Are RN's going to be a thing of the past?

[Emma_H]

Just wanted to know your thoughts on the shift from using more LPN's on units instead of RN's as they are cost saving for health authorities. We are beginning to see this in my health authority gradually. Any thoughts?

[Trishrpn80]

I work in Northern Ontario. We have an equ combo of RNs and RPNs. Cant really tell the difference who is who except in the delivery room. Not suprised at all by the ignorance already seen oncthis thread. LPNs in the USA are nothing like RPNs in ontario and alberta. Some of the other provinces need to catch up too

[Pepper The Cat, BSN, RN]

We have more RPNs than RNs on most shifts. They function very highly. Truth be told, there are many RPNs on our unit that I would want caring for me over some RNs. I think as hospitals continue to struggle with their budgets, we will see an increase of RPNs and a decrease of RNs.

[vintage_RN, BSN, RN]

On the Medicine floor that I am currently doing my placement on, you literally cannot tell the difference between the RNs and the RPNs unless you get right up there and look really closely at their name tags. There are 5 RNs and 3 RPNs per shift. I am a PN student and while shadowing an RPN I asked her the limitations to RPNs on the floor...and she said there is literally no difference except pay of course. Everyone works as a team, and it really is seen as all of the nurses working together rather than RPN and RN...even the nurses seem to make no distinction between each other. I think the only things RPN's cannot do is hang TPN or IV push but they don't really ever do that anyway on that floor. Of course the difference depends on the floor and RNs will be needed on any type of critical floor...but I can see RPN's increasing as their scope increases. And there is a HUGE difference between the LPN of the US and LPN/RPN of Canada...I don't even read the LPN forum on here because I can't really relate...we have a huge scope here in Ontario with very few limitations (depending on the facility)...I can't imagine not being able to hang IV meds and do many of the stuff I see that LPNs elsewhere cannot do. I think both are highly valued and needed!

[vintage_RN, BSN, RN]

Wow my grammar in the above post was terrible. My apologies...too many to bother editing

[SuesquatchRN, BSN, RN]

And there is a HUGE difference between the LPN of the US and LPN/RPN of Canada...

There's a tremendous difference in scope of practice within the various states here, let alone US to Canada. I moved from NY, where I started as an LPN, and found myself frustrated by the limitations under which I worked. Here in TX the LVNs (for vocational, not practical) have a much wider scope.

[vintage_RN, BSN, RN]

There's a tremendous difference in scope of practice within the various states here, let alone US to Canada. I moved from NY, where I started as an LPN, and found myself frustrated by the limitations under which I worked. Here in TX the LVNs (for vocational, not practical) have a much wider scope.

Sorry to generalize....I was speaking in generalities of course, just from what I've seen on the boards. :)

[Fiona59]

In America, in acute care medical centers throughout the country Lpn's are non existent. Especially in ICUs. No place for an lpn. In my hospital Lpn's were forced to retire, go back to school, or be demoted to techs.

If there were a prize for the most insulting post in this forum, I'm pretty sure this would win.

[SuesquatchRN, BSN, RN]

Sorry to generalize....I was speaking in generalities of course, just from what I've seen on the boards. :)

Oh, I wasn't offended, just clarifying. I get astonished at the differences just between states, and I would imagine there are some between your provinces, as well.

[joanna73, BSN, RN]

What should happen for LPNs is more money to accurately reflect their abilities and scope of practise, instead of governments trying to be cheap to cut corners.

I work with LPNs regularly and many of them are just as competent or more so in some cases than the RN. In fact, one of the new grad RNs complained to the LPN she was with that she thought it was unfair that the LPN with 14 years experience made more than her....because she is an RN. Outrageous!

I wish this whole debate would end. In reality, we all do the same job, and all LPNs and RNs are needed. Just wait until the mass exodus of retired workers really begins. It hasn't hit yet, but when it happens, all these health authorities will be scrambling.

[Esme12, ASN, BSN, RN]

If there were a prize for the most insulting post in this forum, I'm pretty sure this would win.

I don't think the poster was being insulting. She was being informative and sharing her expereince.

For years here in the US....the practice of the LPN has been shrinking by limiting what they are allowed to do by the nurse practice acts....which every state has their own. Imagine how confusing that is..... LPN Nurse Practice acts have been shrinking for years now.

MANY facilities have been phasing out the LPN and have required those still employed to return to school or they could no longer remain in their present position.....sad really. This has been occurring for AT LEAST 20 years with the slow removal of LPN from the Acute care setting....which I think hurts the bedside care of patients.

LPN's have found a new role in the setting of the Long Term Acute Care Hospital that has become another acute care tier her in the US. These are REALLY sick patients that have suffered multiple complications have complex wounds and multiple co-morbidities....that have (by the healthcare system in the US) "run out of Acute care days".....and can't go to rehab or a skill SNF...many of these facilities have actual intensive care units...LPN's are employed here.

I for one feel that losing the LPN at the bedside as another licensed personnel on the team is a big mistake but no one cares what I think.

[BrandonLPN, LPN]

What should happen for LPNs is more money to accurately reflect their abilities and scope of practise, instead of governments trying to be cheap to cut corners.

I work with LPNs regularly and many of them are just as competent or more so in some cases than the RN. In fact, one of the new grad RNs complained to the LPN she was with that she thought it was unfair that the LPN with 14 years experience made more than her....because she is an RN. Outrageous!

I wish this whole debate would end. In reality, we all do the same job, and all LPNs and RNs are needed. Just wait until the mass exodus of retired workers really begins. It hasn't hit yet, but when it happens, all these health authorities will be scrambling.

As much as I appreciate the sentiment, I'm going to actually disagree with some of this.

Although an experienced LPN will obviously have an edge over a new RN, they don't really do the same job. No matter how new the RN is or how experienced the LPN is, the LPN is out ranked. They're two different levels of licensure and there's no real getting around that.

I think it's a mistake to have LPNs take they're own assignment in acute care settings. LPNs should be reintroduced to the hospital, but in a purely "team nursing" role. The LPN should take over more of the tasks of nursing (medications, treatments, routine monitoring), resulting in the RN taking on more of a care management/assessment role.

This arrangement would also result in said RN taking on a larger overall patient load as part of their assignment. And this is the aspect that understandably sticks in the craw of most RNs. Who wants to take responsibility for eight or nine pts in med/surg on day shift? Even if you do have a LPN and an aide?

But if RNs really want to use more education as a way to move up the ladder toward more pay

and prestige, than taking on such responsibilities surely must be part of the deal. Why on earth would hospitals start paying a BSN-only RN workforce more money if they were doing the exact same job that the ADNs and diploma nurses used to do? if they're going to pay more, they're going to expect more.

So, something's going to have to fill the void in this scenario. A LPN/RN team model seems like the best option on the table if this comes to pass.

Of course RNs aren't going to be a "thing of the past". But the role will change and evolve. Like it always has and always will.

[joanna73, BSN, RN]

Depends where you work Brandon, and this varies widely. Where I work, the LPN and the RNs are doing exactly the same job.

The LPN role varies in Canadian Provinces and from Canada to the US again there are many differences. You're free to disagree, you just aren't aware of the differences from where you sit.

LPNs can't access picc lines, for example (at least where I am) but we don't ever have them anyway where I'm working. Everything else is the same....

We don't have ADNs anymore in Canada. RNs are BSN prepared now and the old Diploma nurses are encouraged to upgrade (our version of the ADN). And LPNs are expected to do A LOT more, and not being paid, which is my point. LPN scope in the US versus Canada is like comparing apples to oranges. Different systems entirely.