Eliminating LPNs - are hospitals doing this?

[kalaith]

Hello All,

My mother is an LPN at a major women's and children's medical center in Honolulu. Recently the hospital announced that it may eliminate the LPN position throughout the hopsital in the next 12 months. My understanding is that they will supplement this loss by hiring additional CNAs.

My question to you all is if you have any experience with this. Do you work at a hospital that has done this? Was it a good choice? Was it a bad choice? And what's your personal opinion? Do you think it's a good idea or a bad idea?

While I'm certainly biased for my mother's position, I am honestly curious what others in the field think of this major decision.

Thanks for your time. :)

[Godswill]

Originally posted by lgflamini

Because an LPN earns 56 credit hrs in that year (at least I did), and most general associate degrees require about 60 credit hrs. So, a mid-level employee with a 60 credit associate degree could be comparable to an LPN with 56 credits, right? That year in LPN school is much more intense than a year in a liberal arts program.

Thank u for saying this techinically LPN's do have an associate, and the school i will be attending is 18 months not a year, it a LPN -RN bridge program :)

[sbic56, BSN, RN]

Godswill

What degree will you get after the 18 months?

[ainz]

I am not aware of professions allowing the entry level to be associate degrees as a wave of the future. Perhaps I am uninformed or maybe my idea of a profession is different, wrong, or out of date. I see professions as physicians, dentists, architects, lawyers, and others that work independently and are self-regulating to some degree. They usually do not have supervisors as we are used to but have a very high degree of autonomy and also require a much higher level of education to get into the field.

I started in nursing with an associate degree because it was economically convenient for me after serving in the military. I later went back an earned a BSN and then an MSN. After being in the field for some time now and observing the way things have been going in healthcare etc., I am inclined support the idea that a person practicing as a "professional nurse" should have a minimum of a BSN. Perhaps the ADN can be called a "technical nurse." ADN nurses do some excellent care and it is very difficult to find any real differences in practice between an ADN and BSN graduate.

The real issue is that having all of these levels of edcuation and all being called a "nurse" has been and remains to be a problem for the advancement of nursing as a true profession. It is difficult to hold such a "profession" in high esteem and really consider it a true profession when it only takes a year of education to enter the field. I will be so bold (and probably unpopular) to say that I think the LPN program and license should be completely eliminated OR the education to become an LPN should be identified as a nursing assistant.

If nursing continues to hold on to the way things are now we will never advance. Ideally it would be best if one obtained an undergraduate degree in "pre-nursing" and then went to nursing school after being accepted, however, real world economics are preventing this from happening.

We simply have to elevate our educational standards and requirements if nursing is ever going to gain the respect, status, recognition, and compensation that it deserves.

Sorry if these remarks offend anyone but if you want to be a nurse please obtain at least a BSN and be willing to make the commitment of time, effort, and money that it takes, much like physicians or attorneys or architects etc. must also do.

[Godswill]

Originally posted by sbic56

Godswill

What degree will you get after the 18 months?

Sbic56, i will not have a degree its a regular program where u get a diploma then u sit for the NCLEX-PN, I think in this program u get IV certified too :)

AS far as going to become a RN u can use the credit toward your BSN or ADN, for the BSN, u have to at least worked for 1 year, u take some Credit by examinations and if u make 74 or better, u don't have to take those classes, but id not u take the class, U can also get credit through National League for Nursing Profile Exams. And if u manage to pass all the exam with out failing, u can start as a 3rd year nursing students, if not u take classes u need, until u can:)

The ADN program just require to take all the pre req- (12 hours), then wait to get accepted once u have u take a class in the summer , than u finish the last year with 2nd year students, so really i think u can finish this in 1.5 years :)

I am not sure which route i would go, i am almost a senior in a Sociology major so i have a lot of liberal art etc and all that extra stuff i would need, but , i still don't know

[sbic56, BSN, RN]

I am not aware of professions allowing the entry level to be associate degrees as a wave of the future.

ainz

I was referring to 2 yr. associates degrees being the entry level norm in fields such as in IS or IT, electronics, physical therapy, radiology etc. I see these fields more analogous to nursing than I do physicians, architects and lawyers.

I do see how a BSN minimum requirement would more clearly define the profession as a whole and tend to agree with it's eventual institution for that reason. But, with the phasing out of LPN's hanging in the balance because of the economic situation of the healthcare industry, I don't think the minimum requirements will be changing in the near future.

[ainz]

Thanks. I think however that many many fields are moving more toward broader liberal education and then narrowing on the specific field. I am not aware of any physical therapy programs that allow you to practice as a physical therapist with an associate degree. As a matter of fact, in my current state, the entry into physical therapy is now a masters degree. This was changed about 2 years ago.

So I see other fields "professionalizing" themselves even in the midst of "shortages." I have to agree with you though that I don't foresee any changes to the nursing educational minimum requirements any time soon. One reason is that nurses seem to find it difficult to agree on most anything.

[sbic56, BSN, RN]

Godswill

OK....just curious as to what your school is doing. I have to say the only way that would be worth it to me is to get a minimum of the AD through that program. I hate to think that you will be rec'ing only LPN status after 18 months of work, but that is because I rec'd the same in 10 months back in '84.

My problem with the current situation is that there is no standard and because of that we, as nurses, are being taken advantage of. The educational requirements should be consistant. Nursing seems to me to be the only profession that this is not the case and that leads to problems in my mind. Anyway, I don't mean to discourage or upset you, I just think something needs to be done to make thing equal for all nurses. Take it from someone who has been there, I would hate to think that after your 18 months of hard work, you may not be able to practice as you'd like because facilities can dictate whether or not you have enough education to perform.

[sbic56, BSN, RN]

ainz

Just to clarify, I am referring to a PT assistant for the AD in that field. It's 5 years minimum in Maine for Physical Therapist.

[BBFRN, BSN, PhD]

Originally posted by ainz

The real issue is that having all of these levels of edcuation and all being called a "nurse" has been and remains to be a problem for the advancement of nursing as a true profession. It is difficult to hold such a "profession" in high esteem and really consider it a true profession when it only takes a year of education to enter the field. I will be so bold (and probably unpopular) to say that I think the LPN program and license should be completely eliminated OR the education to become an LPN should be identified as a nursing assistant.

Firstly (not to flame), I was a nsg assistant before I was an LPN, and there is a MAJOR difference between the 2 disciplines. LPNs delegate to nsg assistants, so there is a degree of autonomy. Yes, we answer to the RN (and I will complete my ASN in a few months), but the RN also answers to someone- and it's not always someone with a higher degree than them. LPNs have a pretty broad scope of practice here in KY, so it might be different for me. I take my own patient load, and am responsible for them. I'm sure it's different in a military setting, though.

Next, I would like to point out that it only took me a year to receive my LPN because I took 24 (yes, 24) credit hrs the first semester, 18 the next, and then 12.

Do I feel like I am a professional? Yes, because I am treated as a professional where I work, and I act like one. I don't think if you asked any of the RNs that I work with, that they would consider the LPNs working along with them as barriers to their advancement as nurses. I think they're just glad to have someone there who knows what the heck they're doing.

[Godswill]

Originally posted by sbic56

Godswill

OK....just curious as to what your school is doing. I have to say the only way that would be worth it to me is to get a minimum of the AD through that program. I hate to think that you will be rec'ing only LPN status after 18 months of work, but that is because I rec'd the same in 10 months back in '84.

My problem with the current situation is that there is no standard and because of that we, as nurses, are being taken advantage of. The educational requirements should be consistant. Nursing seems to me to be the only profession that this is not the case and that leads to problems in my mind. Anyway, I don't mean to discourage or upset you, I just think something needs to be done to make thing equal for all nurses. Take it from someone who has been there, I would hate to think that after your 18 months of hard work, you may not be able to practice as you'd like because facilities can dictate whether or not you have enough education to perform.

I thank u for what u are saying, but the problem here is that the AD programs are so hard to get into with out having some type of experience in the medical field , they do have an LPN program here thats 13 months too, but it 3 times more expensive than the 18 month, go figure:rolleyes: , but i am still thinking of going there too:). just to finish early.

The things is that in my state we are use really well as LPN's, compare to other states we can do just about everything, even Initiate and maintain IV therapy and administer IV medications by IVPB and/or IVP (including hyperalimentation, blood and blood products) and Perform "head to toe" physical assessments

. Louisiana does not in other words limit the scope of LPN's.

http://www.lsbpne.com/scope_of_practice.htm

Thank God for that:)

I do want to be a RN, but i have to do it this way :)

[BBFRN, BSN, PhD]

I would also like to add that there are over 14,000 actively working LPNs in my state. Aside from those who are in an RN program right now, what do you think it would do for the shortage if these LPNs were eliminated? That's 14,000 nurses taking approx. 6-10 patients each in a workday. Say you generally have 2-3 LPNs on your floor, alongside 2-3 RNs. Would you really want to take those 12-30 patients and divide them up among yourselves? That's a minimum of 4 more patients you will have to add to your patient load. I know none of the RNs I work with would stand for this. They would then be SOLELY responsible for more patients. Would this make you feel more professional? It would make me feel scared for my license.

[ainz]

Reality is one thing and to aspire to an ideal is yet another.

Reality is we need every set of hands we can get in nursing with the current structure, roles, and scopes of practice.

Ideal is to have all personnel identified as a "nurse" to have one clearly defined path of education and licensure in order to be called a "nurse" and perform "nursing" functions. Problem is we can't clearly identify pure nursing functions and society is not willing to pay for many services that a higher educated nurse is uniquely qualified to perform.

I am not minimizing the work that LPNs and nursing assistants do, not by any means. These tasks are necessary for the comfort and health of our patients. Just that we should, in a sense, reclassify and rename the various positions to distinguish professional nurses from technical nurses or health care workers. The term "nurse" would be reserved for those who have put forth the effort and successfully completed the education and licensure requirements. I know people are passionate about their work and many LPNs will take offense to what I am saying as if I do not recognize the value and contribution they make to patient care.

However, to advance the nursing profession we must shape it as that of a profession, this is a basic premise, if we continue to fail to do this then we will forever be seen as we are today and many nurses are not satisfied with this perception.