Are LPNs Second Class Citizens?

[flashpoint]

Lately, the RNs I work with have been treating the LPNs and CNAs like dirt. I'm not the only one with this complaint and a lot of us are getting very frustrated. Classic example...today we had 14 patients...LPN had 7, CNA had 2, one RN had 3, the other RN had 2. All 14 were 2 points on the acuity scale they use, so no, the LPN didn't have 7 easy patients and the RNs to difficuly patients. The charge nurses have also been denying the LPNs and CNAs breaks or paging them 10 minutes into their breaks and telling them to come back to the floor. Also, one of them has been making really rude comments, like "Stupid CNA" and "Worthless LPN" when talking about other staff.

Management is aware and is going to "have a talk" with the RNs at the next RN meeting...on Nobember 15th. Also they're going to have the charge nurses justify a difference in more than 3 acuity points when making patient assignements. So...until November 15th, I guess we have to put up with it.

Is this the norm in other places? Are RNs everywhere being assigned lighter loads? Here, the responsibilities are really no different except the patients who are assigned to RNs do not have to be assessed by the charge nurse. We have a med nurse who give all meds including IV (except PRNs). Does anyone know any logic behind giving the RNs such light assignments compared to the LPNs?

Venting more than anything here. A lousy few weeks. I'm leaving the unit in a couple weeks...can't wait to get back to the ER.

[ktwlpn, LPN]

Originally posted by 3rdShiftGuy

If this is indeed the situation, sounds like you have twice the load the RNs do and that is unfair. Hope you get some resolution.

So what's a "swingbed" patient.

It's a step-down from acute care patient.I believe that some smaller hospitals could apply for swing bed status-they had to be a number of miles away from any rehab facility...The patient is d/c'd and then re-admitted for rehab in the hospital.The details are fuzzy now but I remember when our small community hospital started swingbeds-it was supposed to be a good thing..This was after the hospital based "TLC" unit went belly up...Patients initially thought it would be great-until they realized that we had the same number of staff and everyone else was much sicker then they were...The actual rehab program was just as good as any rehad facility could offer but the mix on the unit was a disaster..The nurses with swingbeds mixed into their districts were not able to keep up with that required paperwork and team meetings,etc...and care for their med-surg patients...Then they actually designated one district as swing..no-one wanted to work it day after day...It was a loser all around

[Tweety, BSN, RN]

Originally posted by ktwlpn

It's a step-down from acute care patient.I believe that some smaller hospitals could apply for swing bed status-they had to be a number of miles away from any rehab facility...The patient is d/c'd and then re-admitted for rehab in the hospital.The details are fuzzy now but I remember when our small community hospital started swingbeds-it was supposed to be a good thing..This was after the hospital based "TLC" unit went belly up...Patients initially thought it would be great-until they realized that we had the same number of staff and everyone else was much sicker then they were...The actual rehab program was just as good as any rehad facility could offer but the mix on the unit was a disaster..The nurses with swingbeds mixed into their districts were not able to keep up with that required paperwork and team meetings,etc...and care for their med-surg patients...Then they actually designated one district as swing..no-one wanted to work it day after day...It was a loser all around

Very interesting. Thanks for clearing that up. There is no such thing here. Thank goodness. We do have a skilled nursing unit and a rehab center where I work. But certainly they patients are mixed in with the med-surg floors. I don't even want to give anyone any bright ideas about that.

Lately the skilled nursing and the rehab patients need a lot of professional care, meaning they still are getting antibiodics, blood products, TPN, etc. Everyone's sicker these days. What used to be ICU is now med-surg, what used to be med surg is "skilled nursing" sometimes.

[nursepenny]

I go to several different nursing discussion boards and seem to be confronted on each by the same thing. This is the second time I have responded to any discussion. Whether or not RN's realize it, there is a difference made in regard to your nursing credentials.

When people find out you are an LPN, the general remark is, "Oh, well I want to talk to a nurse."

Well what am I chopped liver? My license states I am a NURSE.

--------------------------------------------------------------------------------

I am an LPN who works in a small ICU, which has 5 beds. I can do anything the RN does except charge. I give my own IV push meds, hang blood, call the docs for further orders, manage CVP and art lines, vent patients, etc. I have the will to learn and ask for assist if needed. I feel I have a broad knowledge base. If I have questions about anything, I ask someone who has more experience than I. I am constantly reading medical articles amd books. I also use the internet for information. Several RN's have asked my advice countless times. The RN with whom I work, and I discuss everything concerning patient care.

As an LPN, I think the requirements to work in an ICU should include that ALL NURSES have experience of working the floor for a few years before transfering to ICU or SDU. All LPN's are not total dunces and some are knowledgable enough to work in ICU's. Remember, LPN students receive more clinincal time than RN students. LPN stands for Licensed Practical Nurse not LITTLE PEICE ofNOTHING...

RN's should remember LPN's are nurses also.

Oh yes, I forgot to mention I am ACLS certified... : confused:

[chad75]

LPN's are not 2nd class citizens, they are a needed component of a well run unit. BUT they work UNDER the RN's licence. So, whatever an LPN does, the RN is responsible for. So if the RN only has 3, in reality, they have your patients as well. What the heck is a CNA doing with ANY patients, much less 2??!!

The last time I checked I worked under my own license as an LPN, if I had to work under an RN's license I wouldn't need to be licensed. However, I do work under the supervision of an RN, just like an RN works under the supervision of a physcian.

You do bring up an issue I have thought long and hard on though, at what point does my responsbility as an LPN end and the RN's begin especially on a primary care unit where "I" am the assigned nurse for the patient. In team nursing this isn't much of an issue but I think we are seeing a lot of grey areas in primary care.

[Vsummer1]

Originally posted by chad75

The last time I checked I worked under my own license as an LPN, if I had to work under an RN's license I wouldn't need to be licensed. However, I do work under the supervision of an RN, just like an RN works under the supervision of a physcian.

You do bring up an issue I have thought long and hard on though, at what point does my responsbility as an LPN end and the RN's begin especially on a primary care unit where "I" am the assigned nurse for the patient. In team nursing this isn't much of an issue but I think we are seeing a lot of grey areas in primary care.

Good question! I think every State may be different on what they allow each to do. The State BON regulates that, so what I may consider to be an RN task may be an LPN/LVN task elsewhere (such as IV push). Here LVN's aren't supposed to do IV, but then they can do it if they obtain special certification, just as an RN would be able to do dialysis if they go and get special certification. So it could be an institutional guideline as well.

[P_RN, ADN, RN]

are lpns second class citizens?

no

any other answer is bogus.