Why Does It Seem That RN's Hate Us and Hospitals Don't Believe In Us?? - page 6

Im a new PN grad and have been a STNA (state tested nurse assistant) for 7 years; but as a graduate it seems that RN's are threatened by PN's or feel that we don't know anything and hospitals dont... Read More

  1. by   BKRN
    to scorp75.... Yikes, I just moved to NC-I will have to research this. I just submitted my application for endorsement.
  2. by   BKRN
    Quote from scorp75
    To bklpn- depending on which state you work in. In NC, LPNs work under the RN's liscense.
    Scorp75, I have read through the nurse practice act for NC, it does state that LPN's work under the supervision and direction of a RN (which is the norm across the board)-but not under their liscense. Could you point me in the direction that you received this information. I just moved to NC and am curious. Thanks.
  3. by   christvs
    I'm a new RN (graduated in May 2005 with my BSN). I work on a med/surg/tele unit with RNs and LPNs and CNAs-we have a team nursing model we use. I personally have no problem with working with LPNs. I understand they are not allowed to push IV meds, hang blood, or do admissions. Yes it can get frustrating for me if it is a busy day but that is just the way it is, so I deal with it. I am grateful I have an LPN to work with (we team up to take care of up to 10 patients together) cuz otherwise there is just too much to do for one nurse. In Mass, the starting pay at my hospital for new RNs is $24.33/hour & for new LPNs it is $17.87/hour. (not including differentials).
  4. by   NYCRN16
    Quote from bklpn
    Scorp75, I have read through the nurse practice act for NC, it does state that LPN's work under the supervision and direction of a RN (which is the norm across the board)-but not under their liscense. Could you point me in the direction that you received this information. I just moved to NC and am curious. Thanks.

    I dont think in any state and LPN works "under an RN's license", but I understand what the OP meant by this. For example, an RN must assess every patient on the floor initially and then periodically, even if the LPN is assigned to this patient. Documenting initial assessments are legally out of the scope of practice of and LPN in all states, so the RN is legally responsible for assessing the patient during his/her shift. The LPN is allowed to reassess for changes in condition, but is not ultimately responsible for this, the RN is. If the patient crashes, the RN who is overseeing the care of the patient is going to be held more accountable than the LPN since they are held to a higher standard legally. An example of this that I learned while I was taking the Kaplan review for the RN boards, dealt with delegation to LPN's and thier scope of practice with assessment. Legally, the RN cannot say to the LPN "Walk Mr. Jones down the hall and tell me how he does". The RN legally must say "Walk Mr. Jones 100 ft down the hall. If he gets tired, dizzy or experiences chest pain tell me right away". In the real world we know this doesnt happen, but legally if the LPN did walk Mr. Jones down the hall and he had an MI and died because the RN did not reassess the pt after being walked, the RN is going to be held accountable, not the LPN because according to them, you cannot leave the assessment to the LPN even though they can recognize and adverse effect. Below is a great website that explains the differences.
    http://lib2.hacc.edu/nursing/nursing...les/frame.html
  5. by   Qween
    I goofed trying to post the message. Sorry.
    Last edit by Qween on Jan 5, '06 : Reason: Meant to quote the individual to whom I was referring.
  6. by   Qween
    "in most facilities, charging is the highest you will ever get to with an adn. so as you are charging over bsn & msn's but soon one of them will be your manager or administrator. so education does count in the long run, trust me."

    remember also, not everyone aspires to be an administrative nurse or an educator. that said, whether or not one seeks a bsn or higher (as related to rn's) depends on how far they want to go with their scope of practice. for the rn (diploma, adn) who is satisfied working on the floor or charge, i definitely see no reason for him/her to seek a bsn or higher. just my two cents.

    btw, i am only a nursing student in my senior year. i don't mean to come off in any way that is offensive. i am new to this site and thought i would give some input to the subject.
    Last edit by Qween on Jan 5, '06
  7. by   nursemelani
    Quote from BigB
    IN the hospitals here , RN make $36+ an hour, LVN's $18. The RN's definitly don't have a problem with the pay lvn's get here. In acute care hospitals in northern california, lvn ONLY do meds. NO charting, no assessments (not even pain assessments), no IV meds. RN's may resent the fact that LVN's only give PO and injectable meds.
    Wow- Can I ask what large city you are near ? I am an LVN near Sacramento, and I know that the LVNs around here do more than just meds. Also, in the SF Bay area, I have LVN friends who are making 27 dollars/hr, which they should be, since they are doing everything the RNs do, except IV medications.
  8. by   ProfRN4
    [font="comic sans ms"]you know, either i'm going crazy (which is highly likely ), or this thread is!! i'm getting e-mails with replies that are not showing up (very nasty ones, i might add). are they being deleted by the mods

    at any rate, this thread is turning insane why do people have to get so nasty about this subject? a friendly debate is one thing, but c'mon... some of you guys really need to grow up. some of these slanderous remarks (if anyone else can see them) are not based on anything. name-calling?? and based on some of these responses, i think we've answered the original question (but still haven't answered why).
  9. by   grinnurse
    I can't answer the question of why these things happen in nursing but I am assuming this is another part of nursing that we should all try to change.

    As a new grad, a student, and a therapy tech prior to NS, I learned alot from each level of nurses. As a new grad, there is no way that I will know as much as an experienced LVN and would never pretend to know that much. I respect my LVNs immensly-I have learned invaluable information from them on the floor for the past 6 months. Starting out at the hospital I am making the same as our LVNs (experienced) but it doesn't bother me b/c I feel that being as new as I am to the profession and not knowing as much as them it's fair. Right now, I feel as if I am being paid for the amount of education time that I have with the thought that I eventually will have a higher earning potential as I gain more experience just as it should be for every nursing level IMO. I am always encouraging them to continue their education as well as the aides so they can truly be paid what they are worth.

    The LVNs at our hospital do everything the RN does with the exception of hanging blood. They can do the initial assessment if an RN signs off on it which could get annoying if it happened very often. Our little rural hospital has more RNs than LVNs and alot of the Dallas area, or so I have heard, are phasing out the LVN positions all together.

    Just my

    Lovin all the nurses!!
  10. by   Alexsys
    I personally never had a problem with LPN's, When I went to nursing school,(ASN) I carpooled with three of LPN's that were going for their RN's. They would quiz me before an exam and breifly schooled me on dosage calculations right before the program started. I was a CNA at first, then went to school to become a MLT, did that for a while until two LPN's convinced me that nursing would be a great career choice. So now I am thankful to them (LPN's) for that. Unfortunatley the hospital I work at does not currently employ LPNS, but they do work in the clinic. So the RN vs LPN really should not apply to every nurse in general. There is always going to be some type of animosity there. I had it towards LPN's when I was a CNA, but only because of a bad experience, I realized that I was generalizing and with nursing, no matter what type of nurse you areis you enjoy your field and what you do and that will make a good nurse wether you are LPN or RN
    Last edit by Alexsys on Jan 8, '06
  11. by   brandee_stanton
    I'm 26 and have been an LPN in Chicago for 8 years and noticed different attitudes depending on the type of skill level required for care, i.e. nursing home, clinic, MD offices, etc. Although I have a variety of experience, most is concentrated in long term care facilities, where I have noticed that RNs mostly hold administrative and supervisory positions where the LPNs essentially run the the hands on clinical care. I have met RNs that didn't know how to reconstitute antibiotics in a piggyback, or don't really know how to chart. I've seen LPNs that could start an IV quicker than the DON. I've oriented tons of RN's and not only that but LPNs that were nurses "before I was born!" I spoke to an RN that had left the hospital scene and she was a total wreck in the nursing home. I gathered that it wasn't her level of education that was holding her back, yet her experience in that type of setting. She was used to charting on the computer by selecting fields that were appropriate and answering questions where she was prompted, while manual documenting was time consuming and difficult for her because she had to use her memory and knowledge of the specific patient to prompt her on what to chart on. She wasn't used to doing as much work like hanging feedings, flushing G tubes, doing wound care, performing trach care, collecting specimens, etc. In her particular hospital setting, her work was not that involved or intense. She quit after 1 week. It is true that some individuals with "more education", meaning longer time spent in school or more advanced degress, believe they "know more" than others without the same. That is not necessarily true. My experience in the nursing home setting makes me a more valuable and knowledgeable asset than an RN who has no experience in that setting. I think it should really boil down to what you can do and not what your "education" says that you know. Of course it works both ways. You don't need a nurse that doesn't know or know how, regardless of the level of education or experience, but companies should be willing to train. They'd save more money. I get paid less than the RN's I work with because of their degree level, but I am the nurse that is chosen to work the most skilled, ventilator dependent side of the unit. Why? Of course its not because I went to school longer or because I have a higher degree. Its because I give excellent patient care and they need it the most, no other reason! I am disappointed however at the lack of clinical positions available in Chicago hospitals for LPNs. Most are concentrated in long term care settings or clinic outpatient settings. I would love to work in a hospital setting for the experience and also because I would be exposed to more facets of nursing. I believe that if healthcare institutions really want an RN, then they should be willing to offer paid education for the many LPNs who want to become RNs. Is there really a nursing shortage or is it that companies only want a particular kind of nurse? I always hear of companies that pay for the ASN RNs to go get their BSNs. Why not assist the LPNs into the ASN or BSN as well? I would hate to see the eventual phase out of LPNs. It's funny though, 8 years ago my LPN instructor made it seem like people would be banging on our doors to come work for them. It didn't exactly turn out that way. I think the bias would be eliminated if more healthcare settings could see the value of having different levels of education and expertise. When it comes down to it, letters behind your name doesn't mean a thing if you can't provide excellent patient care. And that goes for the CNA, LPN, ASN. BSN, PhD, MD, etc!!!!!!!!
  12. by   leamom2
    the hospital where I work treats the LPNs great. We are all IV certified and take anywhere from 5-7 pts on nights. We can't no admit assessments or hang blood or do pushes, but we are allowed to take a lot of resposibility for our patients. I think that the system works well. The difference in pay is only about $6 per hour, but the RN do have a lot more resposibility as far as staffing, and ultimate judgement calls on anything dicey. A lot of a happy work environment is a good attitude and willingness to work together.
  13. by   PurpleHairUnicorn
    Sorry, this is gonna be a long one......I have been an LPN for 15 years and have worked in 3 different states. (Oh,Ga,Il). My personal experience has been that SOME of the newer grad RNs are a little bit intimidated by the hands on experience the LPN has. I have worked with some who have never started an IV. When I received my IV cert., I had to complete a 40 hour classroom course, pass a written exam, and then perform 25 successful IV starts. The policy was, you could be trying to start your 25th IV, but if you missed 3 times you had to start the "stick" portion all over, and if you missed 3 times again before 25, you had to retake the class. This did cause some resentment from the newer RNs, especially the ones with BSN degrees from the local universities. (This was in Ohio). When I moved to Ga., the one hospital I worked for used LPN's as "Designated Medication Nurses". That meant that I passed meds to the entire unit (1 nurse to 22 patients).THAT really caused resentment because then the RN's had to do direct patient care. I heard more than one say "I didn't go to school for X amt. of years to put people on a bedpan" I left that hospital and went to work at another one in the Atlanta area where the only things I couldn't do in that hospital (2003) was spike the blood (I could go get it, verify it with an RN, set up the flush, monitior the pt. for a reaction, and at this hospital I could dc the transfusion if needed) I could push IV meds, cardiac meds if they were on a monitor, take phone orders and do admission assessments. They were glad to have LPN's. Now I live and work in central Illinois and am planning to get my RN (dependent on my husband getting his consulting contract renewed), because I have found that at least around here, my experience and certifications are useless. My point is, I think it varies from state to state and person to person,however I do feel like I get blown off more when I see something is incorrect(like crush toprol xl and give via g-tube, yeah if you wanna bottom out their blood pressure and maybe kill them) and the RN's learn that I'm "only an LPN". I must say I do get some satisfaction from the look on their faces when they find out I am right. My other thing is there will be 3 RNs for 60 residents on eves, I work nocs, I come in and they have things they didn't get to, could I? BTW I am by myself on nocs, with an am med pass for 30 residents,2 gravity feeds,4 g-tube flushes, 4 cath flushes, 2 straight caths, and whatever other txs there are, and charting on 16 medicare residents on top of fall vitals. It ALL gets done on my shift. Wow, now that I write that out, I can see why they're intimidated, 3 of THEM,20 residents a piece, a desk nurse through the week, and the little ol lpn comes in and gets it ALL done (just a joke, just a joke) .....

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