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!

[roser13, ASN, RN]

I don't miss the added responsibility. The wise, seasoned LPN's that I worked with were outstanding nurses with years of experience. However, they were not necessarily welcoming to a new RN who was placed in charge of them. I totally got that. But their resentment carried over to an unwillingness to collaborate, which carried over into my being responsible for all of their assessments and IV meds, while they declined to assist me with any patient care issues.

Double the the work for me.

[RNforLongTime]

To be honest? No.

While I've worked with a few kick-butt LPN's most of the ones I did work with, did not like to take responsibility for anything and would constantly blame the RN...like look, YOU CAN call the Dr yourself for your patients LOW BG...giving him more SQ insulin IS within your practice so therefore you can take a phone order for that. I had to give any/all IVP meds AND cosign their assessments/charting, even though that was all fully within their scope of practice.

Working with an LPN just made more work for me. NOT A ONE of them EVER offered to do something to ease MY burden. NOT ONE!

[KatieMI, BSN, MSN, RN]

I can imagine things running smoothly in a very stable environment. I worked with LPNs in rather "acute" SNF (it was actually more rehab than anything else, with many IV stuff to be given). If everybody owned the job and did it right (which was the case often but not always) all was good enough, although I never felt totally ok to just sign assessments done by someone else. In environment I work now, I cannot imagine trusting anyone with assessments and even oral meds for at least 50% of times. I do not like CNAs doing vitals because theyadd to my assessments and helps to "keep the track", so to say. Add to that sure to happen constant fight for undesirable tasks like calling "difficult" docs, tendency of many family members to "split" staff, possible loss of vital information... no, thanks. I am all for cooperation and helping each other, and maybe I am just not a "leader" deep inside, but IMHO there got to be one chef in the kitchen.

[TiffyRN, BSN, PhD]

I have worked with some very knowledgable and capable LPNs/LVNs. But to be honest, it's been about 15 years since I worked with them regularly and I don't "miss" it. They were no more than equivalent to a similarly experienced RN (as in years of bedside nursing). And I did have to take more responsibilities for their duties (IV pushes and such).

I've worked in NICU for 14 years. LVNs haven't worked in my particular unit in a long long time (and not since I've been here). I cannot have an opinion on how well they would function in this environment since I haven't witnessed it.

So try not to take this as a negative, but I don't "miss" LVNs and it has nothing to do with having a negative opinion of them as a profession.

[kbird03]

I loved working with a LPN's and i was the new grad with the older more experienced LPN.It's a team. I can see their value. I do believe there is a place in the hospital for them! LPN'S have skills and a license that can be utilized for the betterment of patient care, but I do understand the difficulties of trying to figure out the division of labor, which is fair and cost efficient.

[EDnurseNY]

I'm a very new RN so I haven't yet worked with the LPNs at the ED I work at. I do know that us orientees are going to be taught how to work with the RN/LPN setup as part of our orientation program, which I like.

I do remember as a student during my capstone feeling absolutely terrible since my mixed progressive/ICU unit had an LPN and I was tasked with doing her initial assessments. At that point, my preceptor had me pretty much autonomous and so here I was, a student not even licensed yet, doing the assessments and giving the green light for the experienced LPN to give the medications. She was great about it and it was never an issue (she also taught me a lot), I just felt horrible.

[smartnurse1982]

Why cam't a similar setup be duplicated with ADN Rn's and Bsn Rn's?

[Here.I.Stand, BSN, RN]

Why cam't a similar setup be duplicated with ADN Rn's and Bsn Rn's?

Why would it? ASN/BSN RNs have the same *clinical* training, same scope of practice, same NCLEX...

[Shanua]

I still work with them. Not very many but a few. They are either "grandfathered" in or must be enrolled in an RN program. All are required to be IV certified too which helps a lot. The attitude of them makes a difference. The one that I work with that is grandfathered in takes great care of her patients and has a great attitude. I trust her more then a new grad RN any day. However, I have worked nights where they made half of my staff and with 8 admits it was not a fun night. They have limitations and sometimes it can greatly break my night. Working an new RN that worked as an LPN is a huge difference so in that aspect I think it's a good thing.

[calivianya, BSN, RN]

I for one don't. It's too much extra work and too much drama. One job I worked, it was pretty clear that the RN did the first assessment of the shift and charted it, and I got along well with the LPNs at that job because the work was clearly divided.

At another job, the overall unit culture was just to sign off on the LPNs' stuff blindly, which I was never comfortable with. We had great LPNs and I trusted their judgment, but if I'm going to sign my name to something I want to make sure I agree with it, so I'd go in and assess the patient as well. Since hardly anyone else did this, it offended all the LPNs, who thought it was a personal insult and I was questioning their abilities to do their jobs. In reality, I just didn't want to sign my name on something without verifying it was true.

I was really tired of all the snide comments and dirty looks I got. I hated when I came in and saw I had a LPN working next to me because I knew my night was going to be bad. I was not hurt in the slightest when my hospital decided to lay off all the LPNs. I felt sorry for them because it sucks that they all lost their jobs, but I'd be lying if I said I wasn't also relieved that I wouldn't have to deal with the drama anymore.

[Janetnzrn]

I remember team nursing. I worked a med/surg floor, I had 10-15 patients, the team consisted of 1 RN, 1 LVN, 1 CNA. The CNA did all the personal care and meal passes, the LVN was responsible for the PO and non IV prn meds and could change basic IV fluids, I was responsible for all the physical assessments and IV meds. Sometimes, I didn't see my last patient for assessment until after lunch (if I got one!). I also had to wait until both the CNA and the LVN had finished charting as I had to sign off their documentation. As you can imagine, I never left on time and the facility didn't pay overtime for charting. Not a fan of team nursing, it didn't work then, why do administration think it will work now? Probably none of them are old enough to remember!

[squiggy241]

I'm actually surprised not many want LPN's. As an example, last night it was my RN and I assigned a group of 5. One patient started going downhill, so while my RN and Charge were getting things taking care of in there, I was able to do all midnight rounds, plus pain, IV, and meds due, plus 2am rounds. That allowed the RN to do the charting on that one patient, and everything else was taken care of. If it was just her, the other patients would still have midnight VS to do at 2am, and all those medications would have been late on the MAR. I don't understand the dislike of LPN's on here. I am also able to do most IV meds, oral narcotics, and hang antibiotics. Plus I was able to assist patients with all their other needs like bathroom breaks, snacks, water etc...