2 hospitals to drop licensed practical nurses - page 33

the changes at mercy and unity hospitals are meant to improve care, but unions say the remaining nurses will be stretched too thin. all 90 licensed practical nursing jobs at mercy and unity... Read More

  1. by   BamaBound2bRN
    I have a good friend, who has a PhD. in Statistics who would disagree with you. The letters behind someones name does not equate to their worth in a society, nor to their level of intelligence or competencies. Less we forget, there was a time not too long ago, when nurses (ie, women) were deemed inferior in education, skills, and importance to their male/doctor counter-parts. An example, I would let a Phlebotomist (non-licensed in most states) draw blood from me any day of the week before I let a Medical Doctor. Some of these same agruements are used by MDA's to state that CRNA's are not as capable in administering anesthesia.
  2. by   BamaBound2bRN
    Quote from lindarn
    The military allows it unlicensed med tech to do anything that an RN does, because they know it is next to impossible for an individual to sue the military for malpractice and negligence. And because of the Ferrys Doctrine, an active duty member cannot sue the military for anything. So the military has nothing to lose, by allowing med techs to do anything and everything, and the unfortunate active duty members, and their dependants, can not do anything about it, or insist that the higher ups hold these practitioners (or the system), accountable. This is the reason I have never used military medicine (we are an active duty, now retired family). I could not live with myself, knowing that I could have taken my kids to a private medical practitioner, who I could hold accountable, but chose to use the military medical system. JMHO.

    Lindarn, RN, BSN, CCRN
    Spokane, Washington

    Is this what we want private health care to end up like? Having unlicensed personnel provide our care? Would you want the janitor to teach first grade in your childrens' school? Think about it. I am sure that a janitor could teach the ABCs and one plus one to a 6 year old. But does that mean that they shold be allowed to do so?

    There is a common myth, that military hospitals and doctors can not, and are not, held accountable for malpractice or negligence. This is not true. Dependents can, and do sue the military all the time (about par with civilian suits). Also, military hospitals fall under JCAHO like civilian hospitals, plus the military command overseeing that hospital has its own inspection process.
  3. by   neygray
    Quote from BamaBound2bRN
    An example, I would let a Phlebotomist (non-licensed in most states) draw blood from me any day of the week before I let a Medical Doctor.
    AMEN!!

    Renee
  4. by   chadash
    It sounds like the military gives exceptional training to techs..I know a military tech who went to RN school, and was way more technically astute than many RN's: great prep for so many RN experiences.
    Unfortunately, out side of the military, tech just don't get that kind of intense prep...I know, I am a CNA, and just cause I can doesn't mean I should.
    There are more variables than can be adequately anticipated in a tech training situation. I have said it before, you just don't have a clue what we dont know!
    Let's don't downplay the critical need for knowledgible, skilled, licensed persons providing care.
  5. by   chadash
    Quote from BamaBound2bRN
    I have a good friend, who has a PhD. in Statistics who would disagree with you. The letters behind someones name does not equate to their worth in a society, nor to their level of intelligence or competencies. Less we forget, there was a time not too long ago, when nurses (ie, women) were deemed inferior in education, skills, and importance to their male/doctor counter-parts. An example, I would let a Phlebotomist (non-licensed in most states) draw blood from me any day of the week before I let a Medical Doctor. Some of these same agruements are used by MDA's to state that CRNA's are not as capable in administering anesthesia.
    This point has some merit. I am amazed at times that the ability to reason can be educated right out of us!

    But let me share what it looks like from the bottom up: I have worked as a NA in assisted living, under the supervision of Med Techs, and also in LTC and home health under RNs and LPNs.
    One experience might illustrate my concern..though this one wasn't too dangerous, just silly. We had a very very old guy in assisted living. The med tech was leaving the room while I entered. The family was sitting there with a stunned look and said to me: the med tech says dad does not have a pulse, he is gone. I looked over at the pt, and it was obvious from across the room the nice man had quiet but regular respirations. I assured the family, he was still with us, and he was up at the dinner table the next day. This was a great med tech, very thoughful, I am sure he was diligent in administering meds accurately and in a timely way. And maybe in assisted living, this is as good as it gets.
    Last edit by chadash on Feb 27, '06
  6. by   BamaBound2bRN
    Quote from chadash
    It sounds like the military gives exceptional training to techs..I know a military tech who went to RN school, and was way more technically astute than many RN's: great prep for so many RN experiences.
    Unfortunately, out side of the military, tech just don't get that kind of intense prep...I know, I am a CNA, and just cause I can doesn't mean I should.
    There are more variables than can be adequately anticipated in a tech training situation. I have said it before, you just don't have a clue what we dont know!
    Let's don't downplay the critical need for knowledgible, skilled, licensed persons providing care.
    I don't mean to imply that knowledge and education is not important. I do feel, very strongly, that some people put way to much emphasis on the 3 (or more) little letters following a name. There was a time when your lineage was the proof of competency, then it was the type of job/position (ie, judge or mayor), now it seems that we are equating degree with pedigree. I mean, look at Bill Clinton- President, Attorney, and Rhodes Scholar- and yet he chose Monica to risk his presidency on- at least JFK chose Marilyn.

    We should not get so high and mighty on self importance and how many letters we can collect on our name tag, that we forget that everyone- from the janitor to the Chief Medical Officer has something to contribute.
  7. by   chadash
    I just signed my tax form to send in, and under occupation, I signed "housewife". It was very liberating!
    I still have a home health patient, but will not be recertifying.
  8. by   BamaBound2bRN
    Quote from chadash
    I just signed my tax form to send in, and under occupation, I signed "housewife". It was very liberating!
    I still have a home health patient, but will not be recertifying.

    "Housewife" and "Mother" the 2 most underrated and underpaid occupations!
  9. by   chadash
    If there was space, and the fed were interested, I would have added mom and gramma!
    Thanks!
  10. by   RN34TX
    Quote from lindarn
    The public equates worth with education. That is why doctors, lawyers, etc, make alot of moneyfo their work, and are held to a higher standard of practice that a PA. And I might add, that they are held in the highest regards and respect. Educated individuals are treated with more respect that HS dropouts, for example.

    Lindarn, RN, BSN, CCRN
    Spokane, Washington
    You've stated "The public equates worth with education" several times on various threads regarding this topic.
    I'm not saying that you don't have any good valid points, but I'm not understanding the emphasis on what the public thinks of our profession.
    In 9 years of nursing, I still say that the vast, vast majority of my patients and their families couldn't tell you the difference between an RN and an LPN and many have no clue that any educational differences even exist between one nurse and another.
    Patients/families want their pain meds, blankets, coffee, bed changed, etc. brought to them on the snap of their fingers and they really don't care who's doing it for them, be it an RN, LPN or whatever.
    They look at us as merely functional people to get things and demand things from, much like a janitor if you will.
    That's the reality of what the public thinks of us.
    And that same public does not suddenly stand up and respect a nurse that walks into the room with BSN written on her badge, so getting rid of LPN's will do nothing to change this, because BSN presence on hospital floors has done nothing to get the public to respect us any more.

    Like I've stated earlier, I have friends who are teachers. They are so green with envy at our opportunity and salary differences it's insane.
    They feel that it is totally unjust that anyone with less than their bachelors degrees in english and history should be making more than they are.

    Teachers are severely underpaid for their very important job and they are the worst, yet most often used on this forum, example in the arguement for BSN minimum entry nursing.
    MD's and lawyers do not bring home big paychecks because they are well-respected by the public. That has nothing to do with it.

    Hospital administrations catering to the public expectation that we are nothing more than waitresses/flight attendants who can give meds and perform treatments with their "customer service" mentality is what's keeping our profession and image down.
    And for the right hourly wage, it seems that most of us nurses can be bought to perform for the public/families and keep up this image regardless of what it's done to our profession.
    Last edit by RN34TX on Mar 11, '06
  11. by   flasandy42
    <<The LPN really couldn't do much to help because several patients required IVP meds and blood (florida does not allow LPN's to spike blood).>>

    I always thought that was funny....that we could check the blood with an RN and monitor the patient during a transfusion but weren't allowed to SPIKE the bag. Once it was hung the RN had to do nothing else with it. Also, we were getting more and more drugs that we could push right before I retired. I also think it's ridiculous that LPN's were suddenly not allowed to do admissions or assessments. If I were an RN I certainly wouldn't want to sign for something I didn't do. I had done my own admits and assessments for 40 years...then suddenly I wasn't capable. They even changed the name on the chart from "assessment" to "data collection." There was also a short time when we couldn't care for our central lines but that didn't last long when they weren't being flushed because the RN never got to them and they clotted off. They gave us a quick course on it and we were allowed to care for them again. And BTW.....most of the time on weekends, we only had ONE RN for 38 patients on a busy med-surg-ortho-neurology-oncology floor where a lot of blood and chemo was given. I feel sorry for the RN's if they do away with LPN's. ALL areas don't have a surplus of RN's.
  12. by   HazelLPN
    Quote from lindarn
    Again, the hospital that I worked in here in Spokane, Washington, got rid of all of their LPNs two years ago. I worked in Critical Care most of my career, and we always had an all RN staff. I cannot believe that their are critical care units that untilize LPNs/LVNs as staff. I go back 25 years in critical care.

    As unfortunate as it is, with many hard luck stories, I cannot disagree with the decisions that hospitals are making. The concept of LPNs and LVNs has come and gone. They were instituted during WWII, when the RNs were going off to war. They were never meant to be permanent. The writing on the wall has been coming for many years, and many LPN/LVNs took the opportunity to upgrade in a bridge program to become RNs. They should feel lucky that they are even allowed to do that. When I graduated in 1975 with a diploma in nursing, LPNs had to completely start over if they wanted to become RNs. I blame the ANA, and State Boards of Nursing for bowing to political pressure, and continuing on an outdated career field. Healthcare is becoming increasingly technical and sophisticted, and a higher level of education is necessary. Physical Therapists have gone to a DOCTORATE AS ENTRY INTO PRACTICE, AS HAVE PHARMACISTS. OCCUPATIONAL THERAPISTS HAVE A MASTERS AS ENTRY INTO PRACTICE. PHYSICAL THERAPY ASSISTANTS HAVE AN ASSOCIATES DEGREE AS ENTRY INTO PRACTICE. None of these career fields dramatically influences patient outcomes, with the exception of pharmicists. Tell me that there is really a place in todays health care for LPNs and LVNs, with a one year educational program. I mean no disrespect for them and I know that they have worked hard to get there. But the time has come to upgrade, or leave. The same for RNs with a BSN. Another option could be having an on site LPN-LVN/bridge program, and on site Diploma-ADN/BSN programs. And the individuals in these programs could retain their jobs. RNs with ADNs and Diplomas would be grandfathered in and retain their licensure. And nurses should start the political ball rolling in their states to institute patient ratios, to lessen the workload of the nurses. And we need to educate the public, that they deserve to be cared for by an RN, who has a safe patient load to be able to provide the care that they deserve.

    Lindarn, RN, BSN, CCRN
    Spokane, Washington


    Patient care technicians should replace LPN/LVNs, an assist only in basic care, and not take over any professional nursing care. RNs should be the only ones peforming medication administration, foley insertions, dressing changes utilizing strerile technique, etc. Nursing needs to take back their career.
    You can't believe that there are still ICU's that use LPNs and you have been in critical care 25 years?

    I have been an LPN for nearly half a century, with over 40 years in critical care. My state and hospital allow for a full scope of practice for the LPN. The RN is not responsible for everything the LPN does. That is mistaken. We have a license that can be lost just as easily as an RNs can. I do 95% of the work on my patients. Can you say that you became a good critical care nurse because of your excellent undergraduate education? Probably not. Probably your nursing education is largely obsolete due to the changes in technology and advances in science that we have seen in the past 30 years. I went to school back in the 50s, and nearly nothing is the same. Everything else was learned on my own or on the job. My LPN program was 2 years. The RN program was 3. Back then everything was based at the hopsital. I'm not sure how magically one extra year of school makes someone that much more of a better nurse.

    Be careful when you speak in gerneral terms. I don't have the fancy initials behind my name. But I have a lifetime of experience and a love of learning that has benefited many people and their families. Good nursing is good nursing, no matter how many letters are behind someone's name.
  13. by   chadash
    The bottom line in my thinking is that we just should not get rid of LPNs for a very important reason. Patient care.
    If LPNs are phased out, lets face it, there will not be more RNs giving direct care, there will be more unlicensed persons giving care: with healthcare, it comes down to "show me the money" every time.
    So, I believe that this will negatively effect patient care.

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