Not being phased out. But being forced back to our traditional role as Licensed Practical Nurse. This article addresses the LPNs role being phased out of acute care and what future LPNs should know about the practical nursing profession.
I'm a new Nurse. I spend a lot of my time on a nursing home corridor behind a med cart, or more like a rolling Walgreens kiosk. I stay at work 1, 2 sometimes maybe 3 hours after shift change behind a nurses station. After 4pm , I function alone. I'm the one in charge. I'm the one who assesses residents, makes judgements, contacts physicians, contacts family members, sends residents to the hospital, it's all me. It's a big responsibility. It's a big job. I'm a NURSE. I'm the NURSE. But I am not an RN. I'm an LPN.
There's been much debate on not only this website, but around the country; about RNs and LPNs and what's the difference. It seems like around every corner you hear, don't become an LPN, or LPNs can't work in acute care. In my area LPNs can work in acute care and are growing strong in med-surg and ortho/rehab units in acute care. But that's not to be naive to the fact that in many parts of the country this is not the case. But I understand. I understand why LPNs have been phased out of ERs, OBs , ICUs, med surg in some areas, and it really does not come as a shock to me.
The current trend for LPNs is not new. LPNs came about ages ago to assist the RN by tending to stable patients with predictable outcomes. But with today's healthcare costs, and all other modern day alternatives to costly acute care like Rehab, LTAC, LTC/SNFs, Home Health, those patients with predictable outcomes just don't camp out on med surg like they used too.
Hospitals today house highly acute patients. And our skill sets as LPNs just aren't effective in this kind of environment. It does not make us any less of a Nurse, it's just not traditionally our role. Our role has moved with the times outside of hospitals. But that does not mean our role is gone. There's a Home Health Agency, Nursing Home, LTACH, Rehab Hospital hiring LPNs in bulk around every street corner.
So my question to all LPNs? Why would you work in a CNA capacity just to get hospital experience? All prospective LPN students need to understand that an LPN is not an RN. Just like a Podiatrist is not an MD. All are doctors. But different types. RNs and LPNs are both NURSES but different types. RNs are acute care nurses, and nurse managers, made for coding patients, and IV drips, and newborns in distress. As LPNs we are there for Accu Checks, PEG Tubes, Walkers, foleys. We LPNs are Nurses whose expertise is management of long term chronic illnesses. But we are Nurses.
Don't waste your time going through podiatry school if you want to be an MD. You'll be disappointed. Same thing if your dream is to be an RN on a busy NICU but you're sitting at clinicals at your local trade school in an LTC facility. We need to embrace the type of Nurse we are and our role as LPNs. Why go to school to be an LPN to work as a Tech on med surg, when you can use your Nurse smarts and leadership abilities in long term care.
I think the problem with LPN insecurities today is we LPNs try to be something we were traditionally not meant to be. It's not the magnet status talk or the BSN requirements. With shortages of Nurses in LTCs and tough budget cuts to federal programs paying a BSN RN to pass meds in a busy nursing home for $15-17$ dollars an hour is scheduled for the 31st of Never.
So let us embrace the LPN's role in nursing as the "chronic illness stable condition nurses". I'm proud to be a long term care nurse. I don't want to deal with critical drips , titrations, deteriorating newborns and such. I want to provide the best nursing care possible to people in need of long term management for chronic illnesses. If these jobs are outside the hospital, we have to follow them. We have to be proud of the Nurse we chose to be.
Again don't become a family medicine specialist if you want to be a neurosurgeon. Both are physicians both have similar knowledge. But the skills and individual knowledge they have match 2 different types of client populations. It's the same with LPNs and RNs. I know that in a perfect little world the LPN is an assistant to the RN and the RN delegates and supervises every little move and task that an LPN makes. Let's get real now. In small rural nursing homes where the DOC knows the Nurses on a first name basis, the LPN has more autonomy than MSN-RN in a large hospital.
Not knocking anybody's role. RNs have more acuity skills according to the BON, they have a better understanding of the big picture and i understand. But I have a role as a Nurse. I'm a long term care nurse. I manage chronic illnesses. It's what I signed up for. I would suggest anyone who wants to fly on helicopters, and start atropine drips in the ER, or care for an infant in the NICU, do yourself a favor and strive to be an RN. Because I do not have these hopes.
The elderly are a blessing and I'm doing what I love. I'm a NURSE. A long term care LPN and proud of it. It's what I do. You stick an ER RN in my job and it probably won't go well. You stick me in the ER, I know it wont go well! So please prospective LPNs. Consider our tradition. Accept it, or strive for your RN, beause we're not the same. And as an LPN I understand.
I would just like to say that with the little experience I have as an LPN, I have noticed that natural intelligence, leadership, and critical thinking skills, trumps all. Anyone who has taken the Nclex PN or RN will tell you that everything you learned goes out the door the second you step into Pearson vue: it all depends on your critical thinking; it always goes back to basics.
Some of us are critical thinkers who can put two and four together, and some of us are textbook; we know the robotics of it all but have no mind of our own ������. I've noticed, whether it's LPNs and BSNs, or PAs and MDs, experienced or not, an intelligent person is intelligent no matter their formal education. After all, some of the greatest minds in history never had formal education or were at the bottom of their classes (Einstein, Gates, Hawkings)
Of course, experience helps a great deal as well. Intelligent or not, we all gain knowledge from repetition.
I've met LPNs who are better at handling critical situations then RNs with years of experience, and I've seen some PAs who outsmart MDs. Now, that's not to say I would trust any of the mentioned to perform surgery, surgery requires repetition of knowledge previous learned to be perfect. But, I've met RNs diagnose patients correctly before the MD even got the labs. If you've actually learned the basics through your program, be it LPN, RN, or BSN, you'll have the knowledge required to make judgements, to see symptoms, labs and put those two together. You might need a little more education to adjust meds to the proper levels, and make lesser known diagnoses, or just more experience reading up on that area.
Don't ever judge a person's intelligence based on their ability or lack thereof to attend and pay exuberant prices for a diploma. Some of us are capable of learning independently. And, with the TECHNOLOGY in today's age, that is soon going to be the norm. There will soon be less of a need to actually ATTEND a traditional campus University just to cut the costs of campus maintenance, printed textbooks, "core" classes, ....IF ANYTHING, technology could eventually take over the entire Nursing field (assessing mechanically, paper work), heck, it could even take over the Surgical field, the entire medical profession. The world will require more creative thinkers and less "doers" at this rate. BUT, CNAs will always have a place in the field. It would take one complicated piece of machinery to perform patient care (and yes CNAs could very easily do an RN and LPNs job with a little on the job training)
So if your judging a Nurse based on CRITICAL THINKING, then from CNAs to BSNs it's not a matter of formal education, it's whether or not your brain works like a tree; stemming basic knowledge into broader, more complicated branches, each stemming from the previous one. Whether you gain that knowledge independently through a book or confidant, or from your own genius.
Be proud of your mind and don't get stuck in titles. Adult life is just like High school: you're the jock or the geek, it's all just a title and can easily be changed ������
Specializes in Med nurse in med-surg., float, HH, and PDN.
Excellent first post, Elevate1.618 ! You made many pertinent and well-considered points. I liked the way you laid it all out. And not only that, but I agree with 98.354709% of what you say!:)
I would just like to say that with the little experience I have as an LPN, I have noticed that natural intelligence, leadership, and critical thinking skills, trumps all. Anyone who has taken the Nclex PN or RN will tell you that everything you learned goes out the door the second you step into Pearson vue: it all depends on your critical thinking; it always goes back to basics.
Some of us are critical thinkers who can put two and four together, and some of us are textbook; we know the robotics of it all but have no mind of our own ������. I've noticed, whether it's LPNs and BSNs, or PAs and MDs, experienced or not, an intelligent person is intelligent no matter their formal education. After all, some of the greatest minds in history never had formal education or were at the bottom of their classes (Einstein, Gates, Hawkings)
Of course, experience helps a great deal as well. Intelligent or not, we all gain knowledge from repetition.
I've met LPNs who are better at handling critical situations then RNs with years of experience, and I've seen some PAs who outsmart MDs. Now, that's not to say I would trust any of the mentioned to perform surgery, surgery requires repetition of knowledge previous learned to be perfect. But, I've met RNs diagnose patients correctly before the MD even got the labs. If you've actually learned the basics through your program, be it LPN, RN, or BSN, you'll have the knowledge required to make judgements, to see symptoms, labs and put those two together. You might need a little more education to adjust meds to the proper levels, and make lesser known diagnoses, or just more experience reading up on that area.
Don't ever judge a person's intelligence based on their ability or lack thereof to attend and pay exuberant prices for a diploma. Some of us are capable of learning independently. And, with the TECHNOLOGY in today's age, that is soon going to be the norm. There will soon be less of a need to actually ATTEND a traditional campus University just to cut the costs of campus maintenance, printed textbooks, "core" classes, ....IF ANYTHING, technology could eventually take over the entire Nursing field (assessing mechanically, paper work), heck, it could even take over the Surgical field, the entire medical profession. The world will require more creative thinkers and less "doers" at this rate. BUT, CNAs will always have a place in the field. It would take one complicated piece of machinery to perform patient care (and yes CNAs could very easily do an RN and LPNs job with a little on the job training)
So if your judging a Nurse based on CRITICAL THINKING, then from CNAs to BSNs it's not a matter of formal education, it's whether or not your brain works like a tree; stemming basic knowledge into broader, more complicated branches, each stemming from the previous one. Whether you gain that knowledge independently through a book or confidant, or from your own genius.
Be proud of your mind and don't get stuck in titles. Adult life is just like High school: you're the jock or the geek, it's all just a title and can easily be changed ������
LPNs are important, there is no doubting that, but I do agree that their role is different than that of an RN. LPN school is far less in depth and they are not taught to handle unpredictable patients. The education does not include that aspect, and given it only takes half the time to do the LPN program as compared to the RN, it does make sense that RNs get paid more. With knowledge and responsibility comes pay, and much like MSNs aren't doctors, LPNs can't do what nurses can. Although, what they do with chronically ill patients is very important.
LPNs are important, there is no doubting that, but I do agree that their role is different than that of an RN. LPN school is far less in depth and they are not taught to handle unpredictable patients. The education does not include that aspect, and given it only takes half the time to do the LPN program as compared to the RN, it does make sense that RNs get paid more. With knowledge and responsibility comes pay, and much like MSNs aren't doctors, LPNs can't do what nurses can. Although, what they do with chronically ill patients is very important.
LPNs are important, there is no doubting that, but I do agree that their role is different than that of an RN. LPN school is far less in depth and they are not taught to handle unpredictable patients. The education does not include that aspect, and given it only takes half the time to do the LPN program as compared to the RN, it does make sense that RNs get paid more. With knowledge and responsibility comes pay, and much like MSNs aren't doctors, LPNs can't do what nurses can. Although, what they do with chronically ill patients is very important.
I am a nurse, just with a different level of license. I can do EXACTLY what my level of NURSING license allows me to do. Thus I can do "what nurses do". I get paid less because I have less education, and fewer skills in some areas relating to educational level. I'm bridging to enhance skills, expand my scope, and be paid more. Please don't discount my license because you don't understand what I actually do (which where I live includes acute care work).
Actually, in the long run, it does. Having a higher degree of education certainly prepares someone to be a better healthcare professional than someone with say a diploma. The ever reaching scope of practice that RN's take on is evidence that higher standards of education are required. So yes, a RN with a BSN will be a better nurse than someone with a diploma.
I'm not saying the LPN or diploma RN won't be very caring or good at some clinical skills, but that is not a "nurse." You can teach anyone to put in a cath or walk someone to the bathroom. Being a healthcare professional demands higher levels of education.
Most ridiculous thing I've seen on this forum and that says a lot [emoji23]
Have you ever been in an LPN program? I have been in an RN program, made it half way through, got sick with lupus and needed money and insurance and a job fast and would have had to wait to continue classes at ADN program. So I know about both for the most part. When I dropped out and transferred to LPN I thought the same thing, that it would be less in depth. Easier. Boy I was wrong. Some Rns think we do things but don't know WHY we do them. It may depend on the school but my school taught me everything that the RN program did. And it was HARD. I graduated top of my class and don't know how I did it. And now that I am in the field working at aLtc I work very independently as THE nurse in charge of patients who have very unpredictable outcomes at times. I don't have an RN with me I communicate with MDs and other LPNs and our RN is only there 4 hours a day most days. She does the paperwork on day shift and helps pass meds. I use critical thinking all the time. This myth that LPN schools are easier is not true it's just shorter and you don't learn as many clinical skills when it comes to IVs. But I fixed that by getting IVT cert lol.
Not trying to cause strife, but if you haven't been in a highly respectable LPN program, you really are just making assumptions.
That being said, Rns to have a wider scope, but LPNs are still nurses!
cree0165, LPN, LVN
29 Posts
OP I wholeheartedly agree. I could not have said it better myself.