LPN vs RN - serious question about differences

Nurses LPN/LVN

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I know this is a touchy subject and I don't want it to become a flame war. As someone with RN training and no LPN experience, I'm still honestly confused by these two different nurse licenses.... so here goes...

Many say "a nurse is a nurse" but that's not always the case. There is different designation and licensing for RNs and LPNs. And facilities often advertise "LPN openings" - but if a nurse is a nurse, why would they ever advertise for just LPNs? Wouldn't it just be a nursing job which either an LPN or RN could fill? And then other positions would be RN-only.

Unless an RN has been an LPN, it IS confusing to RNs what LPNs are and aren't legally qualified to do and why they aren't legally qualified to do certain things yet often function in an almost identical role RNs (eg only can't do initial assessments and hang blood in acute care). We all know that many LPNs have great assessment skills and technical skills and critical thinking skills. A patient wouldn't recognize any difference between a good LPN and a good RN. In that case, "a nurse is a nurse."

But then what more exactly did the RN learn in their program to allow them to qualify for significantly more pay than LPNs in most facilities? Why ISN'T an LPN allowed to do an initial assessment or hang blood? It wouldn't take that much extra formal training to bring them formally up to speed on these tasks and include that in their scope of practice. So what more does the RN education have to offer in regard to actually practicing nursing in most settings?

Specializes in Complex pedi to LTC/SA & now a manager.
My LPN program was 20 full time months plus a year of science and math.

Are you in Canada? Canadian RPN/LPN programs are two years full time.

I agree with you 100%. While most RNs I worked with were easy to work with some let their ego's get in the way. One even tried to get me fired because I refused to tell a pt. that he should wait for sick call (I worked in a prison) to be seen. I politely advised her that I felt he needed treatment and as I was the one evaluating him and assessing him she should allow me to do so. She became verbally abusive and rather rude. (and not quietly either) She told me that as she was an RN and I was "just" an LPN I had to obey her. The next day we met in the supervisors office- the supervisor had already heard from the officers as well as several inmates about her behavior. As well as my responses to it. In the end she was transferred to another unit and told that while she was an RN she should respect that my years of experience in corrections had a lot to do with my decision to treat the inmate rather than have him wait for treatment. Her RN'itis (as some of us seasoned LPN's like to call it) eventually caused her to quit the prison system.

I often thought about going back to get my RN but it seemed to me they did more paperwork and less actual hands on care I decided to remain an LPN and keep doing the hands on part I enjoyed.

The LPN course I attended 40 yrs ago had us doing care plans. We were taught to see a whole picture not just the dx. Maybe things have changed or the school you attended was less intense than mine. But then it could be just a sign of the times. Or maybe the instructors only cared about the basics. My instructors were hard on us but when all was said and done we learned that nursing care was just part of the picture. We even spent time in other areas of the hospital learning what dietary and maintenance did so we would appreciate that every job in the hospital was important to the pts. welfare and recovery. Yes as nurses we do the actual care but each dept. and person in it is important.

Specializes in Clinical Documentation Specialist, LTC.

I graduated from a full 12 month LPN program in 1996. Shortly thereafter the program was expanded to 18 months to include more of an expanded role, plus the 12 month program was so accelerated and difficult at the Community college I went to the dropout rate was very high. I remember starting with 40 or more in my class with maybe 30 graduating. We had to write care plans which was very tough, but it helped me tremendously in my 15 year role as a MDS Nurse.

As for requirements for getting into the LPN program I went through, it required an ACT score of at least 19 (may have been 20. It was a long time ago), I had to take an exam and score above 70%, then had to be interviewed by the instructors. That interview was nerve wracking LOL!!

Specializes in Geriatrics.

In my facility we dont need RNs so they are hired as RN/LPN. We do the same protocol. One of the hospitals here utilizes LPNs as glorified CNAs...CNAs are tech 1 and trained into tech 2. They do foleys, remove IVs etc.

At my facility CNAs cant do anything except routine ADLs

Specializes in Transitional Nursing.

I was just reading through old threads and came across this one. I think the question is posed quite nicely.

I wanted to add that in my state, and in my role especially, there is little to no difference in terms of scope. The only thing I would need to fetch an RN for is if one of my patients passes, as the one thing we can't do is pronounce.

I do recognize that I don't know what I don't know, but I too find it a bit confusing.

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