Hospitals That Phase Out LPNs

[psalm]

Recently we were told our hospital (255 beds) is phasing out LPNs. I'd like to hear from other hospitals that have already done this and know:

How has it helped patient care

How has it hurt patient care

What impact, if any, has it made on nursing workload for RNs and aides (grids)

How long a time in months or years has your hospital been w/o LPNs

How do YOU feel about it

What part of the country or country are you from

Personally I think it is a slap in the face of the wonderful LPNs I work with, who have taught me and other RNs our way around the floor. I think it will be a disaster and we will be then begging LPNs to come back in a year or two. What has happened in your experience?

Thanks.

[CHATSDALE]

if there are sufficient number of rns to hire and maintain a good patient-nurse ratio then maybe this is the wave of the future

if this is in fact the case, then the lpn schools should be required to shift to rn training because it is wrong to teach if the student has no prospects of obtaining employment

[barefootlady, ADN, RN]

The phasing out of LPN's from hospitals had something to do with reimbursement to these facilities by the government and insurance companies was the story we were given. Never knew if it was true.

[RazorbackRN, BSN, RN]

I work at a large university teaching hospital. There are no vacancies for LPN's. I have never met an LPN at this hospital.

Same here...I work in a large teaching facility as well. I wonder if it has to do with be a teaching hospital?

[Midwest4me]

This is such a sore point with me. Our hospital is a mental health facility and is NOT phasing out LPNs(thank goodness) but I know the local hospital IS doing so.

In my opinion it makes absolutely NO sense to phase out ANY licensed nurse. We LPNs should be utilized to our full capacity--we have many valuable skills yet in many areas we're taking a back seat to CNAs.This is NOT, by any means, meant to degrade CNAs but we attended nursing school and it's quite discouraging to NOT have the opportunity to work in a regular hospital. What hospital WOULDN'T be better off with more licensed personnel???

[Midwest4me]

if this is in fact the case, then the lpn schools should be required to shift to rn training because it is wrong to teach if the student has no prospects of obtaining employment

Amen to that! There shouldn't even be LPN programs anymore when the employment prospects are slim to none.

[CaPsychLVN, LPN, LVN]

It's easy to say LVN's shouldn't even be taught, but I like many other LVNs I know, could not (for various reasons) complete an RN program. Yet, I, like most LVNs I know, do a valuable medical service.

I find it interesting that as hospitals decrease the use of LVNs they are increasing the use of NPs and PAs. Why is it that as a society we can see the need for one type of "sub-specialty" and not another?

[Indy, LPN, LVN]

I think it is the hospitals that suffer from a case of inflated arrogance that do this. My first job - my local hospital, actually both of them, don't hire LPN's. There are a few that work there but they have been there a long, long time. The charge on those units where they work usually makes sure they don't have an assigned pt with things like a central line, and has to sign their admission assessments behind them.

Now that's funny to me because most of the time I saw the charge not even look at the thing and just sign it. And our nurse to pt. ratio wasn't that great. 1:4 was peachy but with fresh post-caths and totals, and no aide anywhere in sight, you could work your tootie off. 1:6 or 1:7 was more like it on medsurg but I think they had decent help in the way of aides. I didn't mind the primary nursing model because that's all I had done. OH and I forgot, when they put me in charge that did not change my load or the staffing one bit, in fact it got worse.

Ok fast forward to where I am now. Team nursing is it. The facility is little, like 40 beds and I'm in a 6 bed ICU. The LPN's outnumber the RN's by a mile. There are nursing aides too. For the medsurg unit, the RN is in charge normally. Charge does not take a load but does all the admission assessments (supervisor can help, and some nights there's not an RN in charge but that's a whole nother story), the chart checks, the MAR's for the next day, calls the doctors, makes room assignments for incoming admissions, makes patient assignments for next shift, and does walking rounds with the next shift charge nurse. It can get pretty hectic and I haven't done charge for that unit but I've oriented once.

For our ICU it's similar in some respects. I do the admission assessments and put in the care plan. Usually there is an RN and an LPN in the unit and we divvy up our assignments how we see fit, we have nothing resembling a secretary so we're it for chart checks, orders entry, all the quirky little paperwork for the unit, all the telemetry monitoring stuff, etc. We usually do our own chart checks and such. If I work with the same person I normally do we have our own routine and whatnot. If they give me an LPN I don't normally work with I sometimes make the assignments outright.

Occasionally, rarely, I can get stuck in there with one patient and one fairly new LPN and get the opportunity to teach. I love it when that happens but it's rare. So far I like team nursing because it does use something from everyone and no one is "better" per se, everyone is actually needed for things to run right. So for the facility overall, I dunno what they have on days but nights typically has an RN in ER, ICU, Medsurg, and one for supervisor. OB only gets an RN in the form of the supervisor if someone actually has a baby and only while that's happening.

Then the sup puts in the baby's assessment. Kind of funny to hear an RN mumbling "ok now let me go figure out what the heck a dubowitz is..."

[txspadequeenRN, BSN, RN]

i have deleted this post because i did not read the entire thread before posting like a dum dum

amen to that! there shouldn't even be lpn programs anymore when the employment prospects are slim to none.

[txspadequeenRN, BSN, RN]

when i was a agency nurse (not to long ago) the hospitals in my area resemble a yo-yo...one day they decide that they want to be all rn and stop hiring or using agency lvn's...the next they are so short they decide it's time to hire them back. one hospital will not hire lvn's but they are willing to staff their hospital with agency lvn's. i stopped going to the hospitals because of this junk....

[NRSKarenRN, BSN, RN]

Most of the hospitals in my area stopped hiring LPN's about 10 years ago. There is not one hospital based SNF in my county and plans are in the works to close 1 or 2 hospital based rehab ----all due decreased to reimbursements and increasing government eg MEDICARE requirements for RN assessments...and PA's BON restrictive LPN license regulations.

UAP's are utilized in LPN's place as cost cutting measure --short sighted IMHO as decrease in quality of care. Cost cutting however has kept facilites open in wake of severe decrease in reimbursement rates and increase in amount of uninsured as PA has no public hospitals.

[Ms Kylee]

I'm on a leave from LPN school due to family issues. I went to the part time program, and I have 10 months to go. I only chose the LPN program because it was the only program that worked with my schedule at the time. Now that I'm working on a Med Surg floor, the pressure is on for me to pursue my RN. That's not a problem, as that was always the plan.

Fortunately, my floor has two LPN positions available. I don't know why more LPN's aren't hired. The LPN's I work with are awesome, and some of them are much better nurses than some of the RN's I work with. That does not mean that I work with all bad RN's. What it does mean is there are about three RN's that I work with that are just not good nurses. They are lazy, want everyone else to do their job for them (One wanted me to put in a Foley before I was permitted to do so), or can't be bothered to give a patient a bath. I have one RN that hunts me down for everything patient care wise--- she spends more time hunting me down than it would have done do to what she's hunting me down for. She couldn't be bothered to clamp a Foley, spent 20 minutes hunting me down, and by the time I got there, there was urine all over the floor.... UGH. Felt so bad for the patient and the family members that had to suffer because someone couldn't be bothered. Really frosts my buns.

[psalm, RN]

Thanks for all your replies. I am hoping and praying that my hosp. will change its mind and not do away with the LPNs. Keep your posts coming, I can maybe use them as an informal survey of why we need to keep our LPNs. Hugs to all.