Blurred Boundaries: Should we eliminate the distinction between RNs and LPNs?

[ilovechadkrause]

It is becoming increasingly obvious that the roles of an RN and LPN are blurring into one another.

My question is: Should we eliminate this distinction altogether? If so, by what means? We could eliminate the LPN program, so that every nurse would be an RN. We could combine the two titles and come up with an entirely new generation of nurses, that are considered equal in the public and medical eye.

What do you think?

[RochesterRN-BSN, BSN, RN]

I was not meaning to say that LPNs are INCAPABLE of assessing.....I too have worked with some wonderful and very smart LPNs.....I was just stating the LAW.....hell we all know how many times we as nurses could DIAGNOSE seeing the same things again and again but we all know only an MD (or NP/PA) can do that!!!! talking the law here not ability so please know I was not trying to offend anyone. I have written a letter to the state who tried to pull an LPNs licence--- to defend her and stand up for her. We are all on the same team here and we need to focus on what's important.....we are all nurses of any level for one reason.....we love people and taking care of them. We need to stick together!

[pawashrn]

the titles are based on education. aide-LPN-RN-CRNP-Doctor-specialist---these titles may integrate with one another but they are separate entities and have defined lines of responsibilities and decision making skills based on education

[RN_Canada]

The roles seem similar but are not equal. The reason they are not equal is that the RN has a broader knowledge base. The extra years of study in a more in-depth program is what distinguishes the RN from the LPN.

Just the Canadian perspective on this discussion

With the RN preparation now a mandatory university degree the lines are not blurred!

RN's have university education and LPN's have between one and 2 years of education. For anyone to suggest that they "do the same thing" is a bit naive.

Research has shown that the people who understand this the least are the working LPN's and the people who understand it the best are the RN's who started out as LPN's and went on to complete their university education to be a RN.

As much as I can understand here is the difference (and this is not well understood in Canada...we have a lot of work to do)

Although self regulating the LPN does not work in an independent role and must be part of a team or work in partnership or under supervision . They cannot enter into a relationship with a client unless that client is already being cared for by another health care provider that can establish a plan of care.

A Registered Nurse can enter into a relationship with a client independently without the client having an established plan of care or being cared for by another health care provider such as a doctor.

The Canadian Association of LPN's describes the LPN scope of practice as a "partnership" so I think I am on the right track here .....

I know that the situation is different in the US but thought you might like the Canadian persepective.

[mcknis]

paycheck, education, etc. all make a difference to me!

[Seishiro]

No. LPNs have a different scope of practice than that of RNs. The level and degree of education is different. This argument can also be made for those seeking DNPs (Doctorate of Nursing Practice) against those with MD degrees. While I believe both should/could be called Doctor, one is still a nurse caring for patients and the other is a doctor treating patients for their disease process.

LPNs work with RNs underneath their supervision to care for clients.

If I have worked 3-4 years for an Associates in nursing, I'm going to be a little more than a little nonplussed about a nurse who has only gone to school full time for a year, or two years receiving the same credit. Granted I'm sure there are a lot of LPNs who can teach many RNs out there a thing or two about a thing or two, but what it all boils down to is the level of education, IMHO.

PS I am currently a LPN student.

[flightnurse2b, LPN]

LPNs work with RNs underneath their supervision to care for clients.

:banghead::banghead:

i do not need a chaperone at all times. thanks.

[Seishiro]

Just because you have a supervisor to report to, isn't meant to imply that they have to hold your hand. You're still a professional. I'm sorry if I made any offense, it wasn't intended.

[RochesterRN-BSN, BSN, RN]

The LAW says that LPNs are to work under the supervision of an RN. To say you as an LPN "don't need a chaperone" is a bit much. No the RN doesn't need to be a shadow and follow and watch everything you do but the LAW says the LPN is not to function independantly. I think the point is being missed that the scope of practice set for each credentialled person be LPN, RN, NP or MD are legal boundries for which one can be penalized legally for practicing outside these set limits. There are a lot of things we might be CAPABLE of doing but if those things don't fall within scope then we are practicing outside our legal scope of practice and will be penalized......just because someone may be doing just this does not make it an less illegal and that person is risking losing his or her license and potentially criminal charges.

[flightnurse2b, LPN]

there are many things i can do independently of an RN. please remember i have a license too.

i am not going to be in trouble for changing my patient's diapers by myself. or giving them a g-tube feeding by myself. or starting an IV by myself. or check my patient's vital signs by myself.

the north carolina BON says an RN has to make my assignment for me. there are things i must report to my supervisor and things my supervisor must do for me that are out of my scope, unless i am working in my paramedic capacity outside of the hospital. i have the nurse practice act in my clipboard, actually. i know the rules.

but i have my very own scope that i can do, too.

[laketrash]

I remember when team nsg {which I thought was great because it made the best use of all our knowledge and talents} changed to primary nsg and it was pretty bad.Our floor might have TURP going along with another pt with a dopeamine drip, and a pt just back from a total hip replacement and the LPNS were lost in doing neurochecks etc. They came {thank God} and asked for help but it was really unfair to expect them to take on a RN job. With that said , it was also hard for us RNS because we were so used to the hands on care the lpns provided such as dsg changes etc,

[patrick1rn, MSN, RN, NP]

no, not at this point, i believe that we should encourage the further education of the lpns but making money available for tutuition and by making loans for expenses during school available

the lpn schools now in exsistance could further the education into the rn field but as things stand now there is a definitive difference in the functions of the rn and the lpn

the lpn who advances to the rn field should be trained to the point that she feels secure in her knowledge

i think that there should be a fast track and that nursing schools should give a preference to lpns who are seeking to return to school over new high school grads or those making a career change..the knowledge gained in the schooling and work experience of the lpn is of great value to the health industry

So your saying that taxpayers should have to pay the tuition of LPNs over traditional students ? What makes them more special ? I dont see the blurred boundry either. I have to disagree with the fast track option also. The LPN to RN programs currently in place already cover that.

Some people complain about the non nursing classes such as history, arts, chemistry, etc that RNs have to take in either the ASN or BSN program. A college degree is not about just learning technical skills for one particular occupation. The humanities are required, because we are human, these classes help open other parts of the mind, explore other ideas, much like taking required algebra classes.

I will be honest, LPNs studentsdont study as long or as intense as RN students. The cirriculum is different. Not insulting any LPN either. But I get a little irritated when an LPN tries to compare my classes that I have taken to the 15 month LPN program and then think they understand as much about the needs of a patient. So, no I dont see a blurred boundry, i see it as a oppurtunity for LPNs to progress to RNs

[RochesterRN-BSN, BSN, RN]

I have to be honest I have only worked in 2 jobs where they even hired LPNs ....LTC and on a medical floor.

In psych-inpatient and psych ED and in L&D, they don't hire LPNs where I live. They had LPNs in the Med ED when I first started there but shortly after made them all transfer to a med/surg floor.