LPNs Fight Efforts To Phase Them Out - page 6

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  GM2RN} profile page
    1
    Quote from nursel56
    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.
    No problem. And of course that is my subjective opinion. I do think that LPNs with enough experience are equal to the task because they have had on-the-job training.

    Small aside, I had to laugh when you mentioned asking questions like a kid. I have a 3-year-old granddaughter whose questions are incessant, with every answer provided turning into another question! Sometimes it goes on for so long that I bust out laughing and she gets upset with me and tells me "it's not funny Gramma!'
    nursel56 likes this.
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  3. Visit  mariposabella} profile page
    0
    I was wondering when LPNs are or if they are going to be totally phased out. There was a nursing school I was going to apply to and I was told that schools in the area were phasing out LPN programs.
  4. Visit  GM2RN} profile page
    0
    Quote from mariposabella
    I was wondering when LPNs are or if they are going to be totally phased out. There was a nursing school I was going to apply to and I was told that schools in the area were phasing out LPN programs.

    No one can tell you that with any real authority. My GUESS would be that LPNs will never be phased out totally, but the types of jobs available will likely continue to shift from hospitals to LTC. However, you need to pay attention to what is happening in your area, especially if moving is not an option, but because I also think that it's dependent on the region you are talking about, at least for now. So if schools are phasing out LPN programs where you live, you should probably consider other options.
  5. Visit  Ginger's Mom} profile page
    2
    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".


    I have no doubt that you can perform all those functions, in my state you would not be allowed to the functions you cited below.
    Also in most hospitals it is the chain of command, in my state and Joint Commission Regulation mandates a RN has the oversight of the floor hence the call to the charge nurse. This does not mean you don't provide excellent nursing care, but you did not have the theory a RN has the knowledge you have comes for the practical experience you have gained. I have worked with some CNA who were brighter and provide care better than a PN or RN, but that does not make them qualified to be a licensed nurse.

    The hospital in this article has all patient outcomes lower than the State and National average. That is a fact, I am guessing management is trying to improve care based on evidence based practices that outcomes improve with better educated nurses.

    I also have taught on the PN level and RN programs, I know the theory the PN is taught and tested on. The PN is intense but it only one year long but a PN is does not have the theory the RNs have. that has been taught in the classroom which the state mandates.

    Since you are so bright and skilled in one year can get your RN, it should be a piece of cake for you since you already know the theory,
    Is you hospital a top provide in patient outcomes?


    Also can you point me to an evidence based article that cites patient outcomes improve with a Rn/lpn staff mix, the research I see is an all RN staff improves outcomes. The LPNs in this hospital can not state their care is superior since there public patient outcomes are sub par, that is a fact.
    lindarn and Mrs. SnowStormRN like this.
  6. Visit  Ginger's Mom} profile page
    2
    Quote from nursel56
    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?

    Many LPN programs can't get placements in hospitals for clinical, they graduate without working in a hospital. LPN are not taught the nursing assessment as extensively as RN. LPN can not learn the theory in half the time of a RN.

    LPN are not taught delegation like a RN program. Pharmcology is scaled down.

    Does this diminish the an individual experiences a LPN may have, no but the system we have in based on nursing education not experience. I know my assessment skills are superior to a new MD, but does this make me a MD since I can assess, diagnosis, and provide the proper orders for a patient, of course. Not.

    If LPN via experience can work at the RN level, smart RN should be able to practice on the MD level.
    lindarn and Mrs. SnowStormRN like this.
  7. Visit  nursel56} profile page
    3
    Quote from Ginger's Mom
    Many LPN programs can't get placements in hospitals for clinical, they graduate without working in a hospital. LPN are not taught the nursing assessment as extensively as RN. LPN can not learn the theory in half the time of a RN.

    LPN are not taught delegation like a RN program. Pharmcology is scaled down.

    Does this diminish the an individual experiences a LPN may have, no but the system we have in based on nursing education not experience. I know my assessment skills are superior to a new MD, but does this make me a MD since I can assess, diagnosis, and provide the proper orders for a patient, of course. Not.

    If LPN via experience can work at the RN level, smart RN should be able to practice on the MD level.
    When I went through all of our clinicals were at acute care hospitals. We never went to an LTC, but that was in 1975 and I'm sure things have changed. I've always been the sort of person who wanted to learn above and beyond the classroom, and there certainly isn't anything that would prevent a person from being committed to lifetime learning as a matter of habit no matter what their current degree is. So maybe I'm assuming too much about other people.
  8. Visit  KDBSN,RN} profile page
    0
    This is so sad and it is happening in the michigan hospital I am working at right now. The LPN's that are in school have to be RN's by the end of may or they are turned into nursing assistants or fired. NICE huh?! But this particular hospital gave ALL the LPNS a chance to go back to school a couple of years ago and the hospital payed for it. Lets just say the lpns on my unit are not happy.
  9. Visit  Anne36} profile page
    0
    KDBSN, I am in an LPN program right now and I lay awake part of the night trying to decide if I am going to go on to RN. I want to, but I am so darn tired and broke. I am signed up for more pre-reqs this summer and am about to cancel because I am having a hard time coming up with the extra money to fund it. Im also about ready to settle for LPN because school takes away so much from my family. I dont have enough time for my kids, and I am exhausted from the stress of the last few years of school. How do other people overcome these obstacles to a higher education?
  10. Visit  tferdaise} profile page
    1
    I think people are missing the whole point, it doesn't matter what education the LPN gets, is what the State Board dictates on what the LPN can do. Here in AZ, the state board changed the scope of practice for a LPN which caused al the acute care hospitals to stop hiring LPNs. LPN can no longer note physician orders. They can do them in SNF but not at acute care hospitals.

    The whole debate about having no more LPNs is finally coming true, but only in Acute Care hospitals. I know that each region is different and there might be some hospitals still using them, but are they hiring new ones? Again, here in Phoenix, none of the acute care hospitals are hiring LPNs and at the hospital I work at, the LPNs that are working the floors have until Jan 2012 to be in a RN programs or they will lose their jobs. The hospital is fazing out the LPN role. The LPNs were told in 2010 about this so they have had plenty of time to get in a program.

    Now as someone who was a LPN for 6 years in a Acute Care Hospital, I can debate both side of this topic, but I truly do not believe that hospitals use the LPN in the correct role. I have for a while at where I work to get them to us the LPN as a Discharge/transfer nurse. Don't take the RN off the floor to transfer someone or D/C the patient.


    Quote from nursel56
    When I went through all of our clinicals were at acute care hospitals. We never went to an LTC, but that was in 1975 and I'm sure things have changed. I've always been the sort of person who wanted to learn above and beyond the classroom, and there certainly isn't anything that would prevent a person from being committed to lifetime learning as a matter of habit no matter what their current degree is. So maybe I'm assuming too much about other people.
    Mrs. SnowStormRN likes this.
  11. Visit  tferdaise} profile page
    1
    Anne its a tough road in nursing school. In the LPN to BSN program I had a couple of classmates who were in your shoes (well all of us where tired) but the added stress of family compounds the issue. But the question remains, will your family be better off once you are done with school? If the answer is yes, then keep going. Don't stop at the LPN, move on the RN. Once you are done, you will see you made the right choice and your family will better off. Right now it look hopeless, but when you are done and you look back you will be happier. I wanted to quite my LPN to BSN program many times, I was up till 1-2am finishing papers, or doing research for a presentation. I am SO happy I finished, my income jumped from 42K/yr to 75K/yr (base not including overtime) and I can go to ANY state and get a job.

    Quote from Anne36
    KDBSN, I am in an LPN program right now and I lay awake part of the night trying to decide if I am going to go on to RN. I want to, but I am so darn tired and broke. I am signed up for more pre-reqs this summer and am about to cancel because I am having a hard time coming up with the extra money to fund it. Im also about ready to settle for LPN because school takes away so much from my family. I dont have enough time for my kids, and I am exhausted from the stress of the last few years of school. How do other people overcome these obstacles to a higher education?
    NurseLoveJoy88 likes this.
  12. Visit  GM2RN} profile page
    0
    Quote from tferdaise
    I think people are missing the whole point, it doesn't matter what education the LPN gets, is what the State Board dictates on what the LPN can do. Here in AZ, the state board changed the scope of practice for a LPN which caused al the acute care hospitals to stop hiring LPNs. LPN can no longer note physician orders. They can do them in SNF but not at acute care hospitals.

    The whole debate about having no more LPNs is finally coming true, but only in Acute Care hospitals. I know that each region is different and there might be some hospitals still using them, but are they hiring new ones? Again, here in Phoenix, none of the acute care hospitals are hiring LPNs and at the hospital I work at, the LPNs that are working the floors have until Jan 2012 to be in a RN programs or they will lose their jobs. The hospital is fazing out the LPN role. The LPNs were told in 2010 about this so they have had plenty of time to get in a program.

    Now as someone who was a LPN for 6 years in a Acute Care Hospital, I can debate both side of this topic, but I truly do not believe that hospitals use the LPN in the correct role. I have for a while at where I work to get them to us the LPN as a Discharge/transfer nurse. Don't take the RN off the floor to transfer someone or D/C the patient.
    I don't disagree with this, but I think it's only part of the point. From what I've seen, LPN programs tend to teach to the level of the LPN scope of practice. That's where the training part comes in.
  13. Visit  tferdaise} profile page
    1
    This makes no sense, of course they teach the LPN scope of practice, why would they teach the RN scope of practice? It would like saying, the RN schools should teach to the NP level...

    My suggestion would be for people to sit in to their states nursing board meetings, they are open to the public since they are a state agency. Its really an eye opener to see how they come about first hand. Had to do this for my BSN program and was amazed at what I learned..

    Quote from GM2RN
    I don't disagree with this, but I think it's only part of the point. From what I've seen, LPN programs tend to teach to the level of the LPN scope of practice. That's where the training part comes in.
    Mrs. SnowStormRN likes this.
  14. Visit  NurseJacqui} profile page
    0
    I have worked at many hospitals over the years and NONE of them hire LPNS. Nowadays, even being an RN is not enough.In my area most hospitals will only hire BSN. But LPN's are still utilized a lot in the LTC and home care settings.


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