LPN = Life's Perfect Nurses

pagandeva2000, LPN · Aug 3, 2007

If you havent discussed the issue of RN/LVN roles with your nurse manager, I would suggest you do. Maybe that can be a start to more clearly define the role of both RN/LVN in your facility. You mentioned that the laws/scope of practice are vaque and unclear. Re examine the Nurse Practice Act in your state and make sure you are not practicing out of your scope. If this does not resolve the issue, maybe you should consider looking for another job were you feel the roles are more clearly defined.
I in no way intended to offend anyone by my responses in this thread. I was just stating my opinion. NO hard feelings.

I have read the nurse practice act for my state, and it appears to be vague, and unfortunately, I cannot just walk away from this position because they sponsored for my education to become a practical nurse. I was on a two year leave with pay (did not have to work at all); tuition was paid and books to become a nurse and part of that contract is to remain here for at least three years (one has passed already). If we leave early, there will be a large sum to pay because we would have broken the contract.

I am constantly in close contact with staff education, but they are also not very helpful, they are vague as well. We are basically on our own and I have to decide within myself if I am not comfortable doing something. Since I work in a hospital clinic, I do not face the same issues as often as the LPNs that work in the ER or med-surg.

What made me a bit offended is that I was trying to say that it seems to be no difference to administration or any governing body on the scope of practice. Most of the time, it is placed upon us at the last moment, where a person is trained the skill and a bit of rationale, maybe how to do it safely (depending on who taught you) and that is it. This is how an LPN may be confused as well as resentful...most of us are saying that we are DOING the skill...are we just trained monkeys? What is the clear difference between what I did as an LPN verses what that RN did in terms of that same skill (whatever it may be...pic lines, hanging blood, IV push, or whatever...) is there something I am missing or is the patient not receiving quality care this procedure should have been done by an RN? Also, everything is okay until something happens. And, when that thing 'happens', no one is going to admit that Staff ED trained the LPN to do it. It suddenly becomes...oh, they don't have the capabilities, or 'who told that LPN to do that' and play dumb. I just happen to be the type of person that doesn't need much to get the basic point. Too much information boogles me and I am a 'bottom line' individual who focuses on what needs to be done, a brief explanation of why, and how to do it safely. I usually connect dots very well and this works for me. The rest will be dealt with later.

We are not allowed, for example here in New York to push IV meds. I attended a seminar where I had a conversation with some RNs who told me that they became RNs because they were forced on many occasions to do IV push and they felt that they might as well get paid for it. I feel that if a person is forced to do something due to a staffing shortage, then, they are, in fact, performing the very skill that the higher licensed person is, and therefore, should be compensated or acknowledged somehow may it be money, position or formal recognition.

Anyway, no hard feelings, either. I did read again and saw how you could have come to that conclusion. I don't think I expressed myself effectively enough.

jjjoy, LPN · Aug 3, 2007

What is the clear difference between what I did as an LPN verses what that RN did in terms of that same skill (whatever it may be...pic lines, hanging blood, IV push, or whatever...) is there something I am missing or is the patient not receiving quality care this procedure should have been done by an RN?
I feel that if a person is forced to do something due to a staffing shortage, then, they are, in fact, performing the very skill that the higher licensed person is, and therefore, should be compensated or acknowledged somehow may it be money, position or formal recognition.

You put these concerns very well. I, too, see these issues as much of the cause of confusion and resentment between the different kinds of nurses.

OneGoodNurse · Aug 3, 2007

Well, I confess I have used the "Low Paid Nurse" a few times. But you know? To Be quite honest I am so sick and tired of being made to feel inferior because I am an LPN, or made to believe I'm not a nurse because I 'sport' three letters behind my name instead of two. However many letters you have behind you name doesn't constitute how good of a nurse you are. I am a firm believer in that. I recently went back to school to get my bachelor's- in nursing? NO in Health Care Management. I'm a great nurse, and I don't need two letters behind my name to verify that.

I have worked CIRCLES around many an RN because they were "too busy" looking cute, or flaunting their degree in my face, saying "I don't do that". Well..... WHAT DID YOU GO TO SCHOOL FOR????????I am truly old school, I love doing pt care, yes, there's paperwork, but that shouldn't take presidence over doing patient care, and caring. I didn't become a nurse for the pay- I became a nurse because I love what I do, and I'm good at it.

So for all of us,(LPNs) STAND up!!!!!! Don't ever let anyone belittle you because you are a nurse!!! We are a vital part of EVERY organization, we have gone to school, and taken boards, and are held accountable for our actions.

DeeDee143 · Aug 3, 2007

Or we should change the acronym to "Love Perfect Nurses" or "Love Practical Nurses". I am proud of what I do.

I like that! Everything is not for everybody. If a LVN/LPN is happy with her career ,who cares what other people think. Thats a total myth that" LPN's or LVN's do not have more critical thinking skills than RN's". Its depends on the education youve had along with addtional knowledge/training. I believe my school has taught me good critical thinking skills and my school is known to be the best LVN school here in the area I lived. Ive seen some RN's who do not have good critical thinking skills.Yes Rn's have more education, but doesnt mean there better than an LVN.Ive seen some good ones on my clincal rotation that run the show. Just my 2 sense;)

jjjoy, LPN · Aug 3, 2007

I'm a great nurse, and I don't need two letters behind my name to verify that.
I have worked CIRCLES around many an RN because they were "too busy" looking cute, or flaunting their degree in my face, saying "I don't do that".

For those who say LPNs aren't nurses - LPNs aren't RNs, that's true, but both are clearly nurses. And those who "flaunt" their degrees or spend time "looking cute" clearly shouldn't have their opinion be taken seriously. I'm sure there are LPNs out there who behave just as badly - such as not helping the CNA even if they have time to because they're "above it" now and have "earned the right" to not do that. So let's take that out of the discussion.

I believe that you can 'work circles' around some RNs. You can probably also work circles around some MDs (especially the new ones). Of course, that doesn't make you an honorary MD. And being more capable that an RN doesn't make one an RN. If you don't need the RN license to do what you want to do, then there's no reason to pursue that. If you want an RN job, though, you need an RN license, regardless of whether or not you learn anything new in the training. The same goes for BSN.

The dilemma to me lies in what Pagandeva describes - the fact the in many places LPNs do seem to be responsible for as much as the RNs are. If LPNs are going to be responsible for all of that, then their pay should reflect that. Or conversely, if RNs aren't doing more than LPNs, their pay should reflect that (though I do believe in some financial incentive for higher degrees regardless of job description). And if there is little difference between LPN and RN responsibilities, then is there any need for the differentiation between RNs and LPNs? Is RN education overkill? Should LPN training be extended in light of the expanded roles many end up with? I find these interesting questions.

pagandeva2000, LPN · Aug 4, 2007

I want to say to CyndiRN2007 thanks for allowing me to clear up what I was trying to say, and for the others for comprehending and identifying what the dilemma is with the LPN. Many LPNs are so bitter and unpleasent that they do, in fact, bring on their own problems by taking out on the RNs what they secretly desire to be themselves. That is not far to the RN. What is happening to the LPN is that in many cases, the role seems to be purposely vague in order to fill in when necessary, but, then, when things go wrong, or the guilt sets in that the patient does not receive care, and should something go awry, then, the LPN has acted out of her scope of practice. Or, as previously stated, taken advantage of, in spite of the performance. This is the main issue, what is being done, the skill being performed. Basically, the LPN may see herself doing the same skill with the intent of the same outcome (hopefully positive) for the client, but may, in fact, have less theory and understanding depending on her schooling or experience as a nurse. I think I graduated from a crummy program, and basically they told us that the thought is for the LPN is "what you see and what you do, with a bit of WHY" while the RN has more of the theory of "why". But, an LPN may see it as this; "I saw an order, gathered data on that client and put on a band aid. What was different between how an RN would put on that band aid verus what I did?" It leads to confusion when someone then comes and tells you that you do not have all of the theory behind it, or that you should not have put on the band aid because you cannot assess the situation. How many ways can you call a spade a spade?

As long as the roles are vague, and the LPN is not getting the recognition for what they do, there will always be bitterness. My hospital is applying for magnet status now, and the focus is on the RN. Personally, I don't care. However, now that we are getting closer and closer to the date, they are now suddenly bugging us with some of this, and my feeling is that if I was not nurse enough before, what difference does it make to me, now whether they get magnet or not? Is the funding going towards the practice of LPNs? Will we get a raise? We won't because city hospitals all get paid the same salary as civil service workers. How can you generate an interest with the LPNs if we are not considered for the same lucrative benefits of the RNs?

The way that I take this is that I don't seek for validation from others; I seek it within myself. Each time I teach a patient and receive a positive outcome, I pat myself on the back. When patients come and request for me, because they believe that I taught them better than another nurse (may it be LPN or RN), I am proud. When the RNs say to me that they don't know what they would do without me, or that they trust my judgement that something is wrong, it shows that their trust in me means more than gold, because I am part of the team. I work hard at what I do, and I try to make sure that I obtain information from reliable resources, confer with others to make sure that I am saying or doing the right thing and want to be trusted and counted on. I may not be liked, but, I want my co-workers to know that no matter what my personal feelings are towards them, that I plan to work as a team to achieve a positive outcome. I feel better now, because, I even value what people on these boards think of me, so to speak. We will not always agree, that is for sure. But, we all have to find out niche to bring ourselves to always focus on positive outcomes for both, ourselves and the client. Nursing, to me, should be like a sisterhood, a sounding board and an opportunity to learn from each other, and I am proud to be a nurse, proud to be amongest nurses. (Okay...I am off the soapbox, now...LOL)

pagandeva2000, LPN · Aug 4, 2007

Should LPN training be extended in light of the expanded roles many end up with? I find these interesting questions.

Yep...and expand the pay, too!

quiltnutty · Aug 4, 2007

I needed to hear this--I work in nursing homes as an agency

nurse and by the end of my shift, I'm usually wiped out!!

And, the reason I'm a full time agency nurse???

To avoid all the nasty back-stabbing and "biting" remarks

that nurses want to make to each other!!

Why can't women respect each other??

And how about a day where you don't gossip about

your fellow workers!! :trout:

celticwoman61 · Aug 4, 2007

As a 15 year veteran LPN who has worked in a variety of nursing settings, I have come to appreciate Licensed Practical Nurse. I find that compared to most of my RN counter-parts, I invariably am the "practical" one when it comes to providing competent and safe patient care. I was fortuanate to graduate from an excellent LPN/LVN program in Ukiah, California and most days I send a silent "thank you" to the amazing instructors that I had!

The flip side of this; I have started and stopped working towards my RN numerous times, found excuses and some valid reasons to not pursue my RN over the years and convinced myself that an RN degree isn't important to me. Now I find myself in a satisfying job, empty nester, extra time and working side by side with an RN (who I don't mean to bash because we are friends) DOING THE EXACT SAME WORK for 1500 dollars LESS per month. I am frustrated watching her make silly and potentially dangerous mistakes because her education/abilities do not appear par to mine AND she gets paid so much more than me because of the RN behind her name and more "respect" when people see she is The RN!

I am 46 years old now and I just received my first nursing book in the mail from half.com and I plan on finishing the RN program through Excelsior. My motive is simply to challenge myself, job/future employment security and to be paid what I deserve!

Sometimes I wonder if alot of problems would be resolved if there was only ONE type of nurse and we all practiced total patient care. The continuity of care would probably be improved and the nasty back-biting over titles would no longer exist.

pagandeva2000, LPN · Aug 4, 2007

As a 15 year veteran LPN who has worked in a variety of nursing settings, I have come to appreciate Licensed Practical Nurse. I find that compared to most of my RN counter-parts, I invariably am the "practical" one when it comes to providing competent and safe patient care. I was fortuanate to graduate from an excellent LPN/LVN program in Ukiah, California and most days I send a silent "thank you" to the amazing instructors that I had!
The flip side of this; I have started and stopped working towards my RN numerous times, found excuses and some valid reasons to not pursue my RN over the years and convinced myself that an RN degree isn't important to me. Now I find myself in a satisfying job, empty nester, extra time and working side by side with an RN (who I don't mean to bash because we are friends) DOING THE EXACT SAME WORK for 1500 dollars LESS per month. I am frustrated watching her make silly and potentially dangerous mistakes because her education/abilities do not appear par to mine AND she gets paid so much more than me because of the RN behind her name and more "respect" when people see she is The RN!
I am 46 years old now and I just received my first nursing book in the mail from half.com and I plan on finishing the RN program through Excelsior. My motive is simply to challenge myself, job/future employment security and to be paid what I deserve!
Sometimes I wonder if alot of problems would be resolved if there was only ONE type of nurse and we all practiced total patient care. The continuity of care would probably be improved and the nasty back-biting over titles would no longer exist.

That can be discouraging and can make a person bitter. One of the major themes I continue to hear is the DOING of the work, with supposed lesser knowledge and skills. This is why I say that it doesn't always take a great deal of theory of why things are done. Most of it is common, 'practical' sense. And, I do see where having three entry levels of nursing causes even more confusion. Best of luck in school!!

payitforward · Aug 6, 2007

See? THIS IS EXACTLY the problem. When faced with an issue, someone is ALWAYS so eager to say, well get your rn, and get more money, or 'you should go back to school and become a "real" nurse". I have heard that ad infinitum, and it really makes me angry. Why?? Because many LPNs aren't in it for the money, and many of us are good, and proud of what we do.. I've notived that some RNs have this 'nasty' little habbit of not addressing us as nurses, but like someone said in a previous thread , "You LPNs". Give me a break. On the other hand, we (LPNs) need to take charge, (in some circumstances) and GET involved in our pts care, go to the meetings, not to show out or show anyone up, but make "them" REALIZE who is doing the care, and who can REALLY relate to our pts.

I will give you a good example, and then I'm off my soapbox. My mother was recently in the hospital to have her kidney removed. Her surgery went well, and she was moved to the regular floor. Well, there were 4 nurses for the 15 people on this floor, including a few CNAs, and I'm not sure if there were any LPNs or not. Well, my mother waited until I got there that morning( around 10am) for someone to help her with her am care. THAT is outragous!!!! Now,my mother complained,which is her right, then the nurse decided to help her after I started making mymother's bed, and getting her basin set up to do her am care. Now, what was that about???? Keep in mind, I NEVER tell anyone I am a nurse. Why??? Because I feel that I shouldn't get any better tx than the person next to me. I say all that to say the nurse (really) thought it was beneath her to even help with am care, and this is an RN,imagine....

ohmeowzer RN, RN · Aug 6, 2007

i was a LPN for 21 years. i just recieved my RN license. i am glad i went back to school to become a RN. i feel my scope of practice is wider, i can do more for my patients , such as draw blood from picc lines , do iv pushes , hang the TPN , and other things. these things may not seem like much to other people , but to me they mean the world. i hated relying on other people to do these things fo me.i am so glad to finally be a RN , i have a larger choice of jobs in the future and i allready have hospitals calling me for jobs. my hospital told me they will not be hiring any more LPN's , but will keep the other 2 LPN's that are on staff . i loved being a LPN , but grateful i went back to school for 5 long years and recieved my degree. i want to thank you all for the great posts i love reading them.