Difference between LPN and RN knowledge?

[stewiegriffin]

I'm in the traditional ASN program at my school. Half of my classmates are on the traditional track and the other half are transitioning from LPN.

One of our careplan questions is, "What RN knowledge did you apply today?" I wasn't worried until the LPN's in the class kept getting low marks for their answers to this question.

The instructor keeps telling the LPN's that they have to start thinking like RN's now. They were told that their careplans only showed their LPN knowledge.

For those of us who aren't already LPN's, how do we even know how to answer the question? I really couldn't explain the difference between RN knowledge and LPN knowledge.

At this stage in the game, the transition students have way more education than those of us going the traditional route.

I'm very confused!

[MrsBradyMom]

I'll be graduating from an LPN program in December. It is 12 months, all year long.

I've logged 1500 clinical hours. Theory time has been close to 1200 hours. I've had rotations in LTC, Acute, Psych, Peds. I've had to pass a dosage calc test with 100% proficiency. I know most things about most meds. Every single week for the last 48 weeks I've had assessments/careplans/concept maps due. I can pull a nursing dx out of my butt. I am well versed on patho and know the reason why I am doing every single intervention. I'd better, it will be my license on the line.

Funny thing. Eight weeks into the program we were cathing....the RN's were still figuring out how to tie their face masks. In our programs, the RN's catch up to us by 3rd semester. They don't log nearly as many clinical or theory hours as we do. When it's all said & done, I would have more hours in my LPN program than if I'd have gone straight for my RN. When our LPN's bridge, we have only 2 semesters to take and the first is review.

Maybe our program is just that good. They did tell us that they structured the LPN program with the idea that most of us would bridge to RN. Our NCLEX-PN pass rate is 99.3%.

I would venture to say that the REAL answer to the question lies within the schools. How good is the program the LPN graduated from? Does the program focus on clinical or theory or both?

[txspadequeenRN, BSN, RN]

this is a bunch of bunk..do you really honestly think that lvn's run around doing things and not having a clue why...think about it...

i am in a bsn program and the way our instructors explain it to us is like this: lpns know how to do things, but rns know why they are being done. .

[totoro]

if you don't know how LPN thinks, then you have nothing to worry about. (as far as your teacher wanting you to think like RN) start thinking like RN from the beginning and you have no problem!!! keep on going, you will get through this. oh and plus, many ICUs and Critical Care areas of the hospitals (if not all) don't hire LPNs or LVNs. you have to have RNs. maybe that tells you something. there are big difference between Med/Surg RN and ICU RN as well. maybe that's the difference. they are competent in their unique ways. i'm not saying one is better than the other. but RN can work at M/S but LVNs can't work at ICU. (or at least until they get RN) and also can't go on to the Masters until they get not only RN but BSN. different way of thinking, definately.

[TheCommuter, BSN, RN]

The algebra for LVN's in my area is on the level of high school math. Students do not earn college credit for that course - but it is the one they use in LVN school to give meds.

To safely complete dosage calculations, only a complete understanding of elementary (high school level) algebra is needed. Dosage calculations do not involve advanced mathematical skills.

I live in a metropolitan area with a population of 6 million people and nearly 30 RN programs. Half of these RN programs do not require any type of math class as a prereq or a corequisite class. One of the local ADN programs requires only 2 years of high school math. My focal point is that algebra is not as important as you are making it out to be.

[MrsBradyMom]

oh and plus, many ICUs and Critical Care areas of the hospitals (if not all) don't hire LPNs or LVNs. you have to have RNs. maybe that tells you something.

I've found that the hospitals here used too.......until they all started trying to get Magnet status. Maybe that tells you something....

[amjowens]

I don't have a problem with someone arguing that an NP probably has more knowledge base than an RN for example, as there's an assumption that the NP has passed a number of classes and tests for licensure. The same could be said that the pharmacist likely has a better grasp on meds than does the physical therapist, or the CRNA probably knows more about anesthesia than the pediatrician. The key is, those of us in health care focus on and so understand different aspects of patient care.

The problem with nurses, per my experience, there's a bunch of insecurity, so what happens then? Nothing good or respectful usually, and a lot of stepping on those who might appear "less than". The RN then is lacking the BSN, the BSN is lacking the MSN, the MSN might be lacking the PhD. LPNs have a history of being looked at as lacking their RN degree (well, obviously, but it's often put in their faces by everyone, including sometimes patients). The difference, LPNs are great targets, and often used as such by RNs. I think this is why there might be so much emotion regarding the ever-so-common question of knowledge comparing the RN and LPN.

I've had my seat in a regular RN program since I started my LPN program. I'm done in Dec with my LPN, and begin the RN in Jan. I purposely don't tell people I'm starting the RN program. It's hilarious-I'd say 9 times out of 10, if a RN student learns I'm JUST an LPN student (we are in the same building), the demeanor completely changes, and I feel the interaction close off. The damn thing of it is, I have a 3.9 GPA, have taken all the science/math/humanities/pharm/NTR, etc. courses PLUS the "boot camp" med-surg/ob/peds of nursing school. It's not worth it to tell them, but I am certain that when I achieve my educational goals, I'll be treating even the maintenance people with respect for the specific knowledge they might have that I don't. We should each be respected for the knowledge we have. LPNs do deserve respect for knowledge that's greater than just action-oriented knowledge, regardless of the RN instructor's OPINIONS as posted earlier.

[futureRNJaz]

This is my understanding of the difference between LPN and RN knowledge. LPNs know all the skills and when to use them. RNs know why things need to be done and decide when they are to be done. LPNs have abasic understanding of pathophysiology but not to the depth of an RN. Both can follow a care plan, doctors orders and critical pathways. However, RNs know the nursing process and can write the care plan.

It is not so much a difference in skills but in depth of knowledge. RNs know what medically should be done for their patients in order to anticpate and facillitate doctors orders. Just think of fundamentals where you learned the skills and interventions to care for the oxygenation and circulation needs of patients. In pathophysiology, you learned what causes those needs and what the doctor's orders associated with those needs are going to be. LPNs are given all the same fundamentals with just an overview of the patho.

This is also what I've been taught....

[Alternator81]

The same could be said that the pharmacist likely has a better grasp on meds than does the physical therapist...

You could probably say that... Really good point.

[Blueorchid, ASN, RN]

I kind of get the feeling that this is another one of those loaded questions that could lead to pages and pages of debates. And while I'm not a nurse just yet (I begin my RN program in the spring) I can see where RNs might think of LPNs similar to the way a paramedic views an EMT, they have less schooling therefore they don't learn as much information. (NOTE: This is only a generalized comparison so all you paramedics don't get mad at little newbie EMT...no comparing EMS to the nursing profession either)

However posts obviously show that LPNs can do essentially the same things as RNs and they have less schooling...and sometimes they don't. It is what it is. I do find it useful to learn about the tension that seems to be between LPNs and RNs so I can try and avoid it in the future...We're all working together guys, shouldn't it should be about combining knowledge to treat the patient instead of "I went to school for X amount of years"?

The reason I chose RN? Because I want to go through a masters education and hopefully become a CRNA and I feel a BSN will get me there faster. But we all made a choice for one or another and it should be respected- I leave it at that.

[Woodenpug, BSN]

Only an RN who once worked as an LPN can answer this question with complete accuracy.

Just like explaining color to someone who has been blind since birth, it's difficult to explain. Or explaining exactly what is a nurse to non-health care people. School is not real life, but one of my mentors explained it well. She said "LVN's are task oriented." That made little sense to me at the time, but as I gain experience as an RN, it seems to be the best description of the difference.

Notice how the posts by people with little RN experience are describing how their knowledge relates to a task.

I liked the old days when we had several different perspectives on the patient. Sometimes, It's hard to see the trees for the forest and the other way around.

[jjjoy, LPN]

The same could be said that the pharmacist likely has a better grasp on meds than does the physical therapist...

I don't think that's a good comparison because PTs and Pharmacists have different spheres of expertise whereas the LPN sphere is completely within the RN sphere.

Functionally, there is often quite a bit blurring between LPN and RN responsibilities. For example, in some places RNs "assess" while LPNs "observe" - but functionally, it works out to be the same thing. LPNs are often responsible for administering all meds except for IV pushes. It seems like a rather arbitrary line to draw as the extra training that RNs have isn't going to magically make them better at handling IV pushes, or at assessing patient status, or at observing for and handling blood transfusion reactions. The RN will learn this clinical skill like all nurses... on the job through first-hand experience.

Bewteen the LPN and the RN working in the same setting, I don't see how the additional RN training makes *that* much of a difference in their ability to develop into safe, competent pracitioners. An extra intro level microbio, chem, and anatomy classes can help deepen one's understanding, but just how much of a difference does it make it one's ability to provide safe nursing care and judgement?

LPNs have a year of nursing coursework. RNs have two years - which covers med/surg, pediatrics, maternity, oncology, orthopedics, geriatrics, community health, leadership, with pharmacology, nutrition, prevention, etc as well. Yes, it's more, but how much more? And in regard to the average hands-on clinical nursing role, how much more does the RN training offer than the LPN training?

[Alternator81]

I don't think that's a good comparison because PTs and Pharmacists have different spheres of expertise whereas the LPN sphere is completely within the RN sphere.

It was my best attempt at sarcasm with out being 100% rude.