LPNs Fight Efforts To Phase Them Out - page 8

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
    0
    Quote from tferdaise
    There are studies that have proven having LPNs in acute care hospital have a positive role in healthcare. I had 3 of them saved on my old lap (until my HD died) I was working on a paper for my BSN on that subject. BTW, the LPN association would have copies of these studies.

    Of course they have a positive role, just as RNs have a positive role, CNAs have a positive role, etc. That does not mean that LPN = RN.

    Regarding state boards, they routinely update the scope of practices. AZ board did that regarding LPNs, which basically sealed the death of LPNs in acute care hospitals. The State Board states that LPN are not allowed to note orders in Acute Care Hospitals, they can though so it in SNFs. So your comment regarding State Boards invalid.
    Assuming your information is correct, the comment about State Boards may be partially incorrect, but not invalid.
  2. Visit  tferdaise profile page
    0
    No, I don't think what I wrote about the State Board is wrong. Most state boards look at what is happening at other boards around the country, they see trends and they do their own research. There are studies out there that shows LPN should not be in acute care hospitals.

    Not too sure what kind of experience you have in research and looking it up, but there are always two sides to research.

    Quote from GM2RN
    Assuming your information is correct, the comment about State Boards may be partially incorrect, but not invalid.
  3. Visit  tlbradshaw profile page
    2
    THE ORDER OF NURSING HAS NOT CHANGED ALTHOUGH NO ONE CAN REMEMBER HOW ONE CLIMBS THE LATTER OF SUCCESS IN NURSING: IF YOU STARTED IN THE NURSING FIELD THE CHAIN WOULD LOOK LIKE THIS: A HOME HEALTH SITTER,CNA ,MEDICAL ASSISTANCE,MEDICAL TECH,LPN, THEN RN,NP,AND SO ON.....WHAT I DON'T UNDERSTAND IS HOW DOES ONE FALLS FROM THE LPN POSITION TO A CNA POSITION WHEN YOU ALREADY HAVE OUR POOR MEDICAL ASSISTANCE BEING HIRED AND USED ALREADY FOR CNA POSITIONS WHEN THEY ARE UNABLE TO BE HIRE IN THEIR FIELD. SHOULD THE LPNS BE OFFER A POSITION AS MEDICAL TECH's WITH ADVANCE CERTIFICATIONS TO HELP AND USE OUR SKILLS ALONG WITH RN's,IF THE TITLE LPN IS COSTING EVERYONE TO MUCH MONEY THEN MAYBE THIS WOULD BE A GOOD ACTION,A BRIDGE IS NEEDED BECAUSE, AFTER ALL IN MOST STATE THE ONLY THING LPN's CANNOT DO IS IV PUSH DRUGS AND HANGING BLOOD WITHOUT RN ATTENDENCE. SOMEONE SHOULD LOOK INTO THIS SITUATION BECAUSE TIME AND MONEY AND TEARS WENT INTO EVERY PERSON THAT BECAME A NURSE WEATHER LPN OR RN.
    martinalpn and FranEMTnurse like this.
  4. Visit  nursel56 profile page
    2
    Quote from tferdaise
    No, I don't think what I wrote about the State Board is wrong. Most state boards look at what is happening at other boards around the country, they see trends and they do their own research. There are studies out there that shows LPN should not be in acute care hospitals.

    Not too sure what kind of experience you have in research and looking it up, but there are always two sides to research.
    The onus is on the person making a claim to provide specific, real world, vetted, hopefully duplicated valid studies. Perhaps you learned something different? I may not be too terrribly bright, but we're talking research 101 here.

    The changes made in scope of practice are miniscule compared to what a nurse does in the hospital in total.

    In fact I looked in the AZ BON website and I could not find anywhere where an LPN cannot note a doctor's order. A unit secretary can note a doctor's order. If you are going to continue to let fly with these vague statements - please respect us enough to back it up and don't tell us to "go look it up"
    HazelLPN and TheCommuter like this.
  5. Visit  junathan11 profile page
    1
    I too work at a hospital here in florida and they are slowly getting rid of the LPNs. I am having the worst luck trying to find a job. Home health jobs are suppose to be easy to get but not for a new LPN. I found 1 job but I only work every other weekend. I work 2 days a week at the hosptial as a CNA until they post LPN poistions but they have not posted any in over 6 months. I guess they are really taking this serious. Why do they still have the LPN programs when most companies only want RN. It's not right. I feel so crazy. Here I am a LPN still working as a CNA. But I am not giving up. I am on the computer everyday trying to see if any new jobs are posted but I wish it was some way we can start a LPN union so we can get justice. This cannot continue.
    FranEMTnurse likes this.
  6. Visit  GM2RN profile page
    0
    Quote from tferdaise
    No, I don't think what I wrote about the State Board is wrong. Most state boards look at what is happening at other boards around the country, they see trends and they do their own research. There are studies out there that shows LPN should not be in acute care hospitals.

    Not too sure what kind of experience you have in research and looking it up, but there are always two sides to research.
    You need to read my reply more carefully. I didn't say what you wrote was wrong. I said, "assuming that your information is correct," because I don't know if it is or not. I have no interest in verifying it, so I'm taking it at face value.

    SO, if I assume that the information you provided is correct, that still does not entirely invalidate nursel56's post, which is what you commented on. It only means that her comment is partially incorrect.
  7. Visit  HazelLPN profile page
    3
    Quote from MissingMyErica
    I'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.
    I've been retired for about a year and a half now. I also worked in ICU but I pushed my own meds, titrated my own drips, called the docs, took off orders, did vents, HFO, PRISMA, IABP, etc etc. The only thing my RN charge nurse (who took no assignment) usually had to do for me was check blood with me before I gave it. I did my own shift assessments, but didn't do admissions. I would still be going strong had knee replacement surgery not forced my retirement from critical care nursing. I was no burden on the RNs unless we were getting an admission. Initial assessment was not part of my scope, so I would have to switch assignments with an RN so she could take the admit and I could take over her assignment. Usually no big deal, and if it was a newer RN, I usually helped her do the admission or in some cases, did it for her if she was still struggling with her clinical/organization/critical reasoning skills. I was happy to take the mother hen role (grandmother hen in my later years) to help these young kids out. Great people took care of me when I was young, so I do the same now that I am old.

    Don't want LPNs? Fine. Don't hire anymore, phase them out and don't train anymore. Close down all the LPN schools. Let the ANA have their way and only train BSNs as the entry into nursing. But allow the existing LPNs a full scope of practice like several states do so they can keep their jobs and retire with dignity. Train no more ASNs or Diploma nurses (the latter being the best training there ever was for nurses..learning by doing and being mentored). Then they wouldn't be in the way like this poster is. No more supply of LPNs, no need of RNs worrying that LPNs will replace them as cheaper labor which greedy big business would certainly do if they could.

    I retired after 54 years in nusing. I too returned for my BSN at one point, but life got in the way and I never finsihed (90% was complete). What I learned in school for my BSN pales in comparason to the knowledge I obtained on the job as an LPN. Experience is the best teacher and critical reasoning (which many confuse as memorization) is not something that is really taught as much as something that one either has or does not have.
  8. Visit  nursel56 profile page
    1
    Quote from HazelLPN
    . . .Don't want LPNs? Fine. Don't hire anymore, phase them out and don't train anymore. Close down all the LPN schools. Let the ANA have their way and only train BSNs as the entry into nursing. But allow the existing LPNs a full scope of practice like several states do so they can keep their jobs and retire with dignity.

    Train no more ASNs or Diploma nurses (the latter being the best training there ever was for nurses..learning by doing and being mentored). Then they wouldn't be in the way like this poster is. No more supply of LPNs, no need of RNs worrying that LPNs will replace them as cheaper labor which greedy big business would certainly do if they could.
    Thank you, thank you, thank you. :redpinkhe Finally someone expressed my feelings better than I could. It's only the greedy business people that have kept us around since the relentless attempts by the ANA and other groups to get rid of us and restrict us, and then turn around and essentially blame us -- because after all, if you can't assess a patient, do patient education, do IVPs, work with those with "unpredictable outcome" it must be because you aren't capable of it, right?

    Even Linda Aiken, the most often mentioned author of studies that supposedly prove what a risk an ASN or diploma RN poses has cautioned about the broad and sweeping causation not correlation statements made by those who cite her studies.

    I'm pretty much done, too. It's pointless to try - we're out-gunned, out-unioned, out-funded, out-lobbied and it is only through my having known people like you that I continue to tilt at windmills. Thank you so much for contributing this.

    Quote from GM2RN
    . .SO, if I assume that the information you provided is correct, that still does not entirely invalidate nursel56's post, which is what you commented on. It only means that her comment is partially incorrect.
    I stopped being able to follow his train of thought a few posts ago. I don't have a problem being partially incorrect, I just want to know what I'm partially incorrect about.
    Last edit by nursel56 on Apr 29, '11
    HazelLPN likes this.
  9. Visit  GM2RN profile page
    0
    Quote from nursel56
    I stopped being able to follow his train of thought a few posts ago. I don't have a problem being partially incorrect, I just want to know what I'm partially incorrect about.
    LOL I don't blame you for being confused.

    You commented in a previous post (I couldn't readily find it to quote it) about the BON further restricting the scope of practice of LPNs. The quote below referenced that post. My point was that even if tferdaise was correct, that still did not completely invalidate what you said.

    I'm not sure if I unconfused you at all, but I tried.

    Quote from tferdaise
    Regarding state boards, they routinely update the scope of practices. AZ board did that regarding LPNs, which basically sealed the death of LPNs in acute care hospitals. The State Board states that LPN are not allowed to note orders in Acute Care Hospitals, they can though so it in SNFs. So your comment regarding State Boards invalid.
  10. Visit  Ginger's Mom profile page
    0
    You are the on the board of directors of this hospital and see reports like this

    http://www.hospitalcompare.hhs.gov/h...1&lng=-76.189&

    You are below the national and state averages in HCAPS

    http://www.hospitalcompare.hhs.gov/h...&lng=-76.189&#

    You are below in quality.

    Your Medicare funding has been cut, you can not add staff. Unless you improve your scores you are going to loose 2% more if your scores don't improve.


    http://www.afscme.org/docs/LPN-Rep.pdf - while this report is to support the role of LPNS in the hospital.

    It has many telling conclusions:

    One no studies saying the LPNS improve or harm patient care.

    The State Boards can be very restrictive of the LPNs practice.

    LPNs is all states have to work under the direction of the physician or a RN.

    While many posts argue that the LPNs are independent and only have to interrupt the RNs practice very minimally , I have not seen one RN post here welcoming overseeing the LPNS and performing their own assignment. I have worked with very skilled LPNs but I always felt the burden and responsibility for overseeing their patients. I never got paid extra for caring for my patients and the PN's patients. There is no legal way a LPN can take responsibility for their patients totally.

    In my years of practice when LPNs where employed in hospitals, I would often here the following:

    A. The assignments are not fair ( usually they were assigned more patients due to the fact the RN had to over see their patient's care.
    B. I would miss breaks and meals while the LPNs were sitting around, the reason why is there patient needed medications or treatments that their patients needed.
    C. Scheduling would be difficult, if I needed a day off a LPN could not take my shift, while a RN could cover for them.
    D.LPNS could never be in charge or be on the code team, so in addition to over seeing their patients, a RN has to be available to be in charge and cover emergencies.

    So as a Board Member, why would I continue to hire a nurse, who can't be independent in practice and has a track record of providing care below the state and national average ?
  11. Visit  nursel56 profile page
    1
    I must say I am very surprised at the post above. Maybe I shouldn't be. Your conclusion that LPNs are not able to take care of more complex patients is based on what a Board of Directors thinks about customer service surveys that don't appear to differentiate who or how they felt their experience was lacking?

    Before you start offering that sort of thing as the proof of a nurse's safe practice in the workplace, you might want to step back and see how many of rank and file nurses of all degrees feel about the accuracy of such assessments.

    You just don't like LPNs it appears because where you work they were in your way. The idea the "LPNs sat around" on your shifts causes you to believe in a global trait all of us must have? Other than being shocked that this is what you offer as proof, I suppose I should be relieved. I expected better, Ginger's Mom.

    You can relax, though. As Hazel said (and so did Richard Nixon) pretty soon you won't have us to kick around anymore.

    I just want to add a public thanks to Marion, Yoshiko, Berrie, and Corrine who brought me into the fold as a new LVN made me feel I had worth, and the cohesive culture of teamwork you provided so all of us could grow as nurses and as people. I appreciate all of you so much, wherever you are.
    Last edit by nursel56 on Apr 29, '11
    HazelLPN likes this.
  12. Visit  Ginger's Mom profile page
    0
    You have no idea my feelings towards LPNs, in fact I have been an instructor in the PN program and loved teaching this group of nurses. I am very proud to see my former students in the workforce. There is a very important these nurses in the US Healthcare system.

    What the PNs are not prepared for is the complexity of nursing care in the acute care hospitals, I am basing this on my personal experience as a floor nurses and an educator.

    As far as government assessments this is way our healthcare system is moving, if you don't like it read the CMS web page when a new measure is proposed it is open for public comment. I would bet the nurses who complain here do not follow what CMS is proposing and never have made a public comment. Easier to complain than to act.

    If LPNs wished to stay in acute care they should have lobbied to have their education modeled after the Canadian Model where they have double the education ( to me if you are going to school for 2 years why not become a RN).
  13. Visit  nursel56 profile page
    1
    Your entire post is based on either a conclusion drawn from mid-air, your personal experiences and opinions, or the personal experiences and opinions of people who have worked at your hospital in your state! I can only hope someone else who agrees with you can offer reasoning that is more valid than all of that, and frankly takes more time to use the language in a way that is reflective of their education.

    I'm not a grammar cop, but it's beginning to really bother me that I'm being told of my deficiencies in education in posts that appear as though the writer doesn't care very much, and it isn't just you who is doing it. But back to content . . .

    When you teach LPN students - do you omit all the information that pertains to anything normally taking place in an acute care hospital? Are they required to take BLS for Healthcare Providers, or would the standard Red Cross CPR course be sufficient? Or do you just tell them they won't need to know that information once they graduate?

    Our customer service scores are down, it must be the LPNs My terminally ill mother sat on a bedpan for almost an hour after she was done* because the RN couldn't find the CNA, but when I went to remind them she was laughing and joking at the nurse's station** and said "Oh? Didn't Judy go in?"

    If Mom gave a lower score on "getting needs met right away" - would you assume that the CNA was providing substandard care? Turns out the nurse told someone else to "go get Judy" and Judy was off the floor someplace. The RN never bothered to check back - and actually said, "ughh. .", followed by -- does this mean all RNs are at fault for lower scores? No!! It is my personal experience on that day with that person.

    Why are you offering the subjective experiences of the lay public as any sort of proof LPNs "have a track record of providing care below the state and national average"?

    I only point that out to illustrate the fallacy of lower scores being blamed on any one job category, or frankly - any one person who kept you from getting you and your fellow RNs from getting your break on time or take the day off of your choosing.

    I'm amazed that you would offer this: I have not seen one RN post here welcoming overseeing the LPNS and performing their own assignment. - to put it bluntly - so what? If there's no post in this thread it's not real?

    This thread does prove that this nurse likes to do this

    If you haven't read the post by HazelLPN - it will give you a fresh look at the situation. Sometime I will write what my experiences have been over the years working in places where it all works fine, and how the litany of problems you have had are not indicative of similar dysfunction everywhere. My hat tip at the bottom of my previous post was an allusion to it. ~~~The End of Part One~~~

    I know what my AN friends are thinking....

    * I didn't take her off myself because she didn't tell me she was on the thing for 1/2 hour!! "Didn't want to be a bother" and she had lots of attached tubing and monitors I didn't want to jeopardize the integrity of ...

    ** no, she was not charting, talking to the doctor, or decompressing after a stressful code. The place was a mausoleum that afternoon and now I know where all the cool TGIF hot spots are in the area.
    Last edit by nursel56 on Apr 30, '11
    HazelLPN likes this.

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