Excuse my ignorance, but what is the difference between LPN and RN?

cwhitlowRN · Jan 17, 2011

In most places the RN overlooks the LPN. They have more credentials and have a wider scope of practice.

cwhitlowRN · Jan 17, 2011

RNs also get a higher pay than LPNs.

carolmaccas66, BSN, RN · Jan 17, 2011

For example are there tasks RN's can do but not LPN's? Years ago the UK had a similar system with Enrolled Nurses and State Registered Nurses. It's a stretch but as I recall EN's could not do IV's, be in charge of the ward, check controlled drugs without an SRN but I really can't recall anything else EN's couldn't do.

What do you have in the UK now? I was born there and have a friend who said I can visit and stay with her in London anytime I want. Don't you have ENs, do you just have RNs now?

Silverdragon102, BSN · Jan 17, 2011

What do you have in the UK now? I was born there and have a friend who said I can visit and stay with her in London anytime I want. Don't you have ENs, do you just have RNs now?

There may be some EN's still practising, usually on the register at the NMC as Registered Nurse Level 2 but a lot of gone on to converting to RN. I don't think the NMC accept EN's anymore on the register unless they trained in the UK and left but maintained practice whilst out of the UK

txspadequeenRN, BSN, RN · Jan 17, 2011

i just have to make a point here and this is not directed at you but at the rules of the states......how strange is it that for your state lpn''s cannot update the all-mighty care plan but give iv drugs .....there is no balance in that....

in my state, the scope of practice is different not only in the sense of certain skills can't be performed by the lpn, but also they don't have the "professional judgement" that rns are supposed to have. i'm not saying lpns don't have judgement, but their scope of practice doesn't. due to this, my bon has stated that lpns can't make or change the nursing care plan or education plan. the rn must create these, and the lpn can make suggestions for changes and help carry it out. and for the education, the lpn can only reinforce what the rn already taught, they can't do the initial teaching.
in my state, the lpn can do most of the skills that an rn can do. they can do iv push meds ect. there are a few things they are only allowed to do as long as the facility has a policy for them to do, and the rn can do it regardless if their is a policy or not. also, the rn must do the inital assessment of any patient, and there must be an rn assessment at least once every 24 hours. so i think acute care facilities that still have lpns have the lpn perform and document their own assessment, and the rn can either co-sign it or document their own with it.
so long story short, there are only a few small differences in my state when it comes to skills. the differences are more about plan of care, teaching, judgement, and delegation.

oldbean · Jan 17, 2011

Hi all,

I'm oldbean a haematology/oncology nurse in the UK and still know of lots of EN's however as SD said they are entitled to use the title RN (level 2) and have very little if any restrictions on practice. I work with band 6 EN's (old F grades) who are obviously team leaders, shift co-ordinators, chemo trained (inc bolus chemo) There is no difference between EN and RN now (at least not where I work). I do think it was a massive shame when EN training stopped. Alot of fantastic EN's I know ending up been pushed out of acute care and into nursing homes (not that theres anything wrong with NH's I've worked in one myself) but acute care lost many fab nurses!!

ObtundedRN, BSN, RN · Jan 21, 2011

i just have to make a point here and this is not directed at you but at the rules of the states......how strange is it that for your state lpn''s cannot update the all-mighty care plan but give iv drugs .....there is no balance in that....

i think they feel that it comes down to the judgement of the rn to make those care plan changes (because we still do lots of formal care plans...). giving an iv medication entails much the same kind of clinical knowledge that any other medication route could have, but changing the care plan apparently requires the "professional judgement of an rn." this judgement is where my state has decided to draw the difference between rn and lpn. i think i mentioned in my previous post, the lpn is able to recommend a change in the care plan. i've never had an lpn work under me, so it doesn't make much difference to me personally. but i did take some careful attention to my bon's recent clarification to the scopes of practice, just in case. btw, i think the lpn may be restricted from hanging blood products, and maybe chemo? i'm not too sure about that, it may just be my hospital system's policy?

danh3190 · Jan 22, 2011

Or a three-year diploma.

Or an 18 month - 2 year diploma

allnurses Guide · Jan 22, 2011

I think they feel that it comes down to the judgement of the RN to make those care plan changes (because we still do lots of formal care plans...). Giving an IV medication entails much the same kind of clinical knowledge that any other medication route could have, but changing the care plan apparently requires the "professional judgement of an RN." This judgement is where my state has decided to draw the difference between RN and LPN. I think I mentioned in my previous post, the LPN is able to recommend a change in the care plan. I've never had an LPN work under me, so it doesn't make much difference to me personally. But I did take some careful attention to my BON's recent clarification to the scopes of practice, just in case. Btw, I think the LPN may be restricted from hanging blood products, and maybe chemo? I'm not too sure about that, it may just be my hospital system's policy?

I think it's because of the inclusion of the NANDA diagnoses that have been attached to the Care Plan before the 80s when they began to get a toehold as a result of active lobbying by "nursing leadership and opinion" groups and their associated supporters in the academic world.

They somehow, as they were never concerned about LPNs/LVNs and in fact wish there was no such thing, did not incorporate nursing diagnoses into the LPN/LVN curriculum as if it was some esoteric thing only grasped by RNs when in truth the care plan itself was a collaborative process prior to that and even CNAs were welcome to put input in them. They were written in pencil on the old "Kardex" forms we used.

A care plan is not rocket science. But I guess if you don't know all the buzz-phrases in the NANDA nursing diagnoses you are excluded from that process-- and people assume the reason for that must be because it is above your pay grade. It's just another silly, illogical choice by the PTB. The idea that it's not safe for a practical nurse to put "turn patient every 2 hours and encourage cough and deep breathing" on a piece of paper but it is safe to inject a drug into their vein is just absurd.