RPNs/LPNs vs. RNs - page 2

I know this has probably been discussed a fair amount on this forum, but as a RPN/LPN that is currently bridging to become a RN, I wanted to share my experiences, questions, and conclusions about the... Read More

  1. Visit  RPN_2012 profile page
    0
    rant, it was very interesting to read about your experience in RPN/LPN to RN education. I'm planning taking the same path, starting the 2 year Practical Nursing program this Sept., and when I'm done bridging to RN. I'm not sure if I'll be doing it through McMaster or George Brow/Centennial and Ryerson, but I'll be doing it because I want to be an RN. Just as I suspected, you said the first year of RN school isn't much different from the PN school, I don't know why they even make that year. I think they should have a 2 year education for RPN/LPN and after that just 2 years more for RN =4 years, without having that transitional/bridging year, and then 2 more years=5 years. I know McMaster has it all in one 3 year program, other programs in Ontario have a 1 year bridging program, then a 2 year Post-Diplma BSN, either way it all ads up to 5 year, instead of the regular BSN of 4 years. ugh. Although sometimes I think it would be nice to just have 1 category of nurses across the country, it very unlikely to happen...
    I just read parts of this document http://www.cna-nurses.ca/CNA/documen...ard-2020-e.pdf
    very interesting... especially chapter 5 Nursing Education in 2020, and chapter 4 Towards 2020: The Road Ahead. They are planning to keep the LPN, RPN, RN roles... but the roads to get there will be different, I think better! Pages 105 to 111 are very interesting... I like some of those education models they are planning to implement. So even if there will be no single nurse category, at least the education and road to different categories will be much better than what it is not (imho)
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  3. Visit  RescueNinja profile page
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    It all boils down to critical thinking. I'm not saying that ALL RPNs lack critical thinking skills and ALL RNs have them, but in my program critical thinking was drilled into us from day one. We were taught how to always expect the unexpected. Because of this, RPNs are ill-equipped to deal with very unstable patients such as in ICU and critical areas of the ER. This is exactly why RPNs are not utilized in critical care areas...at least in my area.

    I disagree completely about RNs having leadership skills being "the only true difference." I know many RPNs that would make far better managers than many RNs. I just graduated and while we did have some classes focusing on learning leadership and management skills, I don't feel prepared to go out and become a DON or a team leader just because I have a BScN under my belt. I don't think that's really what you were getting at with your comment, but I'm just saying.

    I'm not sure how I feel on having just one type of nurse, but I can say that after just finishing a very demanding 4-year program I would be upset if I was making the same thing as someone that just finished a 2 year program. I worked very hard for my degree and feel that I deserve compensation for my 4 years of blood, sweat, and tears. Do I feel that RPNs are underpaid? Yes. Do I feel that RNs are also underpaid? Yep. All nursing is incredibly demanding - it is NOT an easy job.
  4. Visit  linzz profile page
    0
    RescueNinja: Yes, you do deserve to be compensated four your education.

    I also think that in Ontario, there should be far more nursing jobs than there are at this time. In addition, I keep hearing that new grads in Toronto are having a tough time finding work after the new grad guarantee ends. Is this the case all through Ontario?
  5. Visit  RescueNinja profile page
    0
    Quote from linzz
    RescueNinja: Yes, you do deserve to be compensated four your education.

    I also think that in Ontario, there should be far more nursing jobs than there are at this time. In addition, I keep hearing that new grads in Toronto are having a tough time finding work after the new grad guarantee ends. Is this the case all through Ontario?
    Unfortunately yes. There are tons of RN jobs, but they are either being "filled" with RPNs and then left posted as a vacant RN position or not being filled at all since almost all facilities are running in a deficit. Some are also being cut out of the budget completely. Although almost everyone in my class had a job before we even finished classes. Mental Health and ER seem to be the areas where they need the most RNs so people hoping to work there are having an easier time finding jobs...
  6. Visit  Fiona59 profile page
    2
    Quote from RescueNinja
    It all boils down to critical thinking. I'm not saying that ALL RPNs lack critical thinking skills and ALL RNs have them, but in my program critical thinking was drilled into us from day one. We were taught how to always expect the unexpected. Because of this, RPNs are ill-equipped to deal with very unstable patients such as in ICU and critical areas of the ER. This is exactly why RPNs are not utilized in critical care areas...at least in my area.

    I disagree completely about RNs having leadership skills being "the only true difference." I know many RPNs that would make far better managers than many RNs. I just graduated and while we did have some classes focusing on learning leadership and management skills, I don't feel prepared to go out and become a DON or a team leader just because I have a BScN under my belt. I don't think that's really what you were getting at with your comment, but I'm just saying.

    I'm not sure how I feel on having just one type of nurse, but I can say that after just finishing a very demanding 4-year program I would be upset if I was making the same thing as someone that just finished a 2 year program. I worked very hard for my degree and feel that I deserve compensation for my 4 years of blood, sweat, and tears. Do I feel that RPNs are underpaid? Yes. Do I feel that RNs are also underpaid? Yep. All nursing is incredibly demanding - it is NOT an easy job.

    Do you feel that as a degree holding nurse you are better educated and deserve a higher wage than those RNs who attended diploma or hospital base programmes? You are opening an entirely different can of worms with that statement.

    Critical thinking is required by my employer, it's even listed as a requirement in PN postings. My critical thinking skills have been honed by studying a different discipline rather than nursing. Yet, they are superior in nursing areas to many RNs with less than five years experience because I have hands on nursing experience and I've been taught to think outside the box.

    RPNs are registered psychiatric nurses west of Ontario. Do you feel that they don't deserve the same wage as RNs because they are diploma educated?

    Be careful how you answer these questions because many of the Cdn. RN posters are diploma grads.
    CuriousStudent1108 and linzz like this.
  7. Visit  RescueNinja profile page
    0
    Quote from Fiona59
    Do you feel that as a degree holding nurse you are better educated and deserve a higher wage than those RNs who attended diploma or hospital base programmes? You are opening an entirely different can of worms with that statement.

    Critical thinking is required by my employer, it's even listed as a requirement in PN postings. My critical thinking skills have been honed by studying a different discipline rather than nursing. Yet, they are superior in nursing areas to many RNs with less than five years experience because I have hands on nursing experience and I've been taught to think outside the box.

    RPNs are registered psychiatric nurses west of Ontario. Do you feel that they don't deserve the same wage as RNs because they are diploma educated?

    Be careful how you answer these questions because many of the Cdn. RN posters are diploma grads.
    You're twisting my comments into something they are not. I said people who have "just graduated" like myself. So the RNs who have not "just graduated" and have diplomas under their belts also have a wealth of experience which is something I do not have - which is something that THEY should be compensated for. Both of my parents as well as two of my aunts and an uncle are RN diploma grads. If the diploma program was still available you can bet your you-know-what I would not have gone the BScN route, but unfortunately that was not an option for me.

    Critical thinking on paper and critical thinking when you're standing there and your patient is crashing are two entirely different things. Critical thinking also varies from unit to unit. I wouldn't have the critical thinking skills necessary for a L&D nurse and a nurse with no ICU experience probably wouldn't have the critical thinking skills to work where I work. I clearly noted that I was not talking about ALL RNs or ALL RPNs.
  8. Visit  Fiona59 profile page
    0
    No, I'm not twisting your comments, merely replying to them.

    I guess you are fortunate not to be working in western Canada where you will find PNs working in ICUs and ERs and doing a good job at it from what I hear.
  9. Visit  rant profile page
    0
    Quote from mia13
    i just read parts of this document http://www.cna-nurses.ca/cna/documen...ard-2020-e.pdf
    very interesting... especially chapter 5 nursing education in 2020, and chapter 4 towards 2020: the road ahead. they are planning to keep the lpn, rpn, rn roles... but the roads to get there will be different, i think better! pages 105 to 111 are very interesting... i like some of those education models they are planning to implement. so even if there will be no single nurse category, at least the education and road to different categories will be much better than what it is not (imho)
    thank you for the link to the cna document. i agree with your assessment that the pathway into the different "levels" of nursing will be smoother and easier to implement. it may make the lines less blurred whilst experiencing nursing within an academic setting, which may indeed be my current problem. however, i have many, many questions about the feasibility of this plan. for example, i wonder about the ease of transition and difference in scope of practice for nurse i and nurse ii (option 1 of the nursing education models) in a practical setting. they describe the 2020 lpn as becoming a community-based nurse, and the rn as being primary-care based and as a coordinator of community health. what implications does this bear on the current nursing paradigm? does this mean that lpns working in primary care may lose their jobs within this new construct? and what of the rns working the frontlines in community care? how does the cna plan to incorporate currently practicing nurses into this paradigm? i have to wonder if this microcosms-within-macrocosms nursing philosophy (having a specialized nurse for each type of health care, equaling dozens of nursing "specialists") isn't complicating our profession further and, in fact, narrowing our ability to be holistic healers.

    regardless, your post made me realize the immaturity of my argument. the cna document has answered many of my questions, but has also opened up many new ones. for the future of the clarity between the lpn and rn roles, i have less fear. the new nursing education models seem to take care of that very well, if they can be properly implemented. so thank you. i appreciate it. you're going to make an excellent nursing student and nurse, by the way. you're already well-versed in intellectual humility and evidence-based practice.
  10. Visit  RescueNinja profile page
    0
    Quote from Fiona59
    No, I'm not twisting your comments, merely replying to them.

    I guess you are fortunate not to be working in western Canada where you will find PNs working in ICUs and ERs and doing a good job at it from what I hear.
    Don't know why I'm fortunate r/t that, but we have RPNs working in ERs here too - just not the critical areas. I never said they COULDN'T I just said they don't in my area.
  11. Visit  linzz profile page
    0
    I also find the CNA document appears to be very accurate in some ways, yet it seems to be overlooking a lot of economic realities and the effects of the political power certain professional groups will exert if you cut into their turf.

    I also dout that only LPN's will be in the community as there are many RN's who really prefer to work in community nursing and they aren't going to be willing to just step aside. Also my area has a lot of cancer patients that really need a lot of advanced care.
    Last edit by linzz on Jun 12, '10
  12. Visit  RPN_2012 profile page
    0
    Quote from rant
    Thank you for the link to the CNA document. I agree with your assessment that the pathway into the different "levels" of nursing will be smoother and easier to implement. It may make the lines less blurred whilst experiencing nursing within an academic setting, which may indeed be my current problem. However, I have many, many questions about the feasibility of this plan. For example, I wonder about the ease of transition and difference in scope of practice for Nurse I and Nurse II (Option 1 of the nursing education models) in a practical setting. They describe the 2020 LPN as becoming a community-based nurse, and the RN as being primary-care based and as a coordinator of community health. What implications does this bear on the current nursing paradigm? Does this mean that LPNs working in primary care may lose their jobs within this new construct? And what of the RNs working the frontlines in community care? How does the CNA plan to incorporate currently practicing nurses into this paradigm? I have to wonder if this microcosms-within-macrocosms nursing philosophy (having a specialized nurse for each type of health care, equaling dozens of nursing "specialists") isn't complicating our profession further and, in fact, narrowing our ability to be holistic healers.

    Regardless, your post made me realize the immaturity of my argument. The CNA document has answered many of my questions, but has also opened up many new ones. For the future of the clarity between the LPN and RN roles, I have less fear. The new nursing education models seem to take care of that very well, if they can be properly implemented. So thank you. I appreciate it. You're going to make an excellent nursing student and nurse, by the way. You're already well-versed in intellectual humility and evidence-based practice.
    Quote from rant


    Thanks rant and you very welcome, that document is indeed interesting, and yea it brings up a lot of new questions... I wish I had the answers to . I didn't even know of this 2020 plan until someone on this tread mentioned something about it so googled it, and found that CNA document.
  13. Visit  2bNurse-88 profile page
    0
    Quote from rant
    I know this has probably been discussed a fair amount on this forum, but as a RPN/LPN that is currently bridging to become a RN, I wanted to share my experiences, questions, and conclusions about the inherent differences between the two nursing roles.

    I completed my RPN program in June 2007, and immediately enrolled into the bridging program at McMaster University in Ontario, Canada in September 2009. I have since completed my first year of university towards my BScN.

    Before I begin, I would like to note that I have not yet experienced a clinical rotation in the RN role (that begins this year). So the viewpoint that I will be representing is purely from an academic perspective, and not a practical one. I realize that this may be severely impacting upon my bridging experience.

    It is my belief that there should not be two types of nurses. And when I say this, I do not mean to say that one is better than the other. Upon the contrary, I believe that RPNs and RNs have a similar breadth of knowledge and that there should no longer be a segregation in pay, entitlement or recognition between them.

    I acknowledge that this may sound like some sort of "RPN paranoia" against RNs, but please be assured that is the farthest thing from the truth. I am not saying RPNs are "better" than RNs, at all. But I am not, as yet, willing to concede that in their base ACADEMIC knowledge, RNs are very much more superior than RPNs.

    Having gone through one year of RN training in the science-based aspects of the discipline, I can honestly and truthfully say that there wasn't much that I learned this year that went beyond the scope of the RPN. Our physical assessment course was identical to that of the one I took in my RPN program. The anatomy and physiology course was identical, as well. Pathophysiology with a pharmacologic inclusion was a new course that I had not taken, but (and perhaps it was because of the professor and her choice of course planning) I do not feel as though I walked out of the course feeling like I had a superior amount of knowledge prior to the amount that I had walked in with. The course material was very basic, and very rushed. I anticipated that I would be learning common and complex disease states for each system of the body, and how to treat them pharmacologically. However, we focused on basic/common concepts like inflammation and common CV/resp diseases. Pharmacology barely came into it, and I felt very disillusioned. I felt, truly, that I had learned much more in the first year of my RPN program than I had in my first of the RN program.

    Many of the RPNs that I have worked with have clinical skills that equate that of the RNs. I have been told many times that the only true difference to be found between RNs and RPNs are leadership skills. I am starting to believe this is true. Because although many RNs have superior disease/pharmacology knowledge to RPNs, I believe this only because of exposure. RNs are granted access to more complex and unstable patients, and it is THIS that gives them the superior knowledge. It is, from what I have seen thus far, not because of an inherent difference in their education.

    It seems to me that there should no longer be two types of nurses. But I don't know what to do with that feeling. Because to suggest that we should remove RPN education seems ridiculous. And doubly so to say that we should remove RN education. But I feel as though this dichotomy is causing a rift in our profession. RPNs get paid almost 40% less than RNs for the same clinical skills. RNs get replaced with RPNs who don't have as much knowledge simply because institutions can pay them less.

    I don't know what to do, or how to feel. And it hurts and saddens me greatly. I would appreciate any thoughts on this matter. It is deeply appreciated.
    First off, I'd like to say, HATS OFF TO YOU! It is very heart warming to see someone who truly looks at the two professions as equals, rather than thinking one is better than the other, you are GREAT for that!



    If becoming an RN is your ultimate goal, then go for it! I initially applied to the RPN-RN bridge as well. I'm going into my 4th semester of RPN at Mo-Mac (same campus you're attending!), but I recently withdrew my application to the bridging program simply because the uncertainty of jobs for RN's right now & I'm sure you're aware of this as well. I have a few friends who, God bless their soul, are new RN grads & are struggling a great deal in finding a job, as well as the gov't likely removing the new-grad initiative for RN's shortly, simply because they are in e deficit, and cannot afford the high max out pays of RN's. Know that throughout most of the GTA, RN's and RPN's start out making almost the same amount. My bestfriend is an RPN in a Toronto hospital, graduated one semester ago, and is making $26/hour + 14% in lieu of benefits, so she's at $28 and some change/hour. Her RN co-workers are at $28/hour, plus their 14%.

    The BIG problem the gov't is having with RN's, is not their starting pay, it's the long-run costs, when RN's are maxing out at $50/hour, and RPN's are maxing out at nowhere close to that ($35/hour at most), the gov't sees this as a huge money saving idea, and that's all.

    They've started introducing more skills into the RPN program now as well too, blood transfusions & I.V therapy. It's just that in the past, RPN's didn't get to work to their full scope of practice because RN's were doing these things, even though RPN's knew how to do these skills as well, now, they're doing them everywhere, so schools are pushing the skills much harder/stricter than before, when they just skimmed through material. Don't be fooled though, as this trend continues to happen, and more and more RN's are let go, with RPN's being brought in, you can bet RPN's will be demanding a raise in pay. Not equal to RN pay, but they will likely want a bit of a higher max out rate.

    It's unfortunate this is happening. My handful of RN's friends I do know, are considering moving a far distance to secure employment, because they cannot find anything here (in the GTA), and it's horrible. My goal was to get my BScN & eventually do a Masters & possibly do the NP program (that would be my ultimate dream!), but I made the decision to finish my RPN now, and get out into the workforce while it's good, and pay off my student loans, and then see where the road takes me from there.

    Never give up on your dream though! I applaud you for going through the bridge, and wish you the best! I hope to be in your shoes one day soon
  14. Visit  2bNurse-88 profile page
    0
    Quote from loriangel14
    I am an RPN and I am responsible for my patients, not the RN on the floor. I work under my license, not hers.
    Yes, exactly. We're all responsible for our own patients. Not sure what hospital he/she works at, but most hospitals don't have one RN who's liable for the whole ward, we all work under our OWN license, RN's & RPN's. It's a legal issue as well, why would one RN be responsible for 100 patients, when 80% of them aren't even hers? Makes no sense, if a legal issue were to ever come of a situation.


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