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.

I wouldn't say these classes are useless. One of the big differences between an RN and an LPN at most jobs I've seen is that the RN tends to be a little more administrative. That chemistry and microbiology class, while you're never going to be in a situation in nursing where a patient cares enough to ask how a drug works on a molecular level, or the details of how that bacteria is able to reproduce and form an infection in your body, it seems useless to force RNs to take those classes. Until you decide you want to get into advanaced practice and specialize in infectious diseases and now you understand that bacteria doesn't have receptors for that type of molecule, so that medicine is completely useless, but this other one would work amazing.

Don't brush off the education differences. Just because they don't apply to the direct care that most nurses give, doesn't make them useless. Everything has a point to it. It's just not always obvious, and not always going to come up in hospitals.

I never said nurses are useless ! I am a nurse .I said some classes are useless and stand by it ! I have taken some chemistry and biology classes and understand the molecular level , proteins that are attached to certain cells and the importance of type and cross match ,germs viruses that react/dont react to certain antibiotics hence the specializing in a certain fields of study. My reference not ignorance is to the rigorous education needed in becoming this book worm without skills to save a life . Education is becoming a sales market place of schools to hook young people in debt full of promises with a lot of useless classes that most of us will never need in our professions! It all reverts back to the all mighty dollar in politics ! What is a nurse practitioner vs a doctor for example the fight to the top involves the amount of classes/education for example and the lobbying by two sides fighting for power and position .I understand the prescription prescribing laws and the higher understanding of patient assessment ,diagnosing etc. But in all that politicking, laws are changed by the BON to prove a point or to top its rival and to hold a status quote. And it is in all that chaos that the trickle down effect happens to those of us starting at the "bottom"where more classes are needed just because two sides at the top are feuding for position and power and where some schools take advantage of people with useless classes. Our national debt is no joke and most of it is in student loans. And that is my only beef with worthless classes !!!

No, I meant classes, not nurses. The difference in those classes do have a use

I have practice as aLVN for twenty years as of tomorrow. I have been at bedside for fourteen of those years in critical care. I have all the same duties save 4 that are explicitly RNs. Chemo, conscious sedation, RN assessments and Cathflo. We work side by side until my hospital began the trek to magnate status. I'm now in a Pediatric Trauma Surgeon's office. Which is okay since I'm heading toward "the corral".

There are as many good RNs as bad and can be said of LVN/LPN. I know it to be said of my school our LVNs could stand shoulder to shoulder on skill, knowledge base and pathophysiology of any RNs. We can hit the ground running. We equally earned certificates of training for ACLS, PALS, etc. This may differ from state to state and hospital system.

I'm proud to be part of the wonderful world of nursing.

23 hours ago, 911nurs said:

I never said nurses are useless ! I am a nurse .I said some classes are useless and stand by it ! I have taken some chemistry and biology classes and understand the molecular level , proteins that are attached to certain cells and the importance of type and cross match ,germs viruses that react/dont react to certain antibiotics hence the specializing in a certain fields of study. My reference not ignorance is to the rigorous education needed in becoming this book worm without skills to save a life . Education is becoming a sales market place of schools to hook young people in debt full of promises with a lot of useless classes that most of us will never need in our professions! It all reverts back to the all mighty dollar in politics ! What is a nurse practitioner vs a doctor for example the fight to the top involves the amount of classes/education for example and the lobbying by two sides fighting for power and position .I understand the prescription prescribing laws and the higher understanding of patient assessment ,diagnosing etc. But in all that politicking, laws are changed by the BON to prove a point or to top its rival and to hold a status quote. And it is in all that chaos that the trickle down effect happens to those of us starting at the "bottom"where more classes are needed just because two sides at the top are feuding for position and power and where some schools take advantage of people with useless classes. Our national debt is no joke and most of it is in student loans. And that is my only beef with worthless classes !!!

Unfortunately, when nurses sit at the table with rehab staff, pharmacists, physicians, administrators, etc. we are often the least educated. What a shame, as nurses spend the most time with patients. If we want to be part of the team that not just provides the bedside care, but also makes big decisions on how healthcare businesses are run, conducting research, how policies and legislation are written, and how future health professionals are educated, we have to strive to match the educational background of those with which we work side by side.

NO class that I've taken has been a waste of time. Micro, pathophys, chem, etc. all come into play. While I don't use (or even remember) the knowledge from these classes on a daily basis, it helps me have the background knowledge to understand research papers or understand what a physician or pharmacist is talking about.

Specializes in Pediatric Critical Care.

@911nurs what is your background as a paramedic? What path has led you to now being an LVN, and working towards RN?

I'm a 15 year LPN. I'm the one that they call when they need an IV started. I'm also the only nurse among 10 other LPN's and 15 RNs that is ventilator certified. Just sayin

The LPN vs RN role has been a somewhat heated topic of conversation since as long as I can remember. One thing that I have seen remain constant over time is that what an LPN can legally do or not do varies from state to state, and these differences can be quite large. Many states will allow for extra certifications (easy example is IV certification) but what is allowed under that certification can also vary. An employee can also further restrict the role of any of their employees, but the LPN role always seemed to have some oddball restriction that would be different depending on the facility.

I remember as an LPN working agency for a large hospital chain. Many could probably guess which one. At a few different hospitals I had different rules I needed to remember while working at different locations all within a 30 mile radius of each other. One I couldn’t push IV medications-I could start the IV, hang the fluids, piggyback meds, but no push (fast forward 20 years and those meds that were 15 minute piggybacks are now coming as 5 minute pushes...), another I could push IV meds but I better not insert an NG tube, another was fine with the above skill set but I better tackle the nearest RN to toss the phone in their hand (attaches to the wall back then) when s doctor finally called me back regarding the labs because they didn’t want LPNs taking verbal orders (even for the one time oral magnesium dose), and finally one hospital LPNs were not allowed to pass narcotics there (and if you knew my demographic area, you would feel pain for the poor RN who had to dose all the patients for the floor if she happened to be working with no other RNs-knowing the employer was doing this to the RN, not the state board.

Job opportunities will also vary greatly by location. This will probably be influenced a lot by supply and demand. If an employer has their pick of applicants, they can be more choosy. Same thing is happening with the associates vs. bachelors (or higher) requirements by many employers for RN and cutting out the LPN positions in states where there isn’t really a nursing shortage. Change the demographics up again several years later, the positions offered will likely change, depending on the job market.

Pay has a lot to do with location as well. Back in 2009 I worked PRN for $26/hr as an LPN but if I were staff it would be $13. The staff RNs were $18 and PRN was $32. I was advised that when I finished my RN I would have to go back to staff for 6 months (negotiated down from 12)....yeah, it wasn’t exactly a motivating factor to pay for and study hard to get that higher level of education/licensure...I instead took a very long and costly hiatus as l learned that the college system had decided to implement a 5 year rule on the science/math courses-except for a few- finding an ACEN accredited school that would take those 15 year old science classes was truly like looking for a needle in a haystack.

Then I later got my RN a few years ago. Made 68 cents more staff than I did as a PRN LPN. The hospital had forced all the LPNs to get their RN or demote to nursing assistant roles at that time. A year later I went PRN-no $32 an hour-nope. After a year in I got a whole $1.25 per hour more than I was making before paying (and still paying) for the degree/licensure exam for my RN. Put it towards my monthly tuition statement and I seem to break even-but I wanted to be able to work in the environment that I wanted to work at that time, so I did what I was required to do. If I had chosen to stay there now I would probably be accumulating more tuition payments for a BSN...and if I were staff I’d get a 50 cent raise upon completion, so less than current PRN rate. If I stayed PRN, well, when their phase out process took place I’d then be able to keep my job with it at the same rate. Yes, now they want mostly BSNs.

Having completed both programs and holding both current licenses, I can tailor my resume and title for whatever job I’m applying for at any specific time. I had one employer tell me after I was hired years ago that they were only interviewing LPN candidates because they didn’t think they could afford an RN. I informed her that their compensation package may be surprisingly appealing to some if given the chance (8:30-5, m-f, no weekends, no shift work, higher hourly rate, and a health insurance policy that didn’t require me to have my colonoscopy completed by the same MD that I would having chewing me a new one over a patient that wasn’t even mine the next morning. No privacy rights there-self insured facility benefits).

Wow. Okay, this became more of a rant. It’s just my two cents with what I’ve experienced on both ends.

Specializes in Hospice,LTC,Pacu,Regulatory,Operating room.
On 1/27/2019 at 10:24 PM, LPNTORN704 said:

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

no stress at all honestly I love what i do every single day.. I actually said what i said to say that pay ranges can vary. It was a response to the original poster and not to you.

First off I would like to say more education = more money.

I started as an LPN to continue my education at a wage that would allow me to not take out student loans, while this is not always desirable, it worked for me. I worked as an LPN for 11 years. I originally started at the hospital in pre-op, in 1999 the LPNs were phased out for RN only. I chose to go to a SNF. During this part of my career, I was a charge nurse and oversaw CNA and RN staff members. I then became a nurse manager as an LPN. I could not sign my own MDS and it had to be checked by an RN. Per most states LPN is not allowed to assess, hang blood, or work in a NICU or acute care setting, they are allowed to pass medications, provide wound care and do all the functions of an RN without the "glory" associated. I then chose to obtain my ADN and continued on my path in nursing. I was now allowed to sign my own MDS. I chose to continue my career in the acute care setting. Upon hire at a magnate hospital I was required to obtain my BSN, which I have done. This did not change my practice, just allowed me to remain employed in critical care. I did not find the article to be demeaning to LPN/LVN. I can't say that I would have continued on if LPN were not being phased out of acute care. I didn't want to continue my career at a LTC/SNF/LTAC personally. I wanted the ED, OR, now PACU. In the magnate hospital I work for, we do employ LPN's. They are not in acute care, again they are not technically allowed to asses ( I know they do), however; we do hire them in the clinics, discharge lounge and weight management (working as a clinic nurse as well). To be able to start IVs as an LPN I had to take a certification to ensure my skills, as well as wound care. As an RN I am not practicing under anyone, I have autonomy to practice (and be sued), therefore; I do not have to obtain certifications as the board of nursing gives me full autonomy in my practice, whereas when I was an LPN I was working under my RN. My certifications are related to where I work. If I want to work critical care, ACLS. Pediatrics, PALS. These are my only required certifications. I am required to have CEUs as an RN, where as an LPN these were not a requirement. If I chose to become certified in my specialty, it's for financial and learning reasons, otherwise, I am not required to become certified. As an ED nurse and PACU, I am required to obtain TNCC and keep it current.

On ‎1‎/‎26‎/‎2019 at 6:57 PM, CarolinaRN0501 said:
On ‎1‎/‎24‎/‎2019 at 12:03 PM, Divine-LPN,BSN said:

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.

I am uncertain how you have a BSN without having a RN. My guess is you challenged the LPN boards after not completing the RN boards? Almost every BSN program requires an RN if it is obtained after a ADN. This whole statement is confusing, unless you received a Bachelors in nursing administration? This is different than a BSN. Where I am employed only an RN is allowed to take ACLS or PALS for free as they are only used in critical care areas. Our LPN staff needs no certification as they do not do much direct patient care. If you truly have a BSN, then you can sit your RN boards without any additional schooling needed. The BSN program at most universities bypass the LPN now and do not have the student take this at all, which is why I question at true BSN, versus a bachelors in nursing administration. If this is what you have, then you would be required to take the RN program. We have an LPN who has a Bachelors in nursing admin who is currently in the RN program. Later she will have to obtain a BSN to stay at our facility as it is a different degree. Is this what you meant?

I read the original article, but it didn't feel as though it was attacking or mean spirited to an LPN/LVN. I have been there and chose to advance my career so that I could work where I wanted too. If not for that, I would never had continued school.

Specializes in OR, Nursing Professional Development.
1 hour ago, missdebrafifi said:

I am uncertain how you have a BSN without having a RN. My guess is you challenged the LPN boards after not completing the RN boards? Almost every BSN program requires an RN if it is obtained after a ADN. This whole statement is confusing, unless you received a Bachelors in nursing administration? This is different than a BSN.

There are entry level BSN programs. I attended one. There was no need for me to have an RN license at all to attend. Most likely, the poster above completed an LPN program, received a license, and then entered an LPN-BSN program (yes, these exist too). However, he or she has then not taken/passed NCLEX-RN to receive the RN license. Very few states now allow the challenging of NCLEX-PN, and many of the licenses granted this way will not endorse to another state.

3 minutes ago, Rose_Queen said:

There are entry level BSN programs. I attended one. There was no need for me to have an RN license at all to attend. Most likely, the poster above completed an LPN program, received a license, and then entered an LPN-BSN program (yes, these exist too). However, he or she has then not taken/passed NCLEX-RN to receive the RN license. Very few states now allow the challenging of NCLEX-PN, and many of the licenses granted this way will not endorse to another state.

Interesting, I did not know. What is the benefit of having a LPN-BSN? Would the LPN never take the RN? After the BSN with LPN are the eligible to take the NCLEX-RN? In the four most recent states I have lived, they bypass the PN altogether, so I am confused with that. You go directly from starting school to BSN, however; have to obtain your RN via NCLEX.