Are LPN's being phased out? - page 6

by JSlovex2

64,639 Visits | 232 Comments

I know people have been saying for years that everyone would need a BSN and LPN's would be a thing of the past, etc. Well, so far, where I work (a large, magnet hospital) there are still many, many nurses without a BSN -but there... Read More


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    This is the first I've heard of this but I live in Ontario, Canada so perhaps it's different here than in other places.

    I work on an acute hospital floor with an RN/LPN staff mixture. I have to say that our LPNs have such a wide scope of practice that they do almost as much as the RNs. They can start IVs, hang blood, do any kind of wound dressing so long as it's not tunneling, they do their own assessments. The only things they can't do on our floor are give chemotherapy, access central lines (due to change soon, according to word of mouth), give/handle continuous IV meds (i.e. heparin drips), and manage acute dialysis patients or anyone who is unstable (still, this is very subjective).

    But, it is different on each floor even within our hospital. I've heard that LPNs on other floors only do basic care (i.e. ALC patients).

    Still, I'm surprised that some places want to phase out LPNs. They are cheaper to pay for, after all, yet they can do a lot if their scope of practice is wide enough (such as on our floor), and in my opinion, an experienced LPN is more valuable than an inexperienced RN.
    DogWmn and OgopogoLPN like this.
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    "The only thing an LPN can"t do in California is push IV meds"

    Anyone in emergent care can't begin to imagine this being off the table...I suppose other parts of the hospital different story.
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    I work in an ICU now but even when I was on a general Peds floor, IV pushes were part of my everyday job. Whether it was pain meds, ampicillin, benadryl, etc. And that doesn't include emergency drugs! It would be a difficult thing to avoid.
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    Quote from Fiona59
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    Hmmm...cold or education, cold or education!
    I'll take education....I'm flexible and I have to do what I have to do.
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  5. 0
    Quote from linearthinker
    I only skimmed, but however inconveniently and pejoratively worded the babysitting comment is, I get the point. Speaking only for myself, due to the limitations imposed by the facilities I worked in, I prefer not to work with LPNs. I have not in many years now, but historically, having to go behind and chart for them was such a PITA I'd rather just do it all myself. CNAs can do their thing and chart same. The LPNS could do it, but then I'd have to sign that I agreed. How can I agree if I don't repeat the assessment? All they could really do for me is CNA duties and pass PO meds. That wasn't very helpful.

    That is not a reflection on the individuals, their innate intelligence or skill, but rather identification of a systems problem. I'd rather not have to deal with consequences of said systems problem. I suspect that that is what was meant by the babysitting comment, however indelicately it was put.
    this is exactly what i meant, and i used the "babysitting" comment because that's the impression i got from the conversation/complaining i heard the other day in the cafeteria by RN's on the subject. where i work - the LPN's have the same patient loads as the RN's. So, it's not that the LPN's are "helping" the RN's. in fact, it's the other way around. the RN's have to go behind the LPN's to "help" them with THEIR patients.

    CNA's are a totally different story. CNA's are there to assist the nurses (RN and LPN) and it's understood that they are working "under" the nurse - so it's expected that they will have to check their work, charting, etc. also, they're helping them with their OWN patients and essentially lessening the work load. i mean, if there were no CNA's the nurses would have to do their own vitals, check their own blood sugars, change their own patient's linens, bathe their own patients, etc. LPN's aren't helping the RNs with their patients (they aren't lessening the workload), but the RNs still have to go behind and check their work which is actually adding to the work load.

    the argument was essentially "why don't they just hire a RN since the LPN can't do the WHOLE job." i'm sure the answer has been money, but i guess someone has decided it's not saving that much afterall bc they are no longer being hired.
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    For the record, I'm not of the belief that "a nurse is a nurse is a nurse." I'm a believer in advancing education in general (and I think continuing education requirements for nurses in general is laughable at best but that's another thread). That's not to say those with less education are lesser nurses! Just because I believe in education doesn't mean I don't also believe in experience or recognize that some people are simply naturally better suited to certain skills/professions than others. Each of those attributes can give one person the advantage over another but natural abilities can't be taught and everyone gets experience with time while education is a choice we all get to make.

    My facility is phasing out LPNs. They have eliminated them from the ED and ICU already and are no longer hiring LPNs hospital wide. The next step is to diminish their scope to that of a CNA who can pass oral meds only. As new RNs are hired, the LPNs will be rassigned to other non-nursing positions (primarily CNA/tech and secretary jobs) with adjustments in pay that are appropriate to the new positions.

    Some of the LPNs at my facility are upset because they don't want to be relegated to only being able to pass pills, particularly since it's only temporary until they are phased out completely and new RNs are hired to replace them. Some of the LPNs however, are elated as their job is about to get a lot easier as they won't have to do anything but pass pills. The difference in that mindset makes a big difference in how I view their plight. For the LPNs who value their roles as nurses, I hurt for their loss and will miss what they bring to the table. These are team players who work with me to make sure our patients are cared for as safely and effectively as we can. For the ones who actually want to be little more than CNAs that pass pills? They can't phase them out fast enough for me! These are the folks who hand me a list of things they can't do (or worse, expect me to magically know on my own) and always have a ready excuse for why they can't do something for my patients when I'm busy with theirs.
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    Quote from pers
    For the record, I'm not of the belief that "a nurse is a nurse is a nurse." I'm a believer in advancing education in general (and I think continuing education requirements for nurses in general is laughable at best but that's another thread). That's not to say those with less education are lesser nurses! Just because I believe in education doesn't mean I don't also believe in experience or recognize that some people are simply naturally better suited to certain skills/professions than others. Each of those attributes can give one person the advantage over another but natural abilities can't be taught and everyone gets experience with time while education is a choice we all get to make.

    My facility is phasing out LPNs. They have eliminated them from the ED and ICU already and are no longer hiring LPNs hospital wide. The next step is to diminish their scope to that of a CNA who can pass oral meds only. As new RNs are hired, the LPNs will be rassigned to other non-nursing positions (primarily CNA/tech and secretary jobs) with adjustments in pay that are appropriate to the new positions.

    Some of the LPNs at my facility are upset because they don't want to be relegated to only being able to pass pills, particularly since it's only temporary until they are phased out completely and new RNs are hired to replace them. Some of the LPNs however, are elated as their job is about to get a lot easier as they won't have to do anything but pass pills. The difference in that mindset makes a big difference in how I view their plight. For the LPNs who value their roles as nurses, I hurt for their loss and will miss what they bring to the table. These are team players who work with me to make sure our patients are cared for as safely and effectively as we can. For the ones who actually want to be little more than CNAs that pass pills? They can't phase them out fast enough for me! These are the folks who hand me a list of things they can't do (or worse, expect me to magically know on my own) and always have a ready excuse for why they can't do something for my patients when I'm busy with theirs.
    yup! there was a RN who was complaining the other night bc she couldn't go down to the cafeteria and get lunch because there had to be a RN on the floor and the other nurses were LPN's. there was another instance where nurses had been called off due to low census and a new grad (new as in one month) was charge nurse over LPN's who had been working for 10+ years with the exception of one who had been working for seven years. it was so silly for everyone - the charge nurse who had not a clue what was going on (and admittedly didn't want to be charge), and the LPNs who were guiding her, but were "under" her.
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    A "nurse is a nurse is a nurse" is the silliest thing going. Theres diploma nurses with 30 yrs experience...theres BSN grad with no experience. Theres ADN nurses with 10 yrs ER 5 yrs psych etc. Education doesnt replace experience in the current market. However once employed for a while, experience doesnt neutralize education. All things being equal an LPN, RN (ADN) RN (BSN) with same yrs exp. same adaptability, communication skills etc....the BSN is probably going to advance to more opportunities. Its just reality. ADN does second best...LPN isnt getting phased out of anything but hospitals.
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    Quote from DonaldJ
    I was an LPN for four years before getting my RN. I can tell you that no one ever had to "babysit" me as an LPN, and in many areas that I worked, I did the EXACT same job as the RN with the same work load, but for less pay.

    As an RN, I do not "babysit" LPN's, and wording it this way is very disrespectful. My second job is a part-time position in a VERY busy ED. About half of the staff are LPN's. When I first started, I could not tell the difference between the LPN's and RN's without looking at their name badges, because they all worked at the same level and with the same professionalism. There are some things that require an RN, such as hanging blood (takes two nurses to do anyway), and accessing central lines (rarely done unless we just can't get access, and we use IO drills if necessary). On the med/surg and specialty floors, 90% or more of what is done can be accomplished by an LPN. The remaining 10% can be covered by a good RN charge nurse.

    Are some hospitals hiring more RN's instead of LPN's? Sure.
    Are LPN's being "phased out"? Absolutely not.
    Will the fact that hospitals are hiring only RN's cause LTC's to hire only RN's? HAHAHAHA. Don't make me laugh!

    I think that my "going up through the ranks", so to speak, has given me a different outlook on the various levels of nursing, and I'm thankful for that. So many new grads over the past several years have this attitude of elitism and entitlement, even BSN grads vs. ADN grads. Guess what? LPN, LVN, RPN, ADN RN, BSN RN. We're all nurses.

    (Sidenote: If I could give any LPN's one piece of advice and have them take it, it would be to go back to RN school NOW. You're going to make a whole lot more money for doing the exact same job )
    I was a LPN 7 years before I was a RN, and there are many things that are out of the scope of practice for a LPN (whether you choose to practice outside of your license is your business/this may differ state to state). Not just hanging blood, pushing IVs, initial assessments, and discharge teaching.... But the knowledge base is also different. With that being said, every position should be respected as we all contribute to the healthcare field in our own way. Many LPNs can do things better than an RN (technically), that comes with experience, BUT the truth is - it IS NOT the same job for the SAME PAY. The responsibility is ALWAYS higher for the higher position. As for the "phase out" only time will tell because this has been said for years, its only evident in the hospitals at this time, but even some hospitals are "phasing out" ADNs. The hospitals are large companies who look to see what can bring them "MORE BUSINESS" and "MORE MONEY" thats what it is all boiling down to. Small companies cant afford to do this, so I doubt the phasing is occurring everywhere.
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    Quote from MekBlizz
    BUT the truth is - it IS NOT the same job for the SAME PAY. The responsibility is ALWAYS higher for the higher position.
    We can agree to disagree. I went to LPN school for one year, but it was 40 hours a week for a year with only a few weeks' break inbetween. Compared to an ADN program that's 12-16 hours a week for 4 semesters or a BSN that's 8 semesters (only 4 of which are nursing-specific). In my RN studies, I didn't feel that I learned much more than I did in LPN school. Maybe nominally more in-depth, but very little. Maybe that's more of a testament to the efficacy of my LPN school than anything else.

    The responsibility is higher for an RN. There's no question about that. But, in many areas, the job is exactly the same. Sorry if that hurts some feelings, but it's the truth. It's not true in ALL areas, but it is true for many areas. It's going to be a totally different story in ICU and Oncology where you have a lot of chemo going on or are having to hang a lot of blood, assist with sedation, etc.

    This is also going to vary from state to state due to scope of practice, but it's the same for RN's. In one state that I work in, I can get EJ access without a physician order. In another, I can't even attempt an EJ *with* a physician order. Just one small example.

    I did not mention anything about going outside of scope of practice. Not sure where anyone would even get that from, but it sounds a little passive-aggressive to imply that anyone in this thread suggested going outside of their scope.
    terry8025 likes this.


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