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.
All that I have to say here...is that we all should respect each other. Some nurses with the same level of education are better at their job than others. Same goes between levels. I have an incredible amount of respect for people in all levels of nursing except when someone thinks their better than someone else.
My mentor is exactly what I aspire to be....I want to be the nurse that takes her education to the highest level attainable....I started off working in a group home, basically an aid. I am now an LPN and I've got experience in LTAC and assisted living. I aspire to be an RN and then a BSN and get experience in both roles, no matter how that be. I eventually want to be a nurse educator because I truly do have a passion for teaching. But I will always ALWAYS have tremendous respect for all levels in the nursing field. I never want to forget where I came from.
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.
You clearly have no idea what you are talking about. An LPN is a nurse, just as an ADN RN is a nurse, and a BSN is a nurse. Please compare coursework requirements of all three, and get back to me as to what the differences are. None of these programs focus only on tasks. If anything, most actual tasks are learned on the job. Anatomy, Physiology, Pharmacology, Sociology, Microbiology, Nutrition, etc are all part of the education of all nurses. A BSN nurse may be a better nurse than one with a diploma, but don't bet on it.
Sometimes it depends more about the person, how they use the information they learned, how much common sense and continued desire to stay relevant they have. Just to get you thinking, have you ever encountered a doctor that makes you uncomfortable, that has questionable
Practices, that eventually gets disbarred? I have. He definitely had more education than myself, but was not competent because of his education. I have nothing against education mind you, I enjoy keeping up to date and have taken college courses over the years - first before I wanted to be a nurse in a different major, then with the intention of getting my RN. So I know first hand what the difference in education is. When someone advises you to look first at the person, then their credentials, you'd be wise to take heed and not assume anything.
I get that nursing is not comparative in terms of education with many other health care fields, thus the push to require more education. Education is perceived as the gateway to finally obtaining respect, and financial compensation commensurate with that level of education. So far, that has not been the case. Hopefully it will.
Specializes in Med nurse in med-surg., float, HH, and PDN.
Since my LPN school was attached to a hospital, we got tons of clinicals throughout the whole program. At a certain point in the program, the med-surg clinical instructor would come into a classroom (having already okayed this practice with the other instructors) and crook her finger at you in the 'come with me' gesture, and off you'd go to get another procedure under your belt. Scared us to death to see her appear in the classroom doorway, but in the long run was one of the best things to happen. Upon graduation we didn't feel flung out into a world. Toward the end of the schooling we would be paired up to cover an entire floor for an evening or night shift. We had supervision available, but it was one of those sink-or-swim things that built our confidence. Yes, they essentially used students as staff at that point; wouldn't fly in today's world, I know. But it was a GREAT education!
No. The post I was replying to asserted that extra school was pointless because it did not pertain to clinical skills. My point was: clinical skills do not make the nurse. So, we're on the same page.
Here's where we disagree. You can argue the science does not help the practice of nursing; whereas, I fully believe it does, and not to mention, most healthcare systems do too (BSN's are required where I work). Having a better understanding of the science, critical thinking, and processes may not overtly be seen as beneficial for a nurse, but it does help in the long run.
It does not 'make' you a better nurse/doctor/pharmacist or whatever just to have a higher degree. But it does provide the baseline to become a better professional than those without.
I certainly do think that science is important for all nurses to understand. I was referring to the premedical level courses that I took that are beyond what most RNs take. They didn't change the way that I did nursing. Perhaps had I become a CRNA, they would, as I would imagine they need to use the advanced pharmacokinetics that we as critical care nurses know a little bit about, but we are not calculating the concentrations or activities at certain moments in time using the rate equations. The nursing level science that I took for my BSN was a refresher certainly, but nothing eye opening for me. But yes...all nurses need to know how the body works and about maladies that they are helping the body to overcome. As far as critical thinking is concerned, I am from the school of thought that one has that or one does not. It can be fine tuned and polished, but I've known many nurses who have faked their way though BSN programs who do not critically think. Many who never look at the patient and rely on the monitor for everything.
I'm glad that you understand now that simply by virtue of having a higher level of formal education certainly does not make one a better nurse. That is silly, and those of us who have been around can speak to that. It does give you more options in your career. As far "provide the baseline to become a better professional"...that is academic esoteric language and I don't know what that means. If I would have stayed one extra year and obtained by RN diploma or finished my final semester of my BSN training, I don't believe for one minute that I would have been a better critical care nurse than I already was as I didn't learn anything useful in terms of the kind of nursing that I was practicing at the time. I would have had more responsibilities on the unit. I could have taken charge class and served as charge nurse, I could have trained to run the ECMO pump, I could have taken admissions and served as a patients primary nurse. I would have had to do committee work, which I have no patience for. What I would have gained was the option to go to CRNA school, and I think I would have enjoyed that kind of technical nursing. It would also have been easier on my knees and body. Perhaps I could have been a clinical instructor, as I enjoyed mentoring the young nurses on the unit...and still enjoy working with them when they come to the schools during their community rotation. However, it wasn't in the cards and I had a fine career....still have a fine career...as an LPN. No regrets.
As far as critical thinking is concerned, I am from the school of thought that one has that or one does not. It can be fine tuned and polished.
Nursing programs are hugely focused on new concept-based curriculum that teaches critical thinking, decision making, and actions. Sure critical thinking can come naturally to many people, but it is still a teachable concept and practice (or else why would every reputable university adopt this curriculum?)
Why is this an argument? Because you want to say education cannot help with this and years of experience and inborn talent are the only factors?
If I would have stayed one extra year and obtained by RN diploma or finished my final semester of my BSN training, I don't believe for one minute that I would have been a better critical care nurse than I already was as I didn't learn anything useful in terms of the kind of nursing that I was practicing at the time.
Let me understand here. So you're saying a bachelor's degree, or RN license, would not have made you a better critical care nurse. Because you "didn't learn anything useful."
So, by your logic, further education and training would have done you no good? You're asserting the idea that all anyone needs to learn in order to be the best nurse (LPN/RN/ADN/BSN/MSN) they can be, is learned in LPN school?
So what makes a good nurse to you? Years of experience and that's it?
Nursing programs are hugely focused on new concept-based curriculum that teaches critical thinking, decision making, and actions. Sure critical thinking can come naturally to many people, but it is still a teachable concept and practice (or else why would every reputable university adopt this curriculum?)
Why is this an argument? Because you want to say education cannot help with this and years of experience and inborn talent are the only factors?
Let me understand here. So you're saying a bachelor's degree, or RN license, would not have made you a better critical care nurse. Because you "didn't learn anything useful."
So, by your logic, further education and training would have done you no good? You're asserting the idea that all anyone needs to learn in order to be the best nurse (LPN/RN/ADN/BSN/MSN) they can be, is learned in LPN school?
So what makes a good nurse to you? Years of experience and that's it?[/quote
I think I've said all that I can say about what goes into making a good nurse. So have many others here. Please go back and re read, because it is there.
I think I've said all that I can say about what goes into making a good nurse. So have many others here. Please go back and re read, because it is there.
So you refuse to explain your idiotic and laughable, point that additional education and licensing does not make someone a better critical care nurse. This is hilarious because it's the argument held over and over again by LPN's - that they are just as good as rn's but without a couple research classes.
So you refuse to explain your idiotic and laughable, point that additional education and licensing does not make someone a better critical care nurse. This is hilarious because it's the argument held over and over again by LPN's - that they are just as good as rn's but without a couple research classes.
Just laughable.
I don't care for that kind of insulting language. You might want to read the TOS about what is acceptable here. I've explained everything before, so have many others. You have refused to read it and now are becoming belligerent. I am happy to engage in intelligent and polite disagreements, but I find yours to be neither.
I don't care for that kind of insulting language. You might want to read the TOS about what is acceptable here. I've explained everything before, so have many others. You have refused to read it and now are becoming belligerent. I am happy to engage in intelligent and polite disagreements, but I find yours to be neither.
Please explain then. You've stated additional education and licensure would not, in any way, make you a better nurse. The equivalent would be for me to say, "No I don't need any additional schooling or licensing because I'm already the best at what I do." That's arrogant and just wrong. If I went to medical school or obtained additional NP certifications - I would be a better nurse and NP.
It's flat out irritating to hear nurses say that additional schooling or training wouldn't help.
Specializes in Med nurse in med-surg., float, HH, and PDN.
meta091,
I think what you fail to understand is that when HazelLPN started out in nursing, LPN's were treated a lot differently and she has had opportunities and learning experiences well beyond what the current crop of new BSN grads have available today.You can not begin to comprehend what her FIFTY FOUR years of experience has encompassed. Many LPN's covered what are thought of now as strictly RN responsibilities. There weren't all the status fights about whether you were LPN,ADN/BSN RN as you see in so many threads here today. If you were a good nurse you were not so bound by the letters after your name as to how far you could go in the field.
She could probably run rings around you with her understanding of patients, the reasons, whys and wherefores , labs ,tests etc. She didn't just bloom into a good nurse, she had help and instruction along the way from other medical personnel. And at this point in her career, further in-depth studies would really be a useless waste of time.
I come at this from a perspective of a diploma RN who went to an NP program (diploma to Master's) who works in a long-term care setting and teaches in an LPN program also. I frequently have to ask if someone at my facilities is an RN or an LPN, and often I trust the LPN's opinion more than the RN's. I think it's more about the person than the education (and the person's common sense, which today is not all that common.)
I think what you fail to understand is that when HazelLPN started out in nursing, LPN's were treated a lot differently and she has had opportunities and learning experiences well beyond what the current crop of new BSN grads have available today.You can not begin to comprehend what her FIFTY FOUR years of experience has encompassed. Many LPN's covered what are thought of now as strictly RN responsibilities. There weren't all the status fights about whether you were LPN,ADN/BSN RN as you see in so many threads here today. If you were a good nurse you were not so bound by the letters after your name as to how far you could go in the field.
She could probably run rings around you with her understanding of patients, the reasons, whys and wherefores , labs ,tests etc. She didn't just bloom into a good nurse, she had help and instruction along the way from other medical personnel. And at this point in her career, further in-depth studies would really be a useless waste of time.
You said this much better than I ever could. I believe that I have already stated that it's more about the individual person than it is about the letters behind their name and the combination of many talents as to what makes a good nurse in previous posts. So have you and so have many others and I wasn't wiling to rewrite everything because someone apparently didn't read or didn't understand, or perhaps was only more interested in being argumentative and rude than having a polite discussion and learning new things.
I see you have been in nursing for over 40 years. Congratulations on your accomplishment. It keeps the mind sharp!
Our formal education, long behind us, is mostly out dated. One thing that is not out dated is how we were trained to respect experienced nurses. Now, I think that some schools teach the opposite because I have encountered the exact attitude of the poster in question with young BSNs fresh out of school or student nurses who are still in school. That attitude is usually dropped once they have real actual experience in the field and they see those veteran nurses in action.
jojo489
256 Posts
All that I have to say here...is that we all should respect each other. Some nurses with the same level of education are better at their job than others. Same goes between levels. I have an incredible amount of respect for people in all levels of nursing except when someone thinks their better than someone else.
My mentor is exactly what I aspire to be....I want to be the nurse that takes her education to the highest level attainable....I started off working in a group home, basically an aid. I am now an LPN and I've got experience in LTAC and assisted living. I aspire to be an RN and then a BSN and get experience in both roles, no matter how that be. I eventually want to be a nurse educator because I truly do have a passion for teaching. But I will always ALWAYS have tremendous respect for all levels in the nursing field. I never want to forget where I came from.