LIES About LPN's and LVN's

I am a nurse who started out in this profession with little knowledge about how complex nursing is, despite all that I have learned in nursing school. There is so much to learn about nursing that school cannot teach. One important lesson that I learned is not to believe everything that I read or hear. I have since enlightened myself on the lies about the profession of LPN'S and LVN's that I intend to raise awareness about to others who read this article. Nurses LPN/LVN Article

The exact definition of an LPN/LVN varies by state, employer and organization. According to the Bureau of Labor and Statistics, a Licensed Practical Nurse or Licensed Vocational Nurse provides basic nursing care. They work under the direction of RN's and Doctors.1 Many websites and educational institutions minimize the role of LPN's and LVN's. I am not certain if this is done in an effort to promote the attainment of a college degree or if the representatives from those establishments have been misinformed about the profession. I have found opposing data on these misconceptions and I am raising awareness about it.

In an article from nursinglicensure.org entitled “LPN's Vs. RN's”, there are several misconceptions present. I read "The role of an LPN is, as the name suggests, practical."2 This is false because I have learned that working as an LPN/LVN comprises basic nursing care and advanced nursing care depending on one's education level, experience and competency.

I graduated from nursing school initially seeking to become a Registered Nurse since I did not know about the option to become an LPN/LVN. When I did not pass my NCLEX the first time, I became discouraged and thought that perhaps I should take a break from trying to become a nurse. I still wanted to work in the healthcare profession so I decided to become a caregiver.

While seeking employment as a caregiver, I encountered an LPN with an Associate’s Degree in Nursing who was the charge nurse in her own office at the homecare company that I applied for. This is when I first learned that an "LPN/LVN" is a nurse. Even though I met a charge nurse, I decided to re-take my NCLEX with the misconception that LPN's/LVN's are inferior to RN's. I was so eager to be a nurse that I held on to this misconception and did not care.

Perhaps the definitions of LPN's/LVN's that I read in the past have added to my confusion. The description from the Bureau of Labor and Statistics and other websites are very misleading since they mention that LPN's are supervised by Registered Nurses and Doctors.1,3 This is true, but so too are RN's who are not supervisors. Staff RN's on different units of hospitals are supervised by their charge nurse who is an RN or a Doctor.

It seems peculiar to me that when looking up the definition of an RN, there is no mention of who they are supervised by. I have since discovered that an LPN/LVN is not an inferior nurse. I think that the lies going around about these types of nurses exist because many LPN schools graduate their students without a college degree. This does not necessarily mean that LPN's/LVN's are lower in status because similarly, RN's may graduate without a college degree, being awarded a diploma from an approved nursing program.2

The length of time that nursing students are educated may be the same for RN's and LPN's too. LPN's and LVN's are not menial or "simple" because they may supervise in a variety of settings and are not limited to supervising unlicensed assistive personnel. The LPN who is a charge nurse requires job expertise that is far from basic nursing care.

The article implied that LPN's do not work in hospital settings very often. The idea of fewer job opportunities for LPN's is misleading since nationwide, there are a lot less Licensed Practical Nurses compared to Registered Nurses. If people tend to get their RN license instead of becoming an LPN, it is only logical that you will see smaller statistical data for the job market of LPN's. This is similar to saying that the availability of meatless pasta for dinner at restaurants is limited if you are a vegetarian. This is a misconception since most people are not vegetarians, so the option for it on menu's nationwide is limited if one were to create statistics on it. The option to order meatless pasta is available in restaurants nationwide if requested, just like the opportunities to work as an LPN/LVN nationwide.

I did a job search for random hospitals throughout the USA and saw that LPN's and LVN's are commonly hired in hospitals. In California, I saw several openings for LPN's/LVN's on the Colusa Medical Center web site.4 Similarly in Ohio, I saw some job openings at the Akron Children's Hospital.5 As I continued to read the article, it stated "In hospitals, LPN duties, as well as advancement opportunities, are more limited.

You’ll find LPNs taking vitals and sometimes administering medications...They won’t have as many options for specialization."3 This too is false because LPN's who are hired in hospitals can become certified to specialize in many areas. Some specialties in pediatrics include Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Neonatal Advanced Life Support (NALS) and Pediatric Emergency Assessment and Stabilization (PEARS).6

LPN's can become certified in other specialties through alternate routes from RN's.6 Some specialties outside of pediatrics that I found especially interesting and noteworthy are certifications as case managers, transplant coordinators and they can even work in surgery with certification as Registered Cardiovascular Invasive Specialists (RCIS).7 If the scope of practice of LPN's were so limited, the aforementioned specialties would not be available.

I believe that the additional education and training required for LPN's to obtain specialty certification prepares nurses for advanced skilled care performance better than training from nursing school. I feel this way because now that I am a licensed nurse who works in the field, I see that the brief timespan covering each skill is not enough to prepare nurses for performance on actual patients.

I graduated with my Bachelor of Science degree in Nursing, which was a 4-year curriculum for full-time students. A lot of information was covered during that time. It is unreasonable to expect someone to remember the details of skills that he or she learned months or even years ago. If I am performing wound care on a patient and I learned this skill over a year ago, I cannot afford to make a mistake if I forget a step. This is where certification is very useful since it reinforces the skills that were learned in nursing school with updated information and it ensures competency for the procedure.

Registered Nurses are not required to be certified for most procedures. If I did not decide to take my LPN boards and decided to take the RN route instead, I would be expected to memorize all of the skills that I learned from my 4-year long nursing school curriculum. This is very risky and I would not know how to go about getting additional training.

In conclusion, I want to commend Registered Nurses on their achievements and hard work as healthcare professionals. I do not intend to discredit the professionalism of Registered Nurses. I am merely revealing the prevarications that exist about the profession of LPN's that I too was misled by. It is most important to remember that every health care professional is vital and plays a critical role in the well-being of patients. It is prudent to remain cautious about misleading information pertaining to the profession of LPN's/LVN's and all professions.

3 hours ago, SURGICALNURSE2NPORMD said:

My mother is an LPN who has been one for over 28 years. she makes $24 hr and she considers this top dollar. I am an RN and make $55 per hour.You will find pay ranges will differ depending on your position. I She also has an associate degree she obtained after lpn school. She has worked as an LPN mostly in nursing homes, home care . The canvas is changing as my sister is an LPN as well and works as a cord blood banker. She however took the position under the contractual obligation that she completes her RN in a certain period of time or be replaced. she makes $18 hr with 7 years experience. I would tell others that there is nothing wrong with LPN however your RN opens many other doors and the scope is still much larger. If you are just comparing pay ranges and meeting a LPN that was a supervisor and these are your goals then this is fine but you must understand home health can have a LPN supervisor if she is supervising HHA,CNA's and other LPNS. What she cannot do is manage the RN's.

Good luck in your future endeavors. I hope that you attempt the RN again.

I love all the different levels of nursing as i started as an CNA many moons ago.

To your mom that's top dollars for what she does.home health and clinics are less stressful.you may get $55 but what's the level of stress of your current job?For me $30 is great for me since I'm doing home health.my friends an rn in an operating room making $23 hr which is cruel

Specializes in OR.

Here’s a slightly different angle....RN= those who have the “luxury” aka the time, money and opportunity to spend in an RN nursing program, right out of the gate. LPN= those who need/want to get to work sooner rather than later. That’s at the start. Next up, those who start out at LPN, find that the work they do is immensely fulfilling and choose to not take on the head pounding stress of the RN route. Third: in my multiple years of teaching and nursing, I have observed LPNs that can run circles around some RNs and not even breathe hard.

Yes, there are certain tasks that LPNs are not permitted to do that makes them not able to work in certain environments where an RN can, just as there are tasks that an ARNP cannot do that makes them not able to work in certain environments where an MD/DO can.

As far as the money? It is conceivable that it is not the central factor in everyone’s career decisions. For most, perhaps. I vaguely remember some study (disclaimer: don’t ask me to cite it, because I can’t) that said something about a hefty number of nurses that had changed jobs over the past year had done so for work environment or how they were treated, rather than the money. I know I can personally state that I would rather make less money and be satisfied with my work than make a lot of money and hate going to work every day. Trust me on that, I’ve been there.

So.. in my opinion, saying that an LPN/LVN is a lower form of an RN is like saying an NP/PA is a lower form of an MD. It’s plain incorrect.

1 hour ago, catsmeow1972 said:

Here’s a slightly different angle....RN= those who have the “luxury” aka the time, money and opportunity to spend in an RN nursing program, right out of the gate. LPN= those who need/want to get to work sooner rather than later. That’s at the start. Next up, those who start out at LPN, find that the work they do is immensely fulfilling and choose to not take on the head pounding stress of the RN route. Third: in my multiple years of teaching and nursing, I have observed LPNs that can run circles around some RNs and not even breathe hard.

Yes, there are certain tasks that LPNs are not permitted to do that makes them not able to work in certain environments where an RN can, just as there are tasks that an ARNP cannot do that makes them not able to work in certain environments where an MD/DO can.

As far as the money? It is conceivable that it is not the central factor in everyone’s career decisions. For most, perhaps. I vaguely remember some study (disclaimer: don’t ask me to cite it, because I can’t) that said something about a hefty number of nurses that had changed jobs over the past year had done so for work environment or how they were treated, rather than the money. I know I can personally state that I would rather make less money and be satisfied with my work than make a lot of money and hate going to work every day. Trust me on that, I’ve been there.

So.. in my opinion, saying that an LPN/LVN is a lower form of an RN is like saying an NP/PA is a lower form of an MD. It’s plain incorrect.

Took the words right out of my mouth..thank you so much

On 1/25/2019 at 9:11 PM, morelostthanfound said:

Second, you seem really hung up on the 'better than', 'inferior to' aspect of the RN, LPN/LVN. Surely you are aware many that many RNs, have equal admiration and respect for RNs, LPNs/LVNs, CNAs, Medical Assistants and recognize their important contributions to patient care. With that being said, the reality is that RNs have additional responsibilities conferred to them by these same Nurse Practice Acts and as such, their salaries are typically higher than LPNs/LVNs. It has also been my experience that acute care hospitals have either enacted a moratorium or curtailed their hiring of LPNs/LVNs-perhaps others experiences will be different but this has been my observation.

This is something I wanted to comment on too. We have a habit of taking words to always mean their most negative definition. LPNs ARE inferior to RNs. In the working world, there's a reality that you have supervisors. LPNs are inferior to RNs, while RNs are switch between inferior and equal to the rest of the team depending on which aspect of the care is involved. That hierarchy just has to exist for everything to run smoothly.

It's a great system, it gives accountability and it gives redundancy since there's always someone else responsible for making sure that someone does what they needed to do.

The difference between the care that's allowed to be given between an LPN and an RN are commonly very different. Every state or facility is free to limit the role of an LPN.

This doesn't mean that LPNs aren't equally respected or equally skilled as RNs. But in the hierarchy of providing healthcare, they're just inferior to RNs. While they can have more skill, if they're not allowed to OFFICIALLY do assessments in their state, that's just a difference in their care between the two. No matter what your job is, you're inferior to someone. We need to stop acting like having to work under someone's supervision is such a bad thing. And in nursing, it's a big part of why mid-level care is slowly becoming more popular than just going to medical school. That NP working under that physician has huge benefits that the physician doesn't get, which it's risking losing because there's such a push against NPs being considered inferior to physicians.

Specializes in Critical Care- Med/surg Tele and Educator.

Thank you for the post and the research you did! Solid work! I worked as a military trained LPN (91C) for 18 years before getting my BSN. So glad I worked in all the jobs leading up to BSN//MSN- a nurse is a nurse and we all work hard!! ♥️ Thank you!!

34 minutes ago, tonyl1234 said:

This is something I wanted to comment on too. We have a habit of taking words to always mean their most negative definition. LPNs ARE inferior to RNs. In the working world, there's a reality that you have supervisors. LPNs are inferior to RNs, while RNs are switch between inferior and equal to the rest of the team depending on which aspect of the care is involved. That hierarchy just has to exist for everything to run smoothly.

It's a great system, it gives accountability and it gives redundancy since there's always someone else responsible for making sure that someone does what they needed to do.

The difference between the care that's allowed to be given between an LPN and an RN are commonly very different. Every state or facility is free to limit the role of an LPN.

This doesn't mean that LPNs aren't equally respected or equally skilled as RNs. But in the hierarchy of providing healthcare, they're just inferior to RNs. While they can have more skill, if they're not allowed to OFFICIALLY do assessments in their state, that's just a difference in their care between the two. No matter what your job is, you're inferior to someone. We need to stop acting like having to work under someone's supervision is such a bad thing. And in nursing, it's a big part of why mid-level care is slowly becoming more popular than just going to medical school. That NP working under that physician has huge benefits that the physician doesn't get, which it's risking losing because there's such a push against NPs being considered inferior to physicians.

Yes ,I prefer not to have all that responsibility ?tbh. My boss I love to death is an rn case manager. She taught me all the skills I know but I dont want her job for nothing .I'm fine being an lpn behind the scenes where I can truly interact with patients and family.

Specializes in Pediatric Critical Care.
9 hours ago, tonyl1234 said:

We need to stop acting like having to work under someone's supervision is such a bad thing. And in nursing, it's a big part of why mid-level care is slowly becoming more popular than just going to medical school. That NP working under that physician has huge benefits that the physician doesn't get, which it's risking losing because there's such a push against NPs being considered inferior to physicians.

Would you mind expanding on this a little bit? What benefits in particular are you referring to? I don't aim to disagree, I just am interested in hearing more of what you are saying.

My family consists of an LPN, me the mom , my oldest daughter is a Nurse Practioner and my youngest has her BSN working on her masters. We often discuss nursing, and we all have something to learn on a regular basis from one another. My daughter’s make a lot more than I do, and Thank God because I know the cost of their education. I have also watched them both study for years . In my opinion I would prefer the nurse, wether it be an LPN or RN with the most years in!!! Experience is everything, you may have the knowledgeable the degree but it takes confidence, practice and calmness. Those key elements come with experience. All 3 of us would do something different better than the other. I have more experience in peg tubes, tracheostomy’s , and wound care. My oldest can read EKG and labs , my youngest can handle guts and gore. However in many cases it is the hands on CNA’s that bring many issues to the nurses. I have met LPNs , RN’s and Physicians that are absolutely atrocious. As an LPN I have seen first handed why RNs make more $$ and I completely understand why. I must work under the supervision of an RN. Their is a reason for it and it’s the Law. “RN Supervisor Notified” my famous notation. However don’t underestimate the value and knowledge of an LPN .

16 hours ago, Julius Seizure said:

Would you mind expanding on this a little bit? What benefits in particular are you referring to? I don't aim to disagree, I just am interested in hearing more of what you are saying.

So very commonly in a decent amount of states, the NP is operating under the physician's license. This basically means that your mistake can also be the physician's mistake, depending on what it was. Because of this, it's pretty much expected that you have to have open communication, you have to truly be a team. If you're unsure about how safe it is to prescribe a needed medication, you have somebody above you, who also has something to lose. A lot of medications in a lot of states REQUIRE a physician to also sign on it. He has to agree that it's safe and necessary.

But if you have his job... You have to make that call yourself on that medication. You have to be positive that it's safe to order. You're not going to have someone questioning something that seems off in your prescriptions.

The liability is just too high when you're the one at the top.

On 1/27/2019 at 6:24 PM, LPNTORN704 said:
On 1/27/2019 at 6:24 PM, LPNTORN704 said:

Sorry, duplicate post.

On 1/27/2019 at 6:24 PM, LPNTORN704 said:

I agree I think alot of the confusion lies from state to state. Where I am in nc I do everything an rn does but in California I wasnt able to which is highly confusing.I currently iv meds when I was told lpns couldnt give it.My pay is great as an lpn but then again it depends where you work,your skill, and ability to negotiate. If you get your rn I dont feel I'd have to negotiate a higher pay rate I'd automatically recieve it.if that makes any sense

All states are different with regard to LPN scope of practice. In my state, the BON formulated position statements that are pretty specific as to LPN/RNscopes of practice. Most states have *fairly* similar differences in scope, however, so whenever an LPN says they "can do the same things as an RN," I find that highly unlikely. Otherwise, what is the point of differentiating nurses' licenses? What is the point of the additional education required of an RN? What is the point of having to take two different NCLEX exams? Why would an LPN accept a lower salary than an RN if "they do the same things as an RN"? Why is the liability higher for an RN if there is no appreciable difference in scope?

In my state:

*The LPN cannot function independently-they must be under the supervision of a RN, APRN, physician, or podiatrist. Note that while RNs are often under the supervision of other RNs, this is not a legal requirement, such as with LPNs.

*While LPNs may do focused assessments, they cannot do comprehensive assessments.

*The LPN cannot initiate care plans.

*The LPN cannot do phone triage unless they have detailed "scripts" to utilize (https://www.bon.texas.gov/faq_nursing_practice.asp#t15)

*The LPN cannot do medical triage in the ER (https://www.bon.texas.gov/faq_nursing_practice.asp#t15)

*The LPN cannot pronounce death.

*The LPN cannot engage in venipuncture or IV therapy without getting post licensure training.

*The LPN cannot start PICC lines. RNs must get specific training, but with this training, their scope allows it. Not true for LPNs.

*The LPN cannot give drugs via epidural or intrathecal catheters, nor can they "manage" those catheters (but can care for patients who have them).

*The LPN cannot administer to or even monitor patients receiving moderate sedation.

*It is not appropriate and is beyond the scope of practice for a LVN to supervise the nursing practice of a RN. This is a big one, as I often hear about LVNs being DONs of facilities and supervising RNs. This is a violation of the Nurse Practice Act.

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None of the above insinuates that the LPN is not an integral part of a health care team. It does not insinuate that the LPN is not an intelligent, skilled, intuitive, compassionate, and knowledgeable nurse. It means only one thing: that by virtue of formal education, there is a defined and limited scope of practice. The same is true for RNs vs. APRNS.

Reality is that LVNs are treated like MAs and paid like that as well ! All the college education in blah blah blah doesn't make a good nurse .It is just the politics and a way to make more money by the BON that titles are given and certain people think they are all that and a bag of chips just because of there college hours ,gpa and so forth .I am an LVN who specializes in dialysis start IVs and probably shouldn't because you need permission from a little certificate taught by someone whom is worse than you are at doing it anyway. I an ex Paramedic with more experience and skills than a nurse with her doctorate degree and i am sorry if anyone gets offended just saying what i know .I've been told at work that the RN is in charge that is until all hell breaks loose , and we have a code then she runs over just to panic shake the patient wishing to wake them up from a cardiac arrest ,and it isn't just at the present job i hold. I have seen this phenomenon across a broad field spectrum in the health industry. I am working to get my RN but all the titles do not mean a thing. Most pre-reqs are fillers and useless .I think the BON should instead of requiring all these useless classes should consider having nurses (all nurse levels) go thru a year of emergency care to get some real useful meaty experience in patient care .All the nursing care plans are just following recipes from a doctor much like baking ! So do not wrinkle your nose at any lower level people because they might just know more than you and all your college classes combined !! I hope to make it some day to be on the BON to change some ways things are run and relax all the mumbo jumbo courses required to provide a very basic human need "Patient Care" !