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.
As the RN program that I have been going through has stated, "you cannot teach someone good critical thinking and clinical judgement. This will have to be learned through experience. You will not find it in the textbook".
What school would ever say this? Critical thinking education is a vital part of any nursing program's curriculum. Sure, you may learn great critical thinking through experience, but still can learn it through school as well.
Specializes in Med nurse in med-surg., float, HH, and PDN.
I was an LPN for 40+ years and never aspired to be more. But I was excellent nurse within my scope of practice, PLUS I am summa cum laude and magna cum laude in connecting human to human even while maintaining professionalism. The 'degree' to which I aspire is lifting fellow humans up from their illness and/or situation. Sometimes it is only for 5 seconds, sometimes a whole shift. I am comfort, love, understanding, accepting, sharing, teaching, accomplishing, and most of the time able to help find a common ground from which I can help a patient be compliant. Oh,it's not 100%. But treating the person like the individual person they are instead of a patient, body, procedure to be performed, and the feedback I receive from the patients and their families ,is/worth more to me than a thousand initials following my name.
This is not to say I also didn't do the learning, advancing, refining my skills or the ones I sought out to be able to do more/better, certifications and the like.
I think there is room for all kinds of nurses, though, and am glad I don't feel compelled climb any ladders. I'm the one down here, holding your ladder steady.
I've already stated this comment of mine was taken incorrectly. I meant compassion and clinical skills does not make one a "nurse." I did not intend to insult other nurses.
This is just desperation. My point was: we can argue about years of experience all you want. Where have you worked? What shift? What hospital? How long? What patients?
It's pointless. I've worked "in the trenches" as you say, but I don't wear it as a badge of honor as you do. We are professionals here and should act as such. Stop with your trivial attempts at holding something over another with years of experience. I've never said someone without high levels of education are sub-par nurses. I'm merely saying higher degrees allow for better professionals.
I've never said that. I merely said they are being phased out because of the increasing need for higher degrees of education. This is why diploma nurses are phased out. The trend will continue.
I've clarified this: saying that my point was clinical skills are not what makes someone a nurse. I never intended to say a LPN or ADN RN is anything less than a nurse.
I've never said experience is worthless or not needed. I've again and again only said that higher degrees of education prepare the nurse to perform at the level required of being a healthcare professional. Physical Therapists are being required to get doctorates, Nurse Practitioners are required to have doctorates, RN's are required to have bachelor's. It's just the way things are moving.
I don't know why you are so mad.
I'm not the only one who took offense to that post. It was worded very poorly if that's not how it wasn't meant to be taken. Referred to LPNs and Diploma RNs with simple skills and great compassion but that does make a "nurse"...how else would we take it?...The requirement to take the RN exam is not 4 years, though more employers may want it. I'm done here. If you still cannot see why that post came off as offensive I'm done defending myself. It's not worth my time.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
For me anyway it's all about what is pragmatic and practical. In that downsouthlaff is absolutely right at least for now. I'm so happy to hear that anyone prefers to work with the population in long-term care.
The reality is that even in that I would say that the best course of action is for all who wish to make nursing a career, to get a BSN as soon as you can practically do so. The ground has shifted in supply and demand and unlikely to be a "buyer's market" as it was for many years.
To me the irony of the acute care vs chronic care dispute is heightened by the fact that the Institute of Medicine itself in it's Future of Nursing Report stated the following:
Most health care today relates to chronic conditions, such as diabetes, hypertension, arthritis, cardiovascular disease, and mental health conditions, due in part to the nation's aging population and compounded by increasing obesity levels.
While chronic conditions account for most of the care needed today, the U.S. health care system was primarily built around treating acute illnesses and injuries, the predominant health challenges of the early 20th century.
Because of shorter hospital stays, free-standing specialty centers like dialysis and outpatient surgery, etc. the number of available jobs in acute care will continue to shrink. At that point in time we will again see LPNs with their job prospects dwindling. I don't want to rain on anybody's parade..far from it. It would not be wise to ignore this reality, though.
You are absolutely correct. The sorry fact is the world of LPN's is shifting, and personally I feel sorry for the students at my city's local LPN school that are being lied to about job opportunities in high acuity settings like labor and delivery and ICU.
I have to say it was refreshing to read OP's post as a LPN. IMO, its too bad the usual education debate has reared up in here. Oh well, this is how these types of threads always seem to go on AN.
Specializes in Hyperbaric Medicine and Wound Care.
Nice, well written article. My one beef was the reference to "$15 to $17 an hour". I am one LVN who truly believes that I am worth $30 an hour. The highest I've been paid was $32, and right now I make $28, and I had to fight for every penny of that, telling the recruiter that I would not accept the original offer of $23.
Is our role so much less than that of an RN that we command less than half of what an RN makes? I say, hell no! Until LVN's/LPN's start refusing work for less than, let's say, $25 an hour, we will continue to be viewed as "Less Valued Nurses". We live in a society that judges ones' importance by the dollars that they command. Is it any wonder the lack of respect for a licensed NURSE making $15 an hour?
Wow, I don't know where you're working but the pay sounds amazing! The LPN's at the hospital I worked at a few years back in Alabama started off making $11.50 an hour and their ceiling pay was $16.75 an hr. At the local nursing home they could make a few dollars more but they were loaded with double the work.
And want a simple ref to education vs experiece to dwell on. I came from the 2nd ranked trade school LPN program in my state according to academics and NCLEX Success rate. The LPN who trained me an orientated me to my job came from another nearby trade school that was nearly shut down by state many timew for sub par NCLEX PN rates and academic standards. She failed NCLEX on the 1st attempt. But ill be danged if she didnt come in like a lifeguard on the gulf coast to pull me out of the waters i was drowning in alone my first night on my own. Debate all you want , but her experience trumped my education like the Sehawks trumped the Broncos last year.
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What school would ever say this? Critical thinking education is a vital part of any nursing program's curriculum. Sure, you may learn great critical thinking through experience, but still can learn it through school as well.