More Use of LPNs In Acute Care Settings

psu_213, BSN, RN · Mar 30, 2011

She could then concentrate on other things and or use her time to bring about all those better outcomes we keep hearing about.

So does that mean that the LPNs would only help the female RNs?

evolvingrn, BSN, RN · Mar 30, 2011

My concern is that they are too expensive to use as 'nursing assistants' so they end up giving them a full pt load and 'teaming' them with an Rn so that an Rn ends up twice the number of pts that legally she/he is responsible for. That certainly is not reducing my burden , but increasing it. when i float as a rn most of my night is spent doing task that lpns aren't allowed to with their pts, iv meds ect..... We have great lpns where i work and i do think there is a place in healthcare for this role but i think in acute care, where pts aren't stable ....lpns should not be used.

mama_d, BSN, RN · Mar 30, 2011

We're being phased out where I am as well. Once the large teahing hospital here went Magnet and eliminated all their LPN positions, whilst advertising the superiority of a RN only nursing staff, other hospitals had to follow suit to stay competitive. I'm lucky...my facility didn't fire us all, just are really pushing for us younger (loosely said!) LPNs to get our RN.

Personally, I'd hate to be put in the role where I was teamed with another nurse with the same pts. Where I'm at we take our own teams with no more oversight than the RNs working the floor have. That includes every setting from stepdown down...just can't work the unit or ED. It works well for us, but I don't know how our scope of practice compares to NY's.

It does seem remiss that there's not some way to get LPNs back at the bedside in acute care. We're cheaper labor, so one would assume that with a few more of us mixed in the staffing ratios might improve. I know for a fact that a RN with the same years of experience in the same setting as I've been in makes about $10/hr more than I do...so if they used LPNs more instead, theoretically, they could also afford an extra tech to work the floor with very little difference in the budget. Although I'm certain that's totally unrealistic thinking on my part.

allnurses Guide · Mar 30, 2011

When I started we had no CNAs (called "ped techs"at Children's) both LVNs and RNs did total care on their patients and the RNs hung the IV meds. We had an IV Team or the residents would start the IVs. Everyone seemed to really like that arrangement. I loved it, especially in our DOU with 3 patients each. We worked together on the other less acute side as well, as who can feed 6 babies at once? :) It seems like the pendulum swings from team to primary and I caught the primary wave. Even those places where "team" nursing was in favor I never saw the strident turf-protecting attitudes I see so often nowadays. I will never understand that. I was gone for a while with family so it seemed all the more jarring when I came back.

Perhaps now would be a good time to point out that I know there are male and female nurses, doctors, etc so I don't get my knickers in a twist if someone omits including both gender pronouns from time to time.

olivia60 · Dec 15, 2013

Yes, you hit the nail on the head. Medical care costs are out of control in this country and yet the hospitals still continue to find ways of taking care of patients the cheapest way possible. Who wants to work for an employer who does not care about you? Why in the world did they every phase out LVN's? I was an LVN at one time. I think that is just bad business. I bet those places have a high turnover of their nurses.

AngelicDarkness · Dec 15, 2013

Maybe just in the USA. Up North we use lpns a lot but the role varies from area to area.

OrganizedChaos, LVN · Dec 16, 2013

It's a business thing. Medical assistants/techs cost less to pay & can still do a lot. I understand why they're doing it, but I don't like it.

smartnurse1982 · Dec 16, 2013

What about having the Adn's under the Bsn?

I understand both are nurses,but with the talk of phasing out Adn's....you get the idea.

Fiona59 · Dec 16, 2013

I'm an LPN in Canada. We are not even being threatened with being "phased out" of Acute Care. I have spent nearly my entire career in Acute Care.

LPNs are cost effective and skilled nurses. I admit, educate, do all care and meds for, and discharge my own patients under my own practice permit. RNs are pricing themselves out of the market with their wage demands either that or LPNs are being sorely underpaid for their skill set.

SquishyRN, BSN, RN · Dec 16, 2013

What about having the Adn's under the Bsn?
I understand both are nurses,but with the talk of phasing out Adn's....you get the idea.

Unless ADNs and BSNs are no longer taking the same NCLEX for licensure, there should be no reason the degree should determine one RN being under another at the bedside. That is why two levels of nursing licensure, RN and LPN, exist already.

NurseQT · Dec 17, 2013

When I first started out as a CNA 15 years ago there were LPNs that worked in acute care. By the time I graduated from the PN program most of those positions had been phased out and/or replaced with RNs. Positions for LPNs were limited to LTC, home care, and hospice. Nowadays LPNs are being phased out everywhere. LTC facilities want only RNs and acute care wants BSN RNs. Clinics want RNs and MAs, at least in my area.

With all the Medicare cuts and the very slow recovery of our economy the refusal to utilize LPNs doesn't make financial sense to me! LPNs have the skills and license to work in most of the areas of nursing.. In my state LPNs can become IV certified through their employer... The LTC facility decided to go with only RNs for floor nurses, the rehab/Medicare wing staffs two RNs on days and PMs...so on Days and PMs there are 4 RNs on the floor plus the charge RN on each of those shifts. During the day there is also the DON and MDS nurse. Four RNs at $25+/hr, when it could be two RNs and two LPNs at $17/hr.. The facility will staff all RNs but than cut financial corners by staffing the bare minimum in CNAs and not give any raises.. Doesn't make sense!