After what year can an RN student work as an LPN?

OgopogoLPN, LPN, RN · Aug 16, 2009

BScN students can write the LPN exam after 2nd year. I imagine they have to submit their application to the CLPNBC, but it's somewhat common here. I worked with an LPN the other day who is going into her 4th year and took the LPN exam after her 2nd year.
We have ESN's on my surgical floor at the hospital and for the most part, they are great!!! Maybe it's just because I get along with them personally, but I also really value having them work with us. I find it great to have extra hands when it's busy. But also, it's a mutual respect. I can learn from them, but also, I've been on my floor for almost a year and know more about certain aspects, procedures and skills than they do. They appreciate my knowledge and are happy to learn from me, an LPN. I will be sad to see them off our floor in a few weeks :)

I don't know why I can't edit my post here...but anyways, just wanted to add as well about ESN's in my hospital...they are used in a supranumerary postion. They don't "count" as a staff member so regular staff don't have hours cut back. The other day we had the regular RN, myself (LPN), an ESN and a end of 2nd year student on my team for 8 patients. I was sent to another part of the ward that was short staffed and they HAD to call in another LPN to replace me. They couldn't "count" the ESN as a nurse on the team, or the 2nd year student. According to "official staffing" that team had ONE employed nurse, the regular RN.

linzz · Aug 16, 2009

This is where comparing educational programming and licensing requirements becomes a bit of a quagmire. Every province is going to do things their own way. Perhaps it might be useful to preface remarks in these sorts of threads by stating where you're from first off so the person looking for information doesn't become overwhelmed and confused by the grab bag of responses.
Just as a comment on Fiona's description of what is currently happening in Alberta as relates to the Undergraduate Nurse Employees... Because Alberta Health Services has decided there is no nursing shortage in Alberta and therefore there will be no new hires, only a redistribution of existing health human resources, many wards in the province are significantly short staffed. At major urban hospitals there will always be at least an RN or LPN to supervise the UNE, (which is why the regular staff are not being offered the extra shifts or are being sent home... they cost a LOT more) but in rural areas and even the suburban community hospitals UNEs are replacing the licensed personnel and working without supervision. This is a disaster waiting to happen. Kaaren Neufeld, the president of the Canadian Nurses' Association has publicly chastised the minister of health for this misdistribution of health care human resources. Not that he's likely to care what "some woman in Ottawa who's just a nurse" has to say.

To all of you in Alberta, I am in solidarity with you. Not that Ontario is doing such a great job managing their resources.

Pediatric Critical Care Columnist · Aug 16, 2009

thanks a lot, linzz. we really appreciate it.

this was posted on our union's secure site (i've edited to protect the poster):

we are a small rural hospital out in xxxxx, and we have been told that due to rn and lpn shortage, they are going to replace our acute care rn with a une to cover shifts left vacant (due to holidays and shortness). we only staff this area with one rn, one lpn, and one na for 14 acute care patients, 1 palliative care bed and there is one rn only in emerg to cover that area. we have been told that the rn in emerg would be "responsible" for overseeing everything the une does. we have to double check everything they do - narcotics, insulins, etc, and they can't hang blood, iv bags, iv meds, etc. i understand the une can't be in charge of the floor or hold narcotic keys, but in case emerg is busy - which it usually is (lots of refineries and big construction companies in our area), how is one rn expected to cover both areas and be responsible for an area that she might not see very much of?

if anyone else has une's working on their floors, can you please pass some direciton my way as how i can handle this? several of the rn's have refused to work in emerg if a une is on the floor, because they feel the safety of the patients and themselves is jeopardized. we feel that we are being backed into a corner with this, and it has left alot of rn's upset and frustrated to the point that some are willing to resign/retire. we can't afford to lose any more staff! our overtime is through the roof and morale is in the toilet!

another nurse wrote this:

on my unit we have 2 unes working with us who have not been adequately supervised. the one student requested more buddy shifts in addition to his 7 stating that on some of his buddy shifts he was just alloted his supervising nurse's patients and left on his own. i ordered extra staff for the next shift so he could be buddied, but our unit clerk made the decision that he didn't need any more buddy shifts and cancelled the extra staff i had requested. as it turned out, the une gave a patient a prn in 2 hours when it was ordered as q6h. our other une processed a med order for 1200 mg of lithium but transposed it into the mar of the wrong patient. luckily, that error was caught and the wrong patient did not get the wrong med. i spoke with my manager regarding the first une's request for more buddy shifts, and her response was that we "must" provide him with extra buddy shifts. in nursing school students are often made to feel that they are supposed to know everything before they even step foot on a unit, and are often afraid of asking for help and support for fear of being viewed as incompetent. however, in situations where units are short staffed and are unable to supervise unes adequately, they should refrain from hiring them as patient safety is obviously compromised as a result.

the responses these posts attracted revealed that not only rural hospitals were resorting to this but some urban ones had been "managing" the same way. to be honest, i've worked with some very intelligent and experienced nursing assistants that i'd be more comfortable delegating to than some of the graduate nurses i've known. i'd be filling out professional responsibility forms and calling the college if i had to let someone who was only part way through their education take responsibility for my patients.

Silverdragon102, BSN · Aug 16, 2009

Going to get worse before it hopefully gets better. Why they expect RN's to put their license and job at risk is beyond me

Fiona59 · Aug 16, 2009

Jan, we've had UNE's who have major attitude towards the LPNs. Yes, on acute floors we can't access central lines BUT the shift assignments are built to reflect this, Patient X has a PICC so he gets an RN.

Now an experienced LPN can tell you when your patient is going sour but some of our UNEs just go "I'll ask an RN". One even went as far as telling a co-worker that in a year she's be Charge and the LPNs were going to get the "crap" assignments when could write them. This is a woman who we have bent over backwards to mentor, hone her skills, and have given her the least difficult of patients because that is all she can handle. This future Charge couldn't handle compassionate care because "like he's dying".

These are my future leaders....

Pediatric Critical Care Columnist · Aug 16, 2009

I hear you, Fiona. I get the same sort of attitude from new grads... "What can you teach me? You only have a diploma in nursing and I have a DEGREE!" Never mind my 14 years of critical care experience and all the continuing education I've obtained at my own expense and on my own time. That attitude is instilled by the faculty of nursing at the U of A; they're brainwashed from day one that they're going to graduate and be the best nurse the world has ever seen... with no clinical skills to speak of and few people skills too.

(Funny but recently I was talking to a MScN student who didn't know I didn't have a MScN... she worked with me a few years ago and really thought that I had a graduate degree! Too funny. Nope, I'm just a know-nothing diploma nurse.)

linzz · Aug 17, 2009

I wish the public had a clue as to how unsafe it is to use grad nurses in place of RN's with experience, not just a degree. I really hope that you guys are able to fight this. Good luck to you, I am rooting for you.

It's interesting that you have noted some of the attitudes of grad nurses as I have heard these same complaints among three nurses that I know, two RN's and one LPN, all with well over twenty five years of experience. I would love to know how long some of these wonder kids actually last before they burn out or just end up turfed out of their unit.

Pediatric Critical Care Columnist · Aug 17, 2009

Thirty-three of the nurses in the first year of their career who came to work on my unit since I first started there have left. Our turnover is incredibly high, and there are people who started orientation on our unit and left before I ever met them. That number, 33, represents only those new nurses I actually met before they quit... out of the 134 people that I've actually met who have left since I began there seven years ago next month. We have several new grads on the unit right now; some of them are very smart and proficient nurses, and others are not qualified to care for a houseplant, IMHO. The acuity on our unit is very high and that's not taken into account when they hire new staff. Those new grads that we have now were hired before the freeze so there shouldn't be any more hired onto our unit for the foreseeable future. Unless they were UNEs... they accrue seniority as if they'd been working as RNs... now isn't that fair?

Spritz · Aug 21, 2009

Here in BC where I work (VIHA), there are student nurses (in the RN program heading into year 3) that can get paid student positions. I am not sure of the parameters around their practice or supervision required. I am an LPN and love it. I know the college I went to offered an RCA to PN bridge type program - perhaps as you already have some of the skills you could look at something like that - maybe the lists would be shorter.

Good luck on your choices

Cheers

canadiangradschoolrn · Aug 24, 2009

You have a couple of options.

You can take the BScN. Many people in the BScN program, have kids during the program and do well. For instance, the lady with the highest average in my program had one kid and was 8 months pregnant when we wrote our final exam. Also, if you really look at some hospitals you can work as a clinical extern while going to school. Clinical externs are nursing students and assist nurses in hospitals. Its a great learning experience and generally pays well. The position is available in many hospitals including London health sciences, Sick Kids, I also think UHN has it. Normally, you can become a clinical extern begining in the summer after your second year or summer after your third year. You can also work as a healthcare aide during your BScN.

Another option you have is to go for the LPN. In Ontario and many province, this takes 2 years. After completing the LPN, you can then go for your BScN which takes 2.5 years to 3 years if you have your LPN. During this last 3 years, you can work as a LPN.

Hope this helps. Let me know if you have any other questions.