RPNs/LPNs vs. RNs - page 3

by rant

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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... Read More


  1. 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.
  2. 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.
  3. 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
  4. 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.
  5. 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
  6. 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.
  7. 0
    Quote from Smith.C74
    From what I've seen, there are some areas of work that seem to be restricted to RNs. I don't doubt the fact that RPNs are being used more as a cost cutting measure (2 RNs @ $30/hr = 3 RPNs @ $20/hr - more people to spread the work around to). In some settings, RNs seem to hae more of an administrative roll.

    I don't agree with the segregation of the different levels of nursing. They have to be able to work together and the segregation doesn't help when there seeems to be so much bitterness betwee the 2 groups.
    Nowhere in the GTA do RPN's make $20/hour. Where I work our HCA (or PSW's make that pay), and RPN's get $25/hour + 14% in lieu of benefits. The reason for the cutting of RN's is because of the long-term savings the hospitals will benefit from. The max out rate for RPN's is much lower than the $50 max out rate for RN's. It's the long-term effects that are the base of these cuts, not the starting pay, because the starting pay is very similar, with a difference of $1.50 where I work, from RN's to RPN's.

    Not sure where you live, but that's how it is here in the GTA (Canada).
  8. 0
    Did the job title RPN existed before the RN diploma program became a BScN degree? I'm just wondering because maybe that is where the difference lies. Diploma Nurses are obviously grandfathered in the whole new system, but the change from Diploma to Degree sort of legitimately turned the Nursing profession into a "real" (and I say this lightly because I lack a better word for it) science and art. I agree with you that there should no longer be two types of nurses. Maybe nursing in the future should be strictly BScN? I don't know how other people would feel about that as some people go into RPN because the schooling is fast, there is job security and pays okay. However, I feel turning nursing into a Degree program was a good move because I feel it validates nursing as a true profession (not that it was not a worthy profession before but it sort of helped change society's perception of nursing).
    I think Advance Practice Nursing does not alter or negatively affect holistic care, in fact I think it enhances it. Professionalizing nursing allowed nurses in areas that were closed to them in the past. Having Nurse researchers let nurses be part of the academic realm where they can take part in discourse regarding health and society. They are able to research, conceptualize and change nursing practice to enhance care. Having specialty in a specific medical areas allows nurses to learn about a disease or illness in depth so that they can provide holistic interventions to a certain population; all in all it is still meeting patients needs. Another point I would like to add is that, socioeconomically the world is dynamic. The nursing profession need to be able to adapt to the present and future socioeconomic times and nurses cannot do that if they do not have an academic background. Nowadays you won't find someone who has a college diploma getting their Masters or PhDs, that's just not how academic advancement works in other professions; why should nursing be any different?
    Anyway, I guess what I'm trying to get at is the ACADEMIC part of (BScN) nursing IS important in differentiating between the two types of nursing, especially in this decade.
    Lastly, I agree with the other nursing student/grad that said that they want to be justly compensated for the amount of time/money they've put through 4 years in nursing school; it's only fair! lol
  9. 0
    kb14:

    You need to do some research on the history of nursing in Canada. Practical nurses (only Ontario uses the designation RPN) have been around for over 60 years. We were introduced to assist in the nursing shortage brought about by WWII.

    PN skills, scope, and education have continued to expand over the decades just as the RNs has.

    The BScN education started to gain more acceptance in Canada in the mid-1970s. I remember UBC started theirs around 1977 or 78. I believe the U of A has one of the oldest programmes in Canada (for some reason 1923 sticks in my mind). Many hospital trained nurses feel the degree has developed the wrong way. One year of the education is in Arts (English, Soc, Psych all worthwhile courses in their own right but nurses should come prepared to write a simple short essay).

    I've had several friends do the degree after their PN here in Alberta and all have agreed that far too much time was spent writing essays. I even remember tutoring a couple of them on their first year English essays and electives.
  10. 1
    Fiona59:
    If you feel that there is something viscerally wrong about the difference in treatment of the two types of nursing then maybe RPNs (this includes LPNs as well, just in case others get offended again) should create solidarity; you know, challenge the system instead of yowling how unfair it is. I'm not saying that sarcastically, I'm being genuine. To me, there is a difference, maybe not long ago in the time of WWII but there has been changes in the last decade or two. There is a purpose as to why RN nursing has become a degree (especially in the present) and that is to introduce nurses in the academic circles. Today, RNs are expected to be adept to BOTH technical and academic skills. Yes, there are essay writing in the BScN programs but that's part of all academic programs. Are you saying that nurses do not have a place in academia because this is not what nurses "naturally" do, and that nursing has to be all technical? I believe the technical skills and knowledge in nursing can be gained through experience and exposure while in the work force. However, some people want to pursue further top positions in nursing and the only way to do that is through university and higher education. Again, I argue that you won't find someone who has a college diploma getting their Masters or PhDs in any profession--inside or outside of the health system. The only way nurses can gain influence in a top-bottom approach of the health care system is to be in with the "in crowd;" if that means pursuing a degree to be accepted in a graduate program and therefore leading to jobs at the top, then so be it. The system is not saying that RPNs/LPNs/hospital taught RNs (note: I'm talking about the individual who hold these titles) are not adequate academics, they just need to get the qualifications (i.e, become an BScN RN). If you don't want to, then by all means, don't become an RN but don't hold it against Degree holding RNs for getting paid more for the "same" work. Sadly, the truth is that qualifications weighs heavily in this society whether we like it or not, that's just how the cookie crumbles. Anyway, this is my last post for this forum. Thanks for reading.

    P.S. Maybe the older generation of nurses (those who were trained in the hospital) that you speak of need to be more open minded and supportive of the new generation of nurses instead of concentrating on how poorly the new nurses are doing in the workforce. There is a difference between constructive feedback and criticism; the latter impedes learning and creates hostility.
    Last edit by kb14 on Jun 13, '10
    tahitianmoon likes this.


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