LPNs Fight Efforts To Phase Them Out - page 3
Licensed Practical Nurses at one hospital are fighting efforts to have them phased out of direct patient care. The hospital intends to go with a different care model calling for expanded use of RNs... Read More
Apr 20, '11Much the same thing happened years ago in the UK when Enrolled Nurses (LPN equivalents) were phased out and faced either converting to RGN's or not being hired.
I knew some brilliant EN's and we lost many when they didn't want to do the RGN conversion course or failed it because of rusty academic skills (no, I am NOT calling EN's stupid, far from it, but many just weren't cut out for academic horsefeathers which is why they were EN's in the first instance)
Their replacements, the largely untrained Health Care Assistants, vary from excellent to bloody awful depending on how much training they ever had. Most learn on the job.
It is a huge loss to the nursing profession that management has no room for the less academically inclined but wonderful bedside nurses and seriously thinks that these nurses can be replaced by HCA's.
Always the same is it not? It comes down to money in the end.
Apr 20, '11I've been an LPN for 15 years. I've worked in M/S, telemetry and ICU. Working as an LPN in the hospital just doesn't work anymore....and I should know since I've been one for 15 years. Pt's that come into the hospital are a lot sicker than they were years ago. They require many push meds, blood products and many have central lines. I can honestly say there is a delay in treatment when I have to hunt down an RN to give my pt. pain meds or any other IV med, because they are swamped too. Not being able to take verbal orders is a mess too. I have only ever worked in a hospital, I don't know what the nursing homes are like. I just know that after 15 years, being able to put RN after my name is going to make life a whole lot easier for me (and my coworkers). I am lucky enough to have my position as an LPN upgraded to RN as soon as I take my boards next month. Like I said before, I'm already pursuing my BSN, because I know ADN's are the next to be phased out.
Apr 20, '11Hmm - didn't the Federal Gov ante up some funding for retraining displaced auto workers in the recent past?? Why the heck can't they do the same in this case?
Not all areas of the country are anti-LP/VN. Some organizations are moving back into team nursing models that incorporate RN, LV/PN & CNAs - all working together with each functioning in his/her scope of practice. As healthcare reimbursement continues to drop, that seems to be the only way to keep enough people at the bedside. The only other alternative would be paying lip-service to the "all RN" mantra, but decreasing staff at the same time & that doesn't make sense to any sane person.
We love our LVNs in Texas. They are the backbone of rural health and have an expanded acute care role compared to other states.
Apr 20, '11While I feel bad for the lpns, the acute hospital is too complex for the lpn. I know the lpns feel they are equal to the rns,but reality they are not. Being a rn who has to assume the meds, the blood trandfusuons for the lpn, it is not easy or the same. If there is an issue, does adm call the lpn, no it is the rn who gets the call.
Do a search on quality measures for this hosptial cited, it is below the state and national average. I went back to school to get my msn, I was close to 50 when I graduated. I was motivated since the positions I wanted needed a msn. If you aspire to work a nurse in a hospital, get a rn, and protect yourself with a bsn.
Apr 21, '11This is so sad! I swear the middle class worker NEVER gets a break! Why is it ever ok that people who are hard workers are losing jobs and being forced into poverty. Heck cut everyone's hours, if need be. I remember when I was working at a restaurant and things were EXTREMELY slow for a while. My manager refused to fire anyone... just not ethical, especially with the economy. But he did have to cut hours. I even let him know that I'm single, with no kids and still living with my parents... just so he could give more hours to people who really needed it more than I did. I was grateful that he cared enough about his employees to not let people go. But NOW is REALLY NOT the time for people to lose jobs! Teachers, nurses, etc., Cut our pay, push us around, phase us out... our country will regret it for years to come!Last edit by Trilldayz,RN BSN on Apr 21, '11
Apr 21, '11This is really sad. I know so many fantastic LPN's that I would LOVE to have take care of me if I were to need it. WHY NOT give them a 5 year period to get their RN at least? Stop hiring LPN's and give the current LPN's time to get their RN. A realistic time, not just 3 years since most can't go to school FT and work FT due to having a family. I think that is being more reasonable to give them at least 5 years to do it before being reassigned to be a UAP. What a waste of knowledge and skills... Don't they realize LPN's are cheaper to pay than RN's, anyway?
Apr 21, '11Quote from MokahFitChickI think the answer to this is simple: Because they can.I am trying to figure out why would they want to phase out LPNs? This seems to be happening other places too.
The stories about a nursing shortage are mostly fiction or at best, wishful thinking. In most parts of the US, the supply of newly graduated RN's has for some time now outstripped the demand for nurses. The practical effect of this excess supply is that employers can now hire RN's instead of LPN's with little change in their marginal wage costs. Employers are also able to take advantage of the nursing oversupply in another important way as is evidenced by the renewed emphasis by many health care institutions on the BSN as the minimum nursing credential.
While I think both trends are regrettable, they represent the new reality in nursing.
Apr 21, '11the days of the lpn (in hospital settings) are nearing the end here in mississippi..we have zero lpns that practice pt care in my fulltime hospital, though there are some that function in our PI dept. doing graphs, charts and surveys. at my part time and prn gigs there are a few older ones on the low acutity units and geri psych floors, but they have made notice that there will be no new lpns hired at those hospitals. i reckon they'll replace those lpns with rns after retirement or if they vacate the job.
Apr 22, '11Quote from MissingMyEricaI'm with you on seeing the writing on the wall concerning ADN's. I dont know why people try to fight things,its coming whether you like it or not. How many years have we heard these things? I've. Been a nurse 7 years and back when I started in 2004 as an lpn I knew I had to get the RN license by getting at least my adnI totally agree. I just finished RN school because I saw that writing on the wall a loooong time ago! I am only one of two LPN's left in my hospital. All the others were laid off, so thank God I was in school already. I am also starting my BSN right away because I feel like ADN's need to look at the writing on the wall too and realize they are next to go.
Apr 22, '11There have not been hospital jobs for LPNs at all for the last few years. I work in LTC, and I think there will always be jobs for LPNs here. However, I didn't go into nursing to get "stuck" in LTC, and I can't move on unless I get my RN.
Going back to school can be daunting. I went through the first half of an ADN program, so I've had all the right prereqs for RN. But my credits are "old" and some already won't accept them. Schools seem to not acknowledge LPN experience when considering working you into their program, they look only at credits. I feel like I'm expected to start over from scratch to get an RN, particularly if I want to go directly for BSN.
There are no LPN to BSN programs in my state, so I have to have updated credits, like all new applicants. I think this hinders other LPNs as well. It isn't just a matter of going back to school for a higher degree. When you have to start over from the beginning, there is a feeling of discouragement. It also reinforcess the idea that LPNs aren't "real" nurses, when your previous education and actual experience aren't acknowledged by RN programs.
Apr 22, '11Back in 1997 when I graduated from LPN school, there was talk then about RNs being required to get BSNs but not so much about LPNs as I can remember. However, I do understand the reason for the trend to a degree. The medical field has made many advances including new medications, new procedures, and even more streamlined healthcare. Meaning, Chole surgical procedures for example are now done via scope instead of the more invasive radical surgery unless a surgeon is forced to perform an open procedure from unforseen circumstances. This does improve patient care in that the patient isn't as severely traumatized now thus it does reduce the hospital stay, but I do think provision should be made for the dedicated LPN to advance her/his education or be given early retirement if that LPN has put in numerous years of hard dedicated work at the institution she works for. Just my .Last edit by FranEMTnurse on Apr 22, '11 : Reason: more info
Apr 22, '11Quote from MissingMyEricaI've been an LPN for 15 years. I've worked in M/S, telemetry and ICU. Working as an LPN in the hospital just doesn't work anymore....and I should know since I've been one for 15 years. Pt's that come into the hospital are a lot sicker than they were years ago. They require many push meds, blood products and many have central lines. I can honestly say there is a delay in treatment when I have to hunt down an RN to give my pt. pain meds or any other IV med, because they are swamped too. Not being able to take verbal orders is a mess too. I have only ever worked in a hospital, I don't know what the nursing homes are like. I just know that after 15 years, being able to put RN after my name is going to make life a whole lot easier for me (and my coworkers). I am lucky enough to have my position as an LPN upgraded to RN as soon as I take my boards next month. Like I said before, I'm already pursuing my BSN, because I know ADN's are the next to be phased out.
OK, this has to be a regional/national thing. Here in Canada, the PN education is based on the old two year RN diploma/hospital certificate. RN is ONLY available via a BScN.
Now, the only area in my hospital that we don't work is ICU, NICU, and CCU. No staff nurse in my hospital is permitted to do IV push unless in the ER or the ICU. The rationale is if the patient is that sick they shouldn't be on the general floors.
Several hospitals in my province are working on the blood/travisol issue with their LPNs being the trial project. Other regions are utilizing LPNs in their ICUs.
It's a given that pain medications are within my scope. We get around the blood/travisol issue by performing the two nurse check at the bedside. Once the bags are pierced and hung, the RN simply walks away. The monitoring is the LPNs duty. Just as LPNs perform the two nurse check at the RN patients bedside and then walks away to leave the RN to care for their patient.
Verbal orders have to go through the Charge Nurse, who doesn't have an assignment.
We LPNs have questioned the acuity of our patients many times. In theory we are to care for the stable. Our hospital defines stable as not being in ICU or OBs. I've often looked after more acutely ill patients than my RN co-workers. When I've asked the unit manager why this is the case, she's replied "best nurse for the patient, I'd rather have you than the RN with less than two years looking after them".
My province seems to be drifting towards the "LPN is THE bedside nurse" model of healthcare. But face it, we are in the end $12/hour less expensive than a top payscale RN. I've worked shifts on surgical units where there are seven nurses (including the Charge) where it's been five LPNs, one RN and the Charge. No patient was harmed, all received quality care, no patient was in pain.
Not every shift requires blood or travisol hung. We do our own assessments. We do our own drugs. We answer only to the Charge just as the RNs working alongside us. We work under own insurance and within our scope.
The problem is the scope is that narrow now.