I'm an LPN and I understand.

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. Nurses LPN/LVN Article

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.

Specializes in Nursing Home.

The point im simply trying to make is if you know you want a job in the hospital and you know in your area that LPNs are now exvlusive to LTC , and Homecare, why go to LPN school ? Just to be called Nurse. Yes you will be a Nurse but you will most likely feel disatisfied. I chose LPN because i like LTC. I wanted to be an LTC Nurse. And RNs do not get hired in my area for floor nurse positions in LTC. So i chose to become an LPN to do what i love. If in the distant future being a floor nurse in LTC requires an RN license i will be back in school. And the problem that may present itself with the trend to BSN , MSN , and Professionalism is , WE ARE NUESES. We are not MDs. We are caregivers. We are listeners. We are not professional scientists. If i wanted to be an MD i would have invested the time. My fear is with this hierachy professional nurse of the future , whos gonna wipe the mouth , and change the soiled gown , and sit there and listen to our patients concern on a personal holistic level?! Will it be these Masters Prepared Nursing Scientists? Think about it!

Well, written and informative post!!!! As a nurse that has done CNA, LPN, ADN and BSN I definitely agree. In my area the nursing homes are ran by LPNS. In fact, nursing homes pay way more than hospitals. When I was a new grad RN ( with lpn exp) I started off with 33 an hour in LTC. When I went to the hospital I had to take an 8 dollar an hour pay cut.

If I were an LPN with that so many loads of responsibilities including med surg. I would really not put myself down. I will stand and be proud that I got to perform the same duties as RNs.

I enjoyed the post but I will say as an experienced LPN who was trained in hospitals for my clinicals and only in hospitals I have had a very hard time accepting the new role in LTC facilities or home health. My skills were honed in on for a hospital and I was trained to do just about everything except for a few things that the RNs were only able to do and the change in the role has been a major culture shock as all of the hospitals in my area have phased out LPNs to pursue a Magnet status. Don't get me wrong, for LPNs that can do these roles more power to you. I just got extremely bored with home health nursing and with LTC I couldn't take the disorganization that I saw with the organizations or the disrespect/neglect that I saw going on with so many of the residents. I couldn't be a part of that and I could see that as being only one person my concerns were constantly falling on deaf ears. Even though I made significantly more in a LTC facility it's just not what I was trained in and I had so much experience in a hospital. So, even though going back to school in my age was never a life dream of mine (and for a bachelors degree at this age to top things off) I have decided to bite the bullet and am almost half way there. If I had known 15 years ago that this would of been the course that I would have to have taken to keep the position that I was trained for I would of done this a long time ago. Oh, well. Life's not perfect and sometimes we have to role with the punches.

Specializes in NICU.

This must be in the US, because here in Canada, the opposite is true.

I am an RPN (LPN..same thing) and work on a busy surgical unit. Here, they are slowly replacing a lot of the RN positions with RPNs because our scope is so wide. On my floor, we do everything the RN does. The only thing I'm not allowed to do is pull a central line. I hang all IV meds, insert IVs, do blood draws, hang blood, complex wound care, insert NGs, PCA/Epidurals....you name it. It's great to be able to do everything, but where I live, the "scope" of the RPN is also to care for "stable patients with predictable outcomes." That is hardly the case, they assign me unstable ICU transfers all the time...and I have to ask the charge nurse if that patient is really appropriate for me? Not all of the RPNs speak up.

I am also in school right now to get my BSCN....and I'm afraid I won't be able to get a job after. 100s of RN lay offs, RPNs moving into almost every area here. And after being in school, I realize the education is vastly different...broader, deeper and more comprehensive.

So, is the main driver for the change in Canada money? Cutting RN jobs because they make too much?

Specializes in Family Practice.

I am proud of my LVN heritage it was the strong fundamental foundation of my curriculum that I survived RN and my FNP program. I have learned so much and with that I will always hold a candle to my LPN/LVNs. You rock!!!!!!

Specializes in Medical Surgical, Dialysis and ER.

I agree with you. I am a former LPN who bridged into a RN program at my local community college and this is my last semester and I will have my BSN. The truth is I gained so much knowledge as a LPN and have a good skill set from the LPN background. I went back to school because I wanted to further my education and did an ADN program. Now I am getting my BSN because the facility I am employed with made me sign a contract stating I would get my BSN. I have worked with some great LPNs who could probably work circles around some RNs the skills they have are awesome and are a great resource. I agree with you that no one should be made to feel that they are less of a nurse because they are a LPN or ADN. The end N in LPN, ADN and BSN means nurse.

Specializes in Geriatrics, Dialysis.

I wish my area was different. I am truly envious of you nurses that get paid more in a LTC setting. Around here the pay is considerably less than acute care. We also don't hire a lot of LPN's in LTC oddly enough, we only have 2 where I work. The rest of the nurses, myself included, are RN's. It makes no sense to me financially. Hospitals rarely hire LPN's here either. The majority of job openings I see advertised are in Home Health and Assisted Livings. I do wonder though if that is a regional preference based on availability of LPN's. There is 1 BSN and 4 ADN programs that pump out RN grads every semester and only one of the ADN programs has the option to sit the LPN NCLEX at the half way point. There are no dedicated PN programs at all. So we just have way more graduate RN's than LPN's around here.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Your state Scope of Practice tells you what you can do, not to be confused with either facility policy or politics. We did all our clinicals in acute care hospitals. We had peds, post-partum, L and D, and ICU rotations. In my first job, I worked at a pediatric hospital and floated to every unit including ICU and NICU (where I did not work with the sickest kids though)

I've never worked in or had clinicals in a long-term care facility. I never heard anyone talk about how you can't assess, you can only "collect data" or anything about "predictable outcomes".

RNs and LVN/LPNs worked together. The RNs would add meds to the IVs, but we had an IV Team with RNs and LVNs to start them.

Thankfully the ADN-BSN conflict was more of a simmer than a boil back then. On the other hand I do believe more education is always a good thing and I never say that that more highly educated nurses are all thumbs or can't handle bedside care - it depends mostly upon the person.

llAgain do you honestly think that BSN Nurses will work on a nursing home floor for 15$ an hour ?

You would be surprised,but yes,there are Bsn educated nurses who would work for $15/hr.

Also,in my area,Lpn's are getting kicked out of nursing homes too.

Many of the nursing homes around here only wanted Rn's.

I looked at the open nursing positions and the VNA only wants Bsn nurses.

When i worked as an ADN Rn in a Ltc facility in 2008,i passed meds and did wound care like the Lpn's.

Many times there is not a difference in the roles,except the pay of course.

The Bsn nurse did all the paperwork.

Specializes in Adult ICU/PICU/NICU.

I think we need to remember that the scope of practice for LPNs differs from state to state, and that its very important not to paint with too broad a brush when describing what LPNs are and are not good for.

I have been an LPN since 1955. I retired from a long career in critical care nursing in 2009 and am still active as a substitute assistant school nurse, although I'm working very little these days.

Even though YOU do not have the skills ( addressing the OP) or desire to care for complex and unstable patients, there are LPNs who most certainly do have the skills. I was one of them and I did so very well for a very long time.

The whole "patients are sicker" argument is just absolutely silly to me. Of course I know they are sicker, I've lived it and I was perfectly capable of participating in professional development activities to keep up with the changes. I still do that as a school nurse, most recently it was about Ebola as my district serves ESL (English as a second language) students who are coming from West Africa. After our in service training with the health department, I went to the library and read all I could about Ebola. It was just like I did when I was back in the PICU.

I tell all young people who wish to enter nursing that they MUST get that BSN fresh out of high school if that is possible. It will give them the most flexibility in their career. I also remind them that that BSN does NOT make you a better nurse than that veteran LPN, ADN or diploma RN who you end up working with.

Best to you,

Mrs H.