LPNs Fight Efforts To Phase Them Out - page 5

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

  1. Visit  brandy1017 profile page
    5
    LPNs would provide superior care than CNA's as far as working under RN's. The bottom line is the almighty dollar. They can stay as long as they agree to take a paycut. $13/hr not $17-19 they were making.

    I don't see why they can't stay and work alongside the CNA's, but keep their hourly wage. But the hospital is too cheap to honor them. It is really disrespectful to tell them to take a pay cut to do what they are already doing. In most of these UAP mix the CNA's do things an RN or LPN would do, but then it falls under the RN's license if a mistake is made.

    If I were an RN there I would definetely prefer the LPN's to CNA's to do the expanded UAP role.

    I hope the union fights back and doesn't let them force the LPN's into a paycut to basically do pretty much the same job for less money.
    HazelLPN, FranEMTnurse, lindarn, and 2 others like this.
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  3. Visit  2longasn profile page
    2
    Quote from bugsy2902
    LPNs would provide superior care than CNA's as far as working under RN's. The bottom line is the almighty dollar. They can stay as long as they agree to take a paycut. $13/hr not $17-19 they were making.

    I don't see why they can't stay and work alongside the CNA's, but keep their hourly wage. But the hospital is too cheap to honor them. It is really disrespectful to tell them to take a pay cut to do what they are already doing. In most of these UAP mix the CNA's do things an RN or LPN would do, but then it falls under the RN's license if a mistake is made.

    If I were an RN there I would definetely prefer the LPN's to CNA's to do the expanded UAP role.

    I hope the union fights back and doesn't let them force the LPN's into a paycut to basically do pretty much the same job for less money.
    Amen, I was just thinking where are the unions and LPN Associations in all this. LPNs have provided good sometimes excellent care in the presence and absence of RNs; as a valued team member. The LPN Association is missing a critical opportunity to educate the public what could happen without the LPN services. Why not ask CNA's to get an LPN in the interest of public safety & evidenced based care. I was afforded great oppurtunities as an LPN-Unit manager, MDS coordinator, and Admissions Nurse. Supervised LTC facilities when RNs did not or could not. The all mighty dollar is the only reason why LPNs are being warned to further their education or downgrade.

    BTW their a few rare occasions when a union deserves to busted (2288 what have you done for me lately). LPN associations communicate with your constituents and let the public know what is going on and how public safety may be affected. Form an action committee!!!!! If all else fails and you are more than 10 years from retirement (soon to be raised to 70 something) go back to school, get your RN and move to state like CA with a decent nurses union.
    FranEMTnurse and lindarn like this.
  4. Visit  txspadequeenRN profile page
    6
    this is non-sense.....

    Quote from ginger's mom
    while i feel bad for the lpns, the acute hospital is too complex for the lpn.
  5. Visit  GM2RN profile page
    1
    Quote from ginger's mom
    while i feel bad for the lpns, the acute hospital is too complex for the lpn.
    Quote from txspadequeenrn
    this is non-sense.....

    if we are talking about some lpns with several years of experience, then i agree that it's non-sense. but if we are talking about brand new lpns, i have to agree with ginger's mom on this.
    Ginger's Mom likes this.
  6. Visit  tferdaise profile page
    1
    HEre in Phoenix, AZ all of the acute care hospitals are fazing out LPN's. At the hospital in which I work, the LPNs have until Jan 2012 to be in a RN program or they will not have a job.

    The writting has been on the wall for a while regarding this, state boards are making it harder for LPNs to work in acute care hospitals. With the flood of new grads, hospitals wont have a problem replacing the LPNs.

    Quote from Juwon
    Wow, I dont think the hospitals should be so blunt with releasing the LPNs from the acute care setting. They should at least give them like 3 years to go back and get their RNs if they want to stay. Those who are not interested in going back to school should be let go, or take a position as a CNA, in which I HIGHLY doubt any licensed professional would want to do. Personally, I feel for the LPNs that are going to be phased out possibly, but at the same time, I dont because everyone knows that hospitals prefer to have RNs working in acute care because of their expanded scope of practice. If you are a LPN and you got into an acute care setting, I would have hope that you would have been taking steps to further your education to RN status instead of sitting pretty because we all know how hospital administration can get. Nothing is guaranteed today, and I hope I didnt offend anyone with what I said.
    lindarn likes this.
  7. Visit  tferdaise profile page
    1
    As someone who was a LPN for 6 years and worked in a Step-down ICU unit, I was happy to have worked this unit as it gave me the skills needed to be make me a better nurse. But the problem isn't LPN vs RN which is better, it's about the cost of having a LPN on a unit and having RN's cover them. In todays healthcare area, cost is the monster. I can argue both side of this issue, but in the long run, having an all RN unit makes much better sense cost wise.

    I have wondered why more schools having opened up for the LPN to RN or LPN to BSN. With more and more states slowly fazing out the LPN the market for the LPN is going to get very crowded.

    Lastly, having a BSN does not make one a mister know it all, when I was working as a LPN, I was having my co-workers (ADN and BSNs) come and ask me for advice on patient care. It's about experience, not education.


    Quote from mama_d
    I guess it all depends on what setting you work in.

    I'd have to respectfully disagree with the assertion that pts in the hospital are too complex for LPNs to deal with. I've been in a supportive environment where I've been encouraged for years to push myself and learn all I can. I regularly get medically complex pts...those ones that are teetering on the edge of needing ICU or step-down care...b/c I can handle the complexity. It's also no big thing on my floor for the BSNs to ask me my advice when they have more critical pts; there's a recognition there that I often have more experience than they do, regardless of the level of formal nursing education any of us have. And I can guarantee you that if something goes down, it's gonna be my butt in the office. I run my own team as independently as any of the RNs do, and have the same accountability. There are plenty of times when it's me in there teaching how to do procedures...CAPD, dropping a NG, NT suctioning most recently...and plenty of times that I'm asked to explain the thinking process behind why docs ordered one med vs another, or certain procedures, etc.

    I realize that not all LPNs have the opportunities or environment I do, and that seems like a waste to me. How can people be expected to excel if they are in a setting that is constantly setting limits based on a skewed misperception of their abilities? I'm not talking about operating beyond scope of practice, of course...just that all too common misconception that "LPNs do tasks and RNs do the thinking".
    NurseLoveJoy88 likes this.
  8. Visit  nursel56 profile page
    0
    Quote from GM2RN
    If we are talking about some LPNs with several years of experience, then I agree that it's non-sense. But if we are talking about brand new LPNs, I have to agree with Ginger's Mom on this.
    What specifically do you feel is the reason acute care is too complex for an LPN? Or to put it a different way, what would a new RN be doing (including thinking) that a new LPN would be unable to grasp?
    Last edit by nursel56 on Apr 26, '11
  9. Visit  GM2RN profile page
    0
    Quote from nursel56
    Maybe LPN training is less rigorous than it used to be. LVNs and LPNs have worked in acute care hospitals far longer than the phasing out process has been underway. LVN school was based on the assumption that graduates would be working in acute care hospitals, and all of our clinical sites were at acute care hospitals. More complex patients (ie stable vent patients)are being sent out to LTCs where often there are only LPNs in the house as well.

    Maybe, but I think it has more to do with the higher acuity of today's patients, along with higher patient ratios and more responsibility in general.
  10. Visit  nursel56 profile page
    4
    Quote from GM2RN
    Maybe, but I think it has more to do with the higher acuity of today's patients, along with higher patient ratios and more responsibility in general.
    What do you mean by that? Just as a completely unscientific guess - as far as I know there is no more acute mutation of the same things people were hospitalized for in the past, only the treatment you will now get for your ailments. So how does "newer" become inherently out of reach of the mental faculties of an LPN?

    In my state ratios are lower than they were in the past due to our ratio laws.

    It's even possible to say that a nurse of the past had to be more on top of things because so many of them-thar new contraptions tell the nurse so very much more accurately what is happening inside of the patient in an instant, and the process a person would go through for surgery has been transformed. People can actually go home from an outpatient center with two 2 inch incisions held together with steri-strips? Jeeze just thinking about what an ordeal a cholecystectomy was back in the day makes me =shudder=.
  11. Visit  VespaLPN profile page
    0
    Quote from harlee
    I've been an LPN for 2 1/2 years. I currently work in Home Health Care and must say I absolutely love it. My company just recently hired an RN to work at the home I'm at. There were plenty of hours to go around. Enough hours that we each could have 55 hours per week. I've been working about 60 hours per week for quite some time. No complaints from me, not a real physically challenging position. With that being said... I really resent the fact that since the RN was hired, she now works my 60 hours and I have been cut back to 38 hours per week!! When asked why????? Because she is an RN and you are not. Yes, I was truly told that. So my bosses answer was, GO GET YOUR RN LICENSE!!! The really funny part of this story... I had to train her at the patients home. I had to show her that when measuring liquid medicine, that you need to set it on a flat surface because "you are holding the cup in such a way that it looks like you put 5mls in but it's actually 10mls!!!" and then argued with me about it. Also had to show this RN how to prime a Enteral Feeding pump. "What job did you work at before here, I ask?" "Oh, I worked at _______ Hospital for 2 years!"

    I realize that this is very wrong here and by no means saying this to be the case of a typical RN. It's more of a vent because of how my company is treating me.

    Just an LPN (and darn proud of it)!
    I have a few residents on liquid meds, and I use a 10cc syringe to measure these meds. But, if I had no choice but a cup, I for dang sure would put it on a flat and level surface.
  12. Visit  caliotter3 profile page
    0
    Quote from harlee
    I've been an LPN for 2 1/2 years. I currently work in Home Health Care and must say I absolutely love it. My company just recently hired an RN to work at the home I'm at. There were plenty of hours to go around. Enough hours that we each could have 55 hours per week. I've been working about 60 hours per week for quite some time. No complaints from me, not a real physically challenging position. With that being said... I really resent the fact that since the RN was hired, she now works my 60 hours and I have been cut back to 38 hours per week!! When asked why????? Because she is an RN and you are not. Yes, I was truly told that. So my bosses answer was, GO GET YOUR RN LICENSE!!! The really funny part of this story... I had to train her at the patients home. I had to show her that when measuring liquid medicine, that you need to set it on a flat surface because "you are holding the cup in such a way that it looks like you put 5mls in but it's actually 10mls!!!" and then argued with me about it. Also had to show this RN how to prime a Enteral Feeding pump. "What job did you work at before here, I ask?" "Oh, I worked at _______ Hospital for 2 years!"

    I realize that this is very wrong here and by no means saying this to be the case of a typical RN. It's more of a vent because of how my company is treating me.

    Just an LPN (and darn proud of it)!
    The agencies I have worked for would have kept the nurse who was there first with her hours. First come, first get. RNs who choose to do LPN level home health care are just like everyone else when it comes to assignments, except probably for new cases. I would guess that the RNs get first dibs at new work partly because the agency wants to keep them happy enough so that they don't go elsewhere to work. But I have never heard of an RN bumping an LVN for an existing assignment.
  13. Visit  GM2RN profile page
    1
    Quote from nursel56
    What do you mean by that? Just as a completely unscientific guess - as far as I know there is no more acute mutation of the same things people were hospitalized for in the past, only the treatment you will now get for your ailments. So how does "newer" become inherently out of reach of the mental faculties of an LPN?

    In my state ratios are lower than they were in the past due to our ratio laws.

    It's even possible to say that a nurse of the past had to be more on top of things because so many of them-thar new contraptions tell the nurse so very much more accurately what is happening inside of the patient in an instant, and the process a person would go through for surgery has been transformed. People can actually go home from an outpatient center with two 2 inch incisions held together with steri-strips? Jeeze just thinking about what an ordeal a cholecystectomy was back in the day makes me =shudder=.
    By higher acuity I mean 2 things. First, I believe that some people are sicker with the same things when they finally get to the hospital because they haven't gone to the doctor regularly and have let their illnesses progress. Second, I believe that patients admitted to the hospital have more comorbidities than ever before.

    It has nothing to do with the "mental faculties" of a new grad LPN, it has to do with LPN training vs. RN training. I know that many believe LPNs = RNs, but if that is entirely true, then why even have RNs? It would be cheaper to get rid of RNs and keep only LPNs. But that isn't the trend, despite the desire of hospitals to cut their overhead every way they can. I've already stated this in a previous post in this thread, but my hospital has completely done away with LPNs in ED, PCU, and anywhere patients need tele. Plus, they were never allowed to work in the ICU. If hospitals concerned with budgets believed that LPNs = RNs, that certainly wouldn't be the case.

    If you work with lower patient ratios than you used to due to ratio laws, you are in the rare minority. The hospitals that I know of personally, plus evidence of the same in the numerous threads on this forum, have increased patient ratios and aren't likely to decrease them anytime soon.
    lindarn likes this.
  14. Visit  nursel56 profile page
    0
    GM2RN --The only issue I was asking about was why you feel patients in acute care hospitals (regardless of how long they've been out of school) are "too complex". It's really an unsupportable claim, as neither of us know for sure who is waiting too long to see their doctor or about co-morbidities - or even if we did that would make the patients too complex for an LPN. If this were true you'd think it would shake up our Boards of Nursing and would call for changes in present LPN/LVN programs and their funding as excluding them only because their education was inadequate would necessitate a wholesale revamping of their curriculum.

    Thank you for responding, though! I know I can get annoying (ahem or so I've been told) when I don't understand the underlying reason someone makes a statement like that -- like when a kid asks "but why?" seventeen thousand times. Thank you for your patience.


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