I'm an LPN and I understand.

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. Nurses LPN/LVN Article

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.

Specializes in MED-SURG Certified.

You have done what many people with higher degrees have failed to explain and I applaud you for that. Yes, there is a bit of insecurity about the difference but there are training and knowledge differences as well as differences in scope of practice. I think we should strive to work hard and do the best in what we were all educated and trained to do and if we become passionate to do more, then be educated and earn that higher degree in order to serve and do what we all love doing. Great post.

Specializes in Cardiac (adult), CC, Peds, MH/Substance.

I'm with Hazel: Anyone who says that it's quite clear that anyone with a BSN will be a "better nurse" than someone with a diploma either has no experience in nursing, or has been breaking into the PCAs and is typing from work. There's a saying in the IT industry (I went to grad school for it, oddly enough), that the more letters after a someone's name, the less competent they actually are. In IT, that's often pretty true, but not always. In the nursing world, standards change constantly. You have people that were putting in arterial lines when you weren't even born that have a diploma, and can tell you exactly what medications and interventions a patient needs by smelling them and reading their chart. Then you have MSNs that work in administration because they wouldn't know an ABG from an ASS. And then you have MSNs who are much better primary care providers than MDs. It has a lot more to do with a person, their reason for being, and their experience (which can ALSO include university education), than what alphabet soup they carry.

Specializes in Cardiac (adult), CC, Peds, MH/Substance.

Just curious, armymalenurse: Still in the Army, or former?

Excellently written! Absolutely nothing I could add. From a sister LPN, LTC charge nurse ;-)

Sharing if I may?!

Specializes in MED-SURG Certified.

Still in and still pushing fluids...:D

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.

Last time I checked the "N" in all of the titles stood for "nurse"...I worked in a hospital the first 8 years of my nursing career and I did a heck of a lot more than walk people to the bathroom and insert catheters. While I gladly did those things, so did the PCT working with me so that I could also have time for my assessments, IVs, central line dressing changes, tracheostomy care, wound care, etc that I could not delegate to unlicensed personnel. The only thing an RN did for me was co-sign my admissions and spike my blood transfusions. Every state has different laws. Having a bachelor's degree will no make someone a better nurse. Also, BSNs and diploma/ADNs take the same darn test for licensure. I would rather have a nurse with experience that knows what she's doing than a new grad that is clueless but hey, they have a piece of paper that tells them they are smarter (in areas that are not essential to patient outcome because they are not skill related). I'm going on for my BSN because of the Magnet status changing my job opportunities. I have yet to see a new skill presented to me that I haven't learned already or would make me a better clinical nurse.

Specializes in MED-SURG Certified.

Hi nicktexas: Still in and still pushing fluids...

Specializes in Cardiac (adult), CC, Peds, MH/Substance.

Hopefully not the sort of fluids available on the internet.

Are you at Madigan? I used to be there forever ago, worked some floors and taught in MCED or whatever they call it now.

Most LPN's I know and programs I'm aware of require 6 months to 1 year of prerequisite college courses, then once accepted into the LPN program it is typically a full year. The original poster had stated that his concern was that the nurse was becoming so educated that they wouldn't be the mouth wiper or gown changer. The CNA is not licensed but is an assistant who is certified and very skilled in ADL's and do those things all day as their main focus. Practice makes perfect.

Specializes in Cardiac (adult), CC, Peds, MH/Substance.

I concur, Mb. While it won't be a horribly long time until I'm a nurse practitioner, the beginning of my career (slightly more than beginning, I was 20) was as an LPN. And I can count on 37 hands the number of new graduate BSNs I personally trained in the first couple years, because they had no clue what to do. Of course, we all have to recognize, "there are different sorts of LVNs." A lot depends on personality, your schooling, and experience. Some programs produce CNAs who can vaguely pronounce half the medications they give, but have no real clue what they're doing. Some are harder than most RN programs. Some are somewhere in the middle. And personality counts for a lot. When you have an LPN/LVN working night shift and things get slow, they've checked all their patients repeatedly, cleaned up the nursing station, then eventually run out of things to do and start reading medical journals, that's "that sort" of LVN.

And if you have yet to see a new skill that would make you a better nurse, you're looking at the wrong people. Remind me to tell you some day about the brilliant doctor from Pakistan. O course he's "just" an RN here.

Specializes in Public Health.

Practical nurse from Ontario Canada, here.

I work in home health. I work by myself, and the only time I see an RN is at a staff meeting. Because of the shift in health care in Canada, the acuity of patients living at home is very different from what it once was. We typically care for very sick and complex patients, yet I don't have an RN in the home with me while I perform assessments (yep, assessments) and make critical decisions.

And here I am, knee deep in my BScN program to become an RN. Is the program harder? Absolutely. Have I learned anything that will make me a "better" nurse? Nope. I'm already a good nurse; I am compassionate, I love my job, and it is reflected in the care I provide. Absolutely nothing my professors teach me from a textbook could make me any better at those things.

Thanks to my BScN program I sure do know how to critique a research article and write one heck of a paper, though.

It's very simple. Experience is great and all, but it will never replace formal education of a bachelor or master degree level. The fact remains that the healthcare world is backing this ideal and requiring bsn nurses for the most part.

I'm not saying someone with experience wont be great at iv's or other clinical skills, but they simply lack the education that is quickly being required of rn's