Nursing Shortage or not???

I don't think that we are discredited so much as viewed as problematical. We can not, technically, work without the direction of an RN. We are somewhat limited in our scope of practice. I will guess that many RN's don't want the responsibility of putting their licenses on the line overseeing LPN's.

I'm in a rural area and LPN/LVN's are still very much alive. However, you are also more likely to get a PA or NP than a doctor in the ED, and shipped to a more advanced facility if presenting with anything complex.

The delegation responsibility for an RN is the same whether or not the person being delegated to is an LVN. Hospitals seem to be using techs in positions formerly held by LVN's. In effect, as an LVN you're overqualified.

Yup. Cheaper, and the same exposure.

Here I go again, like a broken record!!!

There is no true nursing shortage. This is evidenced by the 500,000 RNs and numerous LPNs/LVNs who possess active licensure in the U.S., but refuse to participate in the nursing workforce any longer.

There's a shortage of nurses who will repeatedly deal the with overall disrespect and despicable bedside conditions for crappy pay rates.

I work for a hospital that only has a few LPN's working with the inpatient population for some of the same reasons you name.

Part of the reason for the selection of CNA's over LPN's relates to the physical design of the units. Our hospital units are collections of small "pods," each holding anywhere from 4-8 patients. That design has become popular in recent years -- though it has both its advantages and disadvantages. As a tertiary care center, many patients have a pretty high acuity level and require a lot of RN involvement.

So the question became, what's the best staffing mix for these pods? Do we staff with 1 RN per pod and an LPN? 2 RN's? 1 RN, 1 LPN and 1 CNA? etc. etc. etc. After a lot of discussion, it was decided that having 3 levels of care providers in these small pods would be too confusing. Roles would overlap too much and it would be hard for the staff to decide who would do what. So, we decided that we would only have 2 levels of care providers -- and the LPN's are overqualified to (and too expensive) to be used as assistive care givers. Thus, the decision was made to go with RN's and CNA's in most units.

We have a few units where we use LPN's instead of CNA's because the patient population includes enough less acute patients that appropriate assignments can be made for the LPN staff. The LPN's can meet most of the patients' needs and only need ocassional assistance from the RN. But on most of our units, the LPN's would need so much assistance from the RN's, it makes more sense to assign an RN to the case with the assistance of a CNA.