Do Rn's miss having Lpn's in the hospital setting?

[Finestnurse, Lpn]

In my area all hospitals have gotten rid of their LPN staff and have all RN nurses and CNA's performing all pt care. Im curious as an LPN who always wanted to work in a hospital setting if this has affected pt care at all? Opinions from experienced nurses that worked alongside LPN's greatly appreciated!

[Farawyn]

I loved working with LPNs back in the day. I would hand their IVs and blood products and they would do my wound care.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I worked in the hospital setting for several years as an LPN; and the hospital that I currently work for still employs LPNs. My experience since becoming an RN has been very similar to that as when I was an LPN: I'm still floated to areas in which I never knew existed within an acute care setting; higher-ups still dump on its nurses, whether LPN or RN, agency or staff. Crap flows downhill.

I was actually hanging blood for years before it became an RN-only policy. So, I didn't get a break there, either. Nope, don't miss them because for me, nothing has changed...except my pay. I got my RN to stay in the rat-race since I was nowhere near retirement age. I got my BSN so that the race would lead me to another trail. What I can't miss is having enough nurses (LPN or RN) on one shift to care for the patients because we can't miss what we never had. Eliminating LPNs from the hospital setting, from what I can tell, has not solved the problems at hand...except maybe on paper. You know what they say: mind over matter.

With some of the errors and mistakes I've seen involving other nurses, I have to wonder if just the mere fact that the nurses making those mistakes and possessing a BSN, makes it not that much of a big deal with some of these patients; whereas an LPN or new grad RN would be thrown under the bus because of the same mistake. Some people are all about titles...they'll accept Dr. Kevorkian any day over Florence Nightingale.

BSN and ASN RNs still make med errors; they still have to cover skeleton shifts with little to no help at times. Some places that I've worked only employ BSN RNs. Again, nothing changed with the absence of ASNs. When the move arrives at MSN-only nurses, then is when we'll see the difference, and not in a good way, either. Too many chiefs and no Indians.

Just my randomized opinion....

[cocoaluv]

I miss having it all. LPN's, CNA's, Tech's, Supplies, adequate staff, supplies....all of it.

[Sour Lemon]

Honestly, no. I like most of the LPNs I've worked with on a personal level, but working with them always creates more work for me. A lot of patients have an ungodly amount of piggy backs and PRN IV meds. And on one small unit, we only had two nurses staffed ...so if the second nurse happened to be an LPN, it often felt like I had the whole unit alone. Rarely did any LPN offer to help me out with anything in exchange for the IVs. If they had, that would have made a big difference.

[RNperdiem, RN]

I last worked with LPNs 19 years ago. They were interchangeable with RN staff on the med-surg floor. I never really noticed any difference in the work we did. I haven't worked with an LPN since I moved over to ICU. I can't say I miss LPNs as a specific group. They were just another nurse like many of the hundreds that have cycled through my professional life over the years.

[Horseshoe, BSN, RN]

I last worked with LPNs 19 years ago. They were interchangeable with RN staff on the med-surg floor. I never really noticed any difference in the work we did. I haven't worked with an LPN since I moved over to ICU. I can't say I miss LPNs as a specific group. They were just another nurse like many of the hundreds that have cycled through my professional life over the years.

I worked in an oncology unit that used LPNs, and it was a huge burden on the RNs. Can you imagine how many IV drugs are given on an oncology unit? And those LPNs never offered to help out the staff nurses while they were medicating the LPNs' patients. That hospital quit hiring LPNs, and let attrition, rather than firing, weed them out. But those LPNs on that unit were still there, last I heard. They know they will never again be hired into that kind of setup in my city. My beef against them was more about their attitudes than their credentials, however, if I'm being honest.

At my current job, we have LPNs, and the difference in scopes is not so apparent. We have some that are really sharp and totally on the ball. We were as a team there.

It really depends on the actual unit/environment.

[cleback]

Never worked with one in the hospital.

[llg, PhD, RN]

When I was a staff nurse, I worked with LPN's -- and it made things more awkward and difficult. They were nice people, knowledgeable, etc. It wasn't their fault. But they couldn't provide all of the care the patients needed, sign off orders, hang blood, give certain meds, change arterial line tubing, etc. So the RN's would have to help them -- and that created more work for the RN's.

Also, it made things really awkward politically when a young RN had to supervise, sign-off things, and do the above tasks for an experienced LPN. Imagine the 22 year old RN having to do these things for a 40 old LPN with 20 years of experience. That created a lot of awkwardness and sometimes, tension on the unit.

Finally, if there were also CNA's on the unit ... then things got really complicated in terms of who would/could do what.

So while we were sad for our LPN colleagues who had to transfer to other jobs when the units became "all RN," we were happy to switch to an all-RN staff (with CNA's in purely assistive roles). But we were really happy to welcome those same people back when they had gone back to school and became RN's.

[HouTx, BSN, MSN, EdD]

Hang in there - team nursing is emerging again.... driven by increasing financial constraints and shortage of qualified RN staff. It just doesn't make sense to use 'highly paid' (this is a relative term... I know you're not all rolling in $) staff to do tasks that can be done very well by lesser-paid staff. It's just economics. But - in order to make this happen, we will need to train a lot of RNs because team nursing was not part of their basic training.

For instance, PP comments about difficulty working with LV/PNs due to unequal division of labor do not reflect a 'team' concept.... where everyone is making their own contribution to the care of a group of patients. If the RN has a ton of IV meds & other RN-only things to do, he would make sure that he's not taking on any additional tasks that could be performed by other members of the team.

[Horseshoe, BSN, RN]

I worked in an oncology unit that used LPNs, and it was a huge burden on the RNs. Can you imagine how many IV drugs are given on an oncology unit? And those LPNs never offered to help out the staff nurses while they were medicating the LPNs' patients. That hospital quit hiring LPNs, and let attrition, rather than firing, weed them out. But those LPNs on that unit were still there, last I heard. They know they will never again be hired into that kind of setup in my city. My beef against them was more about their attitudes than their credentials, however, if I'm being honest.

At my current job, we have LPNs, and the difference in scopes is not so apparent. We have some that are really sharp and totally on the ball. We were as a team there.

It really depends on the actual unit/environment.

I should have said RNs. LPNs and RNs are all "staff nurses."

[llg, PhD, RN]

For instance, PP comments about difficulty working with LV/PNs due to unequal division of labor do not reflect a 'team' concept.... where everyone is making their own contribution to the care of a group of patients. If the RN has a ton of IV meds & other RN-only things to do, he would make sure that he's not taking on any additional tasks that could be performed by other members of the team.

We found our "teams" work best with 2 levels of staff (RN and CNA) than 3 levels (RN, LPN, and CNA). I remember team nursing with LPN's. On some units, with relatively low acuity, it can work. But as the acuity has risen in the inpatient areas, it gets increasingly difficult to pull off. There are fewer and fewer patients that the LPN's can provide much care for. We are better off with the RN/CNA combo.