Are LPN's going to be phased back into the hospital settings?

smartnurse1982 · Apr 24, 2014

There are a lot of RNs that will tell you that CNAs just can't do enough to really help them. I'm a CNA, I have been one for 3 years and I love my job. I'm soon to be an lpn. CNAs can't help nurses with anything except for dressing and maybe prime IV tubing. That's it. They can't pull meds, give meds, call the doctors... I live in nc where LPNs can do quite a bit. Except for blood products and care plans we can pretty much do what a RN can do. So, I'm sure that most RNs out there are 1. Delegating already because you have CNAs under you. And 2. They would love the help of an LPN when they have 4 patients calling out for pain meds at one time when they still have to chart or have a lot on their plate. And by the way even though the LPN works under the RN, the LPN is still responsible for their actions and scope. I don't see any reason why LPNs can't work in a hospital setting, they did for many years and the only reason why they still aren't is because of magnet.

Actually,in some places Cna's can give meds. They are known as med aides.

There is nothing wrong with lpn's working in the hospital,but to say "lpn's can do what Rn's can do but cheaper" is wrong.

Of course,if he talking just skills,he is correct,to some extent.

There is more to nursing then skills.

Nursing is more than a skills based "profession"

Otherwise,a Cna can say "Nurse techs and med aides can do the same things Lpn's do but cheaper".

smartnurse1982 · Apr 24, 2014

My point was that in almost all cases the LPN is responsible for an error not the supervising RN which another post suggested otherwise.

There is a thread on the General forum where a nurse manager lost her license because of the poor care of the nurses under her.

mfigueroa22 · Apr 24, 2014

There is a thread on the General forum where a nurse manager lost her license because of the poor care of the nurses under her.

A manager is a completely different story. I am talking about RNs on the floor working with and along side LPNs providing care. Of course if you are in a manager role. You are responsible for everyone under you. And your boss is going to hold you accountable for everyone under you. If your employer decides to fire you it would to do with the management side of things or something you have done as a manager, not what an individual has done under you. But still, even if you are a manager you can't get disciplined by the Board of Nursing if an RN or LPN under you makes an error. That would be the RN or LPNs fault and they would subject to discipline.

Esme12, ASN, BSN, RN · Apr 24, 2014

A manager is a completely different story. I am talking about RNs on the floor working with and along side LPNs providing care. Of course if you are in a manager role. You are responsible for everyone under you. And your boss is going to hold you accountable for everyone under you. If your employer decides to fire you it would to do with the management side of things or something you have done as a manager, not what an individual has done under you. But still, even if you are a manager you can't get disciplined by the Board of Nursing if an RN or LPN under you makes an error. That would be the RN or LPNs fault and they would subject to discipline.

Not true. While it is unusual it does happen.

You are basing your assumptions on YOUR BON in YOUR STATE. Yes each nurse is responsible for herself/himself...but the RN is still responsible over all as the highest license present. Depending on the Nurse practice act of each state the RN is still responsible for the patients as is the LPN. Each nurse is responsible for their actions but the higher license is responsible to ensure that appropriate care and practice as well as appropriate delegation is being utilized for patient care. The RN is still responsible for the higher level of care because he/she is supposed to "know better".

I have seen the RN LPN and manager/supervisor all fall for one individuals action. Even in what you posted it states the RN is responsible and the LPN participates.

mfigueroa22 · Apr 25, 2014

Not true. While it is unusual it does happen.
You are basing your assumptions on YOUR BON in YOUR STATE. Yes each nurse is responsible for herself/himself...but the RN is still responsible over all as the highest license present. Depending on the Nurse practice act of each state the RN is still responsible for the patients as is the LPN. Each nurse is responsible for their actions but the higher license is responsible to ensure that appropriate care and practice as well as appropriate delegation is being utilized for patient care. The RN is still responsible for the higher level of care because he/she is supposed to "know better".
I have seen the RN LPN and manager/supervisor all fall for one individuals action. Even in what you posted it states the RN is responsible and the LPN participates.

What your employer does and what the board does is two different things. As I stated I'm not saying you can't get fired but you are not subject to discipline by the board in nc.

smartnurse1982 · Apr 25, 2014

I worked as an Rn briefly in NC and Sc.

They did have some weird things going on,but i think Nj may be unique in that lpn's can even insert G-buttons nor Ngt's if they come out.

Did you know Cna's can be trained to insert IV's?

The Cna's have levels.

Also,it was not that Rn's do not want to work in Ltc,but many places did not hire them in Nc.

Why? i have no idea.

I had seen ads down there for level 2 Cna's.

xoemmylouox, ASN, RN · Apr 25, 2014

Back to the topic at hand.. Again LPN's can provide great patient care in all settings. They could serve a purpose in acute care such as hospitals, but are not utilized very often in this setting. More and more often hospitals are requring BSN nurses even leaving ADN's out in the cold. Times are a changing, but as with all things who knows what the future holds. More often than not things have a way of coming back around. In 15 years maybe hospitals won't want RN's and will hire a load of LPN's again. In the meantime we just make the best of things and should be SUPPORTING each other and doing what is best by our patients, while surviving the ever changing minds of Administrations and BON's.

LadyFree28, BSN, LPN, RN · Apr 25, 2014

I found it interesting with all the statutes and research (such as the one that put out the research on mortality related to BSN) that comes out of PA that they are one of the few states who do not have a statement on delegation in their statutes.

Yup, we don't; due to the vast areas that need nurses in the most rural areas; there are places that will need to use an LPN in their full scope; as a former LPN who has worked in the Philly area; there were technologies around a IV push; and I was also IV therapy certified where at one employer I could draw off PICCs and access Broviacs; now that there are many complex pts in acute care, it's not happening as much; however, PA is a pretty big state; I am sure there are many LPNs exercising their full scope (only exception is hanging blood currently; may have changed...) in addition to our states association that have LPNs to DNPs that serve do make for a more "inclusive" influence...

sistrmoon, BSN, RN · Apr 28, 2014

I'm in Capital District NY state. I'm in a large teaching hospital. We have one LPN on our floor(Oncology) and she's been there for many years. She sometimes works as a care partner and sometimes she's put into an assignment and the RNs cover her for things like central lines, IV pushes, etc.

cinlou, BSN, MSN, RN · Apr 28, 2014

Yup, we don't; due to the vast areas that need nurses in the most rural areas; there are places that will need to use an LPN in their full scope; as a former LPN who has worked in the Philly area; there were technologies around a IV push; and I was also IV therapy certified where at one employer I could draw off PICCs and access Broviacs; now that there are many complex pts in acute care, it's not happening as much; however, PA is a pretty big state; I am sure there are many LPNs exercising their full scope (only exception is hanging blood currently; may have changed...) in addition to our states association that have LPNs to DNPs that serve do make for a more "inclusive" influence...

AZ just past the law a few years ago that LPN's can draw of PICC lines and maintain them. When I was an LPN in NY we used Buritrols/solu sets, to put the pain meds in, in about 10cc and run it in, this alleviated having to give IVP.

AZ is mostly poor rural as well, I expect many things to have to change as the east coast does it will eventually move this way I believe

cinlou, BSN, MSN, RN · Apr 28, 2014

I worked as an Rn briefly in NC and Sc.
They did have some weird things going on,but i think Nj may be unique in that lpn's can even insert G-buttons nor Ngt's if they come out.
Did you know Cna's can be trained to insert IV's?
The Cna's have levels.
Also,it was not that Rn's do not want to work in Ltc,but many places did not hire them in Nc.
Why? i have no idea.
I had seen ads down there for level 2 Cna's.

Phlebotomists have been trained to insert IV's at one hospital I worked in here in AZ. CNA's used to be able to put in Foley's and do other tasks, not sure if they still can in any states, so much often depends on the facility, and the additional training provided.

LadyFree28, BSN, LPN, RN · Apr 28, 2014

AZ just past the law a few years ago that LPN's can draw of PICC lines and maintain them. When I was an LPN in NY we used Buritrols/solu sets, to put the pain meds in, in about 10cc and run it in, this alleviated having to give IVP.
AZ is mostly poor rural as well, I expect many things to have to change as the east coast does it will eventually move this way I believe

Eh, what I learned about PA as even though it's on the east coast, it still likes to hold on to "classic" forms of operating things; granted healthcare has evolved rapidly, especially recently...