I just heard they will remove all LVN/LPN?

agldragonRN · Dec 18, 2009

i would think that an rn would be hired over an lpn in ltc as they can do a lot more, and don't need supervision.

i beg to differ! they will not hire the rn over me in ltc because we have the same job duties in ltc. unless the facility needs an rn specifically for a special floor such as sub-acute floor because they have lots of ivs and need rn assessments.

in regular ltc floor, no way. why pay the rn more for the same job duties? plus, i don't "need" supervision in ltc. when i need something from the rn supervisor, i ask her for help. i have autonomy on my ltc floor. lpns do their own iv therapy themselves because pharmacy sends the meds in piggy back so no need for the rn because we are not iv pushing. we can hang them ourselves as long as we are iv certified.

in addition, other states have wider scope of practice for the lpns and they can iv push and hangs blood products, etc..so it depends what state you are located. always check the nurse practice act for that particular state.

anyway, to the op, yes they are not hiring lpns anymore in hospital setting but ltc is our domain so lpns will always have jobs there.

txspadequeenRN, BSN, RN · Dec 18, 2009

not true....in ltc with the exception of a few things ..rn's and lvn's do the same job ( of course this all depends on your state laws and such)....it is also not cost effective to staff with all rn's when lvn's are more than capable of handling what ever comes up in ltc... also, lvn's don't need constant direct supervision... there just has to be a rn somewhere by phone they can contact if needed...

i would think that an rn would be hired over an lpn in ltc as they can do a lot more, and don't need supervision.

Lovely_RN, MSN · Dec 18, 2009

LPNs are more cost effiecient for bedside care than RNS in an LTC setting. You don't need an RN to do wound care, medication administration, or IV therapy with peripheral lines. When we have residents with PICC lines then we call the supervisor to flush the line or hang the fluids or abts. Now the central line issue is a NY thing, I believe in some states LPN/LVN can handle PICCs and central lines so I am only speaking about my own experiences.

When we have an admission the LPN collects all the information and the RNs fills out the admission assesment and what happens most of the time once you establish trust with your manager or supervisor is that you do the admission paperwork and they sign off on it.

This happens a lot at my job since I work evening shift and have no floor manager only a house supervisor. I do what needs to be done and the RN signs off on it. I know the residents because I am on the floor with them everyday so when I call the supervisor and present them with information and say this person needs to be sent out 99% of the time they will take my word for it and send them out. I always ask them to come and look because I like a second set of eyes but for the most part they take my word for it and I've never had a resident sent back from the hospital because they were constipated (LTC nurses know what I am talking about). :smokin:

Except in subacute units RNs are mostly for paperwork (MDS, care plans etc) because of the assesment part of filling out the paperwork.

RNs at my facility are paid roughly $32/hour LPNs start at $22/hour and of course we both receive 10% differential for evening and nights. Why would a facility pay someone $10/hour more to do the same job unless it was required by law to do so?

In a well functioning LTC/SNF teamwork is extremely important. RNs are not doing primary care for 4-8 people they are managing up to 40 or more in some facilities. It takes CNAs, LPN, and RN on the floor...and lets not forget about dietary, rehab, respiratory, PT/OT, speech and the list goes on and on to get the job done.

NurseCubanitaRN2b, BSN, RN · Dec 18, 2009

I've been hearing this for a long time. LVN/LPN have been removed from the hospital setting which is a shame because some of them can out perform some of the RN's. The thing is that the LVN/LPN lack the degree in most cases that the RN has. Here in California the LVN/LPN who is IV Certified can do everything the RN can except IV Push, initial assessments, and draw from the picc line. Please add to it if I've left out something.

I think what they mean by having the CNA doing the LVN job is basically limiting the LVN to do what the CNA does even though they can do so much more than the CNA. I like it how in Canada they have the LVN=RPN (Registered Practical Nurse [Ontario]) as a 2 year program. The RN is a minimum of a Bachelors degree. As far as I know the RPNs are still used in hospitals there in Canada. I just wish we were used here because the LVN can fill in while the RN is elsewhere.

I've also heard that it's a cycle, and maybe LVN's will come back to the hospital. The LVN is just as important as the RN.

BlondieNH · Dec 18, 2009

IMVHO, the day they get rid of LPN's/LVN's is the day they should resurrect the three year diploma RN programs. If they still had those 3 year diploma RN programs today, I'd seriously consider getting my RN. The 3 year diploma RN's were the very best ever. I'm perfectly happy and content being an LPN. It's not always about money, prestige or having more responsibility.

NurseCubanitaRN2b, BSN, RN · Dec 18, 2009

I've heard so many good things about the 3 year diploma programs. I knew a RN who graduated from a diploma program and she said it was very intense and they learned a lot and were ALWAYS on the floor. As the previous poster stated sometimes it's not about th emoney or having more responsibility. Prestige, I'm unsure if I agree with that because sometimes it all depends on your clinical experience as a nurse, not always about the title.

txspadequeenRN, BSN, RN · Dec 19, 2009

come to texas we still have 2 diploma programs going......one in lubbock the other in san antonio ...

DogWmn · Dec 21, 2009

There will always be a place for LPN/LVN's. In the metro areas yes they have been phased out of most hospitals but if you look at rural America they are still in the hospital settings and when that supposed "nurse shortage" happens I'll bet you'll see LPN/LVN's back in the hospital setting.

There is more to nursing than the Hospital; LTC, Rehab, Home Health, Traveling Nurse, the VA still uses LPN's too.

I graduated from school in '72 and our scope of practice has significantly expanded since then. Back then we had to take an additional pharmacy course to pass meds and we could only adjust flow rate on a hanging IV per RN and we could d/c an IV...now that has all changed.

We are here to stay and it's not always about the $$$. At 59, I have no interest in "going back" to get my RN, I'll be happy with a less stressful job.

realnursealso/LPN, LPN · Dec 23, 2009

Just my :twocents: . I graduated from LPN school in December of 1979. That nonsence has been going around since then. That is what it is, NONSENCE! I have watched all this go around and around. LPN's are very important. You cannot do away with us, you all need us too much. I listened to former coworkers, who knew it was pure silliness, go to upgrade to RN, and all of a sudden they would try to say it was true. But I'm still here, still working, and in all the years I've been an LPN, I haven't been "done away with" yet. :nurse:

horrorxgirl · Jan 3, 2010

i beg to differ! they will not hire the rn over me in ltc because we have the same job duties in ltc. unless the facility needs an rn specifically for a special floor such as sub-acute floor because they have lots of ivs and need rn assessments.
in regular ltc floor, no way. why pay the rn more for the same job duties? plus, i don't "need" supervision in ltc. when i need something from the rn supervisor, i ask her for help. i have autonomy on my ltc floor. lpns do their own iv therapy themselves because pharmacy sends the meds in piggy back so no need for the rn because we are not iv pushing. we can hang them ourselves as long as we are iv certified.
in addition, other states have wider scope of practice for the lpns and they can iv push and hangs blood products, etc..so it depends what state you are located. always check the nurse practice act for that particular state.
anyway, to the op, yes they are not hiring lpns anymore in hospital setting but ltc is our domain so lpns will always have jobs there.

yes i agree with this post 100%. longterm care, at least in my area is the area for lpns. there are hardly any functions in a longterm care facility that rns do, that lpns cannot. every floor rn that i work with has the same exact job that i have. there is not a single difference. we send people to the hospital for blood transfusions, and iv pushes are few and far between, so there isn't any reason to pay an rn more to do the same job i do. i suspect that the rns i work with probably don't make much more than i do, and are working in longterm care either for a love of it, or settling when hospital jobs are scarce.

i also have autonomy on my floor. my supervisor is hardly needed. if i have an incident report or send someone to the hospital or get new orders from a doctor, at the end of my shift if she comes to my floor i will update her on it, or i will call her extension to update if she doesn't make it to my floor as she usually has 5 other units to supervise other than mine, and sometimes other nurses to help who are far more needy (floor rns included).

i have rns i work with calling my unit asking me for advice and opinions on patient care, and paperwork.

perhaps this is different in some other states, but saying that rns are able to do a lot more care than lpns in a longterm care setting is definitely not a blanket sweep, and 100% untrue in pa.

deleern · Jan 3, 2010

L
RNs at my facility are paid roughly $32/hour LPNs start at $22/hour and of course we both receive 10% differential for evening and nights. Why would a facility pay someone $10/hour more to do the same job unless it was required by law to do so?
In a well functioning LTC/SNF teamwork is extremely important. RNs are not doing primary care for 4-8 people they are managing up to 40 or more in some facilities. It takes CNAs, LPN, and RN on the floor...and lets not forget about dietary, rehab, respiratory, PT/OT, speech and the list goes on and on to get the job done.

I manage 68 residents. in our LTC. I make make $22.00 Per hour as an RN, EACH LPN is on a wing with 17 residents. the make $13.-$15 per hour. I am on the Run from the moment I arrive. I want my staff to work within their scope of practice. But I want to be updated when something is going down.... YES it takes a team. if I have a nurse call in and cannot find a replace ment I take the cart and do the LPNS job...But they cannot do mine.

When State comes in the RN's and the Don are the ones that are accountable. we are the ones that are Drilled about care plans. and every thing else they look at.

Our Hospital laid off every LPN 2 years ago. They do not employ CNA's... the train their own techs. to do basic care and procedures. (even start caths, VS and such.) when I was an LPN I saw the writing on the wall and kept on going to school. I also said things LIKE.... I can do every thing an RN can... much to my shame. NOW I know that is not true.

Ginger's Mom, MSN, RN · Jan 3, 2010

I've been hearing this for a long time. LVN/LPN have been removed from the hospital setting which is a shame because some of them can out perform some of the RN's. The thing is that the LVN/LPN lack the degree in most cases that the RN has. Here in California the LVN/LPN who is IV Certified can do everything the RN can except IV Push, initial assessments, and draw from the picc line. Please add to it if I've left out something.
I think what they mean by having the CNA doing the LVN job is basically limiting the LVN to do what the CNA does even though they can do so much more than the CNA. I like it how in Canada they have the LVN=RPN (Registered Practical Nurse [Ontario]) as a 2 year program. The RN is a minimum of a Bachelors degree. As far as I know the RPNs are still used in hospitals there in Canada. I just wish we were used here because the LVN can fill in while the RN is elsewhere.
I've also heard that it's a cycle, and maybe LVN's will come back to the hospital. The LVN is just as important as the RN.

I have worked with LPNs and RN combo on acute care hospital. There were several times I was the only RN with all LPNs and I felt the LPNs gave great care. My issue was that I was ultimately responsible for everything and my assignment was caring for the high acuity patients since they need the assessment skills of a RN. The RNS, I worked with became to resent the LPNs since the RN had harder assignment and had extra work to do admissions, IV push meds, etc. While the Lpns didn't have an issue with this arrangement it could be very stressful for an RN to be responsible for her own assignment and assist the LPN ( who usually had the easier patients due to their education).

As far as LPNs be removed from the healthcare system it will never happen they are the backbone of LTC and with the impending budget cuts in LTC there will never be RN only staffing.