It’s time for the internet and the NCLEX to do better when describing LPNs

[downsouthlaff, LPN]

Do a career search on the internet regarding what a Licensed Practical Nurse does. You’ll find something along the lines of

Quote

LPNs work under the direction of RNs, main job duties include feeding and bathing patients, giving alcohol rubs and massages. In some states LPNs are permitted to administer prescription medications

Then on the flip side pull information from any NCLEX RN review material it will say that that the LPN can't teach, assess, or perform any duties regarding IV therapy.

The reasoning behind this is that this is general description for the LPN role. But upon looking at a good percentage of Laws regarding practical nursing. Most states, nearly all states, haven’t found one yet that doesn’t allow LPNs to start IVs and hang fluids or administer prescription medication. Also many states address the issue of patient teaching, and assessment, and the BON clearly states that LPNs can assess patients.

This is not meant to start a debate of LPN vs RN, nothing of the sort. Just simply raising the question of why the LPN/LVN scope is so watered down to nearly the scope of a nursing assistant. The overwhelming vast majority of states allow LPNs to perform many of  these tasks that are listed as prohibited. 

[nursel56]

Quite a bit of it has to do with the influence of professional nursing associations like the AACN and the ANA.  They're very influential in the legislative lobbying world, and they actively lobby against any type of expansion of the LPN scope of practice that encroaches on their territory, in their view.  

The same group of people are often involved in textbook wording and curriculum content for RN programs.

Sometimes it appears they are successful in that, but clearly LPNs and LVNs work in environments where they are not "under the direction of an RN", such as when they are charge nurses for LTC facilities and working as private duty nurses.

I admit it is very confusing at times, but I think the bottom line is that hiring LPNs is pure economics for many employers, and that is not likely to change anytime soon.

These same associations turn their criticism to Associate Degree RNs as well, trying to differentiate them as "technical" vs "professional" Registered Nurses even though they all take the same NCLEX-RN.

[Glycerine82, LPN]

This has always irked me, too.  While I understand in some settings this may be the case, it seems the settings we typically work in are for the most part autonomous positions. The scope varies by state, but not only do I do all of the above - I also delegate to RNs and LPNs alike.  In a subacute setting our roles are identical.  There isn't one thing I cant do that an RN can when it comes to our day to day workflow.  If a patient expires, I cant pronounce, but that's literally it.