographics or diagnoses were distasteful to them, they were absolutely uninterested in learning anything new, and were unwilling to take any responsibility for their screw-ups because they weren't in charge and the RN was supposed to take care of problems. Fortunately for my professional development, after that first year I worked for 7 years in an all-RN environment, and the care was exemplary.
Some years later I had occasion to teach in an LPN-to-ADN program when my ADN program put one together with a large hospital that was phasing out LPNs. The hospital put a boatload of bucks into paying for sixteen LPNs to take this program at no cost to themselves, and was going to give them their years of seniority in their new RN positions to boot. We worked very hard to make this program a success; it was taught at a lower level than the generic students' program, and we offered extra time for tests, free tutoring, extra office hours, review sections... the hospital gave them extra days off for school and all... And what happened?
You never heard such ***** and moaning about how mean this was, how they didn't want to be RNs, they didn't want the responsibility, this was too much learning, if they wanted to be RNs they'd have done it in the first place, they hate this. So much for opportunity. Of the sixteen, only four or five made it halfway through, and I think only 2 passed NCLEX RN. The others lost their jobs because they were either too stupid to learn or couldn't be bothered to learn what they needed to kee them.
Generalities? Sure. But no less so than these other rainbows-and-unicorns "we're all on the same team so we're all of the same value." Horsepucky. If that's not you I'm glad to hear it, and I am aware that this is the LPN/LVN forum I'm posting on. But let's not be self-delusional, either.
You know, I've never been one of those LPN posters who says things like "LPNs bail RNs out all the time" or "LPNs work circles around RNs". Comments like that are just silly and defensive. Yes, there's been nights where I bailed out a RN who was oblivious to a resident spiraling down the drain. And there's been nights where I was in over my head and was grateful for the education and experience of a RN to go to.
I refuse to believe that you've only worked with ignorant LPNs.
If LPNs were strictly task oriented and ignorant, let me tell you, the LTC industry would literally collapse overnight. If I didn't know how to assess residents and intervene appropriately (and, yes
, independent interventions. Not just calling a RN or the doctor) there would be dozens of residents who wouldn't be alive right now.
Your experiences with LPNs reveal that you don't work with LPNs in the environment that the vast majority of us operate. We can't just pass the buck to the RN when we screw up because there ARENT any RNs most of the time on 2nd and 3rd shift in LTC land. You can say "LPNs work in a dependent role under the supervision of a RN" until you're blue, but it's utterly meaningless in an environment where a LPN is the only licensed person present.
Would it be "better" if all the LPNs in LTC were replaced with RNs? Well, yes, I suppose so. RNs have more education, and a unit where every last floor nurse was a RN would be a best case scenario. It would also be "best" if you replaced the CNAs with LPNs. And if the mid level practitioners were replaced with MDs. And why not make housekeeping have a healthcare license so that they're educated in aseptic cleaning practice?
The reality is, you'll never find enough RNs willing to staff all the nursing homes, and EVEN IF YOU COULD, it wouldn't be economically viable.
I know for an indisputable fact that my licensure and education is sufficiently suited to my position and responsibilities.
GRN Tea, I'm often at a loss as to what exactly you want
for the world of nursing.
If you want all licensed nurses to have the highest possible education, you'll price us right away from the bedside, leaving a vacuum that will only be filled by UAP. LPNs exist because there is a clear and obvious role for us. Ditto for ADN RNs.
In another thread you took me to task for saying we (in LTC) should keep giving soap and water showers. And that it was irresponsible for me to say it's okay to give scheduled, set, doses of novolog to stable diabetics as opposed to sliding scales with carb counting.
This is these people's HOME. It's fine to give them a shower with regular shampoo and soap. And to treat stable diabetics with insulin regimens similar to what a doctor would prescribe a person in their home. It doesn't make one a bad or lazy nurse to think this. What a horrible life a LTC resident would have if we treated them like they were on a med surg floor.
The stubbornness and lack of flexibility puzzles me.