Can RN's moonlight as LPN"s?

[haitianrn]

To earn extra $$, can an RN work as an LPN, or is that prohibited?

Thanks.

[MikeyJ, RN]

I am an RN and have worked as a CNA when there was a hole in the schedule. I was paid RN wages. This is not something our hospital does alot, but has been known to do it many times on an as needed basis. I have also worked as a ward clerk and was paid RN wages.

That is very interesting. From a financial standpoint, that is a horrible move by the hospital but great for you! The hospital I work at strictly prohibits RN's from filling those slots. The only time an RN would be paid to do unit clerk duty is if he/she were on "light duty" due to an injury, pregnancy, etc. Even then they have them do RN duties such as admission paperwork and plan of cares.

As a nurse apprentice, they have used me for everything from unit clerk, to CNA, to patient sitter, and even to "janitorial" staff to prepare for JACHO.

[kcochrane]

I am under the impression that you actually have to have an LPN license to work as an LPN even if you are an RN.

I believe you are right. One of the nurse managers at my facility keeps her LPN license for that reason. Many years back this facility laid off most of the RNs to save money and she was able to stay as an LPN since she had a current license. Of course they tried to get her to work at the RN level, but she set them straight real quick.

I have and am required to, as an LPN, to sometimes fill a CNA slot. But I still must work to the LPN level. That means I have to do their treatments and deal with any health issue that might crop up as I am doing care. I still get paid my LPN rate.

[Grace Oz]

Here in Oz, once you qualify for RN as opposed to EN (Enrolled nurse), you have to relinquish your EN registration. You cannot hold both.

Reminds me of this ....................

Back in the days when you could hold both, a friend of mine was doing agency work. She was sent to a facility as an EN. Never said a word to any of the other enrolled nurses that she was also an RN. She was treated very badly by the other Enrolled nurses and nursing assistants on the floor. Next day, she returned to that same facility, same floor. As the RN!!!!

She said she'd NEVER before had such sweet revenge!!!

Said the look of sheer horror on the faces of those nasty nurses was priceless!

And, she's the only one of our group who has climbed the ladder and is now the CEO of a hospital!

[wooh, BSN, RN]

I have also worked as a ward clerk and was paid RN wages.

One hospital I was at, they were so desperate for a unit secretary they paid me premium RN pay to do it one shift. I'm a much better RN than I am a secretary though, so I was really getting the much better end of that deal.:)

[wooh, BSN, RN]

I still don't quite get why an RN working in a LPN or NA role is considered "dangerous because you're still being held to RN standards." An RN working the LPN or NA role isn't doing anything out of their scope of practice. I don't see why there'd be a substantial increased risk that they wouldn't perform up to RN standards in their circumscribed role as opposed to when they are taking on full RN duties. Is it that an RN might held more liable than an NA for missing some vital symptom if a lawsuit were brought against them? But that sounds reasonable and not more risky than working as an RN. Is it that if the supervising RN makes a poor judgement that the RN-in-LPN-role will be held more liable than an LPN in the same situation? Wouldn't it depend upon the RN's experience and if the RN *clearly* knew that the supervising RN's judgement was wrong and didn't follow up with the chain of command? Again, how is that more dangerous than everyday RN liability risks?

The big problem is if you work an aide shift as an RN or LPN. Usually you have more patients than an RN or LPN, since you're "just" doing vitals, bed changes, accuchecks, etc. The problem comes when a pt goes bad, your name is on the chart because you did the vital signs, and the primary nurse on that patient (especially bad if you're an RN doing aide work and the primary on the patient is an LPN), and the lawyers are going to want to to know why YOU didn't do a full assessment and all the things that go along with being an RN. Never mind you had 14 other patients to do vitals on and you didn't get a "real" report on the patient so you don't really know to look for anything in particular. In court, you're an RN, you went in the room, accepted responsibility for that patient.

[suni, BSN, RN]

so my question is this, if you were an LPN who went back to school and got your RN is there any benefit to maintaining your LPN license?

[behensley]

If you are working in an LPN position and want to continue working at the same location, you may have to wait for a open RN position to come available. But be aware, some places when you change from LPN to RN you loose your seniority and your benefit packages changes. (Sometimes for the better, but not always!)

[jjjoy, LPN]

The big problem is if you work an aide shift as an RN or LPN. Usually you have more patients than an RN or LPN, since you're "just" doing vitals, bed changes, accuchecks, etc. The problem comes when a pt goes bad, your name is on the chart because you did the vital signs, and the primary nurse on that patient (especially bad if you're an RN doing aide work and the primary on the patient is an LPN), and the lawyers are going to want to to know why YOU didn't do a full assessment and all the things that go along with being an RN. Never mind you had 14 other patients to do vitals on and you didn't get a "real" report on the patient so you don't really know to look for anything in particular. In court, you're an RN, you went in the room, accepted responsibility for that patient.

How is that different from a colleague RN who assists a pt to the bathroom or administers a med for a busy colleague and then that pt later has a problem that the assigned nurse didn't notice in a timely manner? Would the helping RN be held accountable to the same degree as if they were the assigned nurse?

I don't quite see how going into a patient room and assisting them in some way means that you as an RN have "accepted responsibility for the patient" - even if they've signed off somewhere in the chart they have been involved in some aspect of the patient's care. The assigned RN has responsibility for that patient from the time they accept report to the time they hand off. Others who help along the way don't automatically assume responsibility for the patient unless it's formally handed over to them. Am I wrong there?

[kcochrane]

so my question is this, if you were an LPN who went back to school and got your RN is there any benefit to maintaining your LPN license?

I plan on keeping my LPN when I get my RN. As I stated in my post, our facility, awhile back decided to save money and lay a lot of the RNs. One of our current nurse managers was able to stay on as an LPN since she had a current LPN license. Since this is the county, she wanted to keep her excellent benefits. To me its small $$$ to have that extra option if needed. You never know what an employer might do.

[pagandeva2000, LPN]

I have a few friends that maintain both licenses. One in particular told me that when she was an LPN, she saw more interesting opportunities for RNs, now that she became one, she is now seeing 'more interesting opportunities for LPNs'. She told me that she has done some home care as an LPN, because these were cases that were more relaxing for her and allowed one on one patient care.

Of course, though, you would have to reinstate the LPN license to do that, or sit for NCLEX-PN (I am assuming) if you have not already. And, yes, you would probably be held to the higher license. I visited the web site for the Office of Professional Discipline and saw many cases of suspended licenses, revocation of licenses and disciplinary action decisions. Funny enough, many of them were nurses that had both licenses active, had both license numbers next to their name. They were unable to practice under both licenses.

Personally, I can see how or why they would come to that conclusion to hold you to a higher standard. You are hired as a practical nurse, yes. But, the same governing body (BON) licenses BOTH, LPN and RNs. They have proof that you are knowledgable in assessment based on having your school records and they can presume that you know certain things based on obtaining the RN cirriculum in the school you are attending. I agree that it sucks like lemons, but I am not surprized.

[pagandeva2000, LPN]

I plan on keeping my LPN when I get my RN. As I stated in my post, our facility, awhile back decided to save money and lay a lot of the RNs. One of our current nurse managers was able to stay on as an LPN since she had a current LPN license. Since this is the county, she wanted to keep her excellent benefits. To me its small $$$ to have that extra option if needed. You never know what an employer might do.

I would probably do the same. In fact, my professor told us that she continues to keep her LPN license active, because she said that in a pinch, she will never sneeze at money. I maintain my phlebotomy certification, even though I don't need it any longer. I worked at it, and earned it. Of course, it was not the same stress, but it is mine. In fact, at times, I have considering being hired at labs just to draw blood sometimes. It would be easier money than what I am doing now, and basically non-committal.

[CHATSDALE]

joy, you are responsibile for any observation you acutually see whether or not you are assigned to that patient...if the distress is immedicate you are to initiate a code, if non-emergency then you need to notify assigned nurse when they become available