LPN vs RN? Not as clinical as society thinks?

IrishIzCPNP, MSN, RN, APRN, NP · Apr 21, 2013

Nope.

First, there are many RNs without a college degree. I obtained my RN through a diploma program. I did go back for my BSN.

Second, it is my understanding that an LPN cannot assess like an RN. In my facility, the RN is the only one who can do a true assessment.

In many states LPNs cannot pass meds that RNs can.

If the difference was minimal the LPNs wouldn't have been in the majority if my RN program. They only got out of 1 nursing class. Many had to take some basic prerequisite classes as well...again I was not in a college based RN program.

There are more differences than what I listed.

There is a huge difference between LPN and RN and you clearly do not understand that.

EdwardDunlap · Apr 22, 2013

I have been an LVN for 28 years there is not much in nursing that I have not done. I think the older a nurse/RN is the more they respect the role of the LVN/LPN. The younger nurses/RN some times don't have a clue when it comes to clinical skills. I still remember the RN that could not take an E cylinder a regulator and canula and make them work. Then there was the RN that Thought the oxygen cylinder was empty did not know you had to open the valve. Lets see I remember the BSN weekend supervisor whose calculator went dead and could not calculate a drip rate for an IV the old fashioned way on paper with the times tables and long division. I remember the Diploma Graduate RN that taught our LVN class always said "The LVN knows the how the RN knows the why." I have worked Long Term Care for 28 years now and am proud of my status as an LVN and have no desire what so ever to be a RN.

TheCommuter, BSN, RN · Apr 22, 2013

I'm an RN who has never set foot on the campus of any university. In fact, I earned an associate of science degree (ASN) from a trade school.

I was an LPN/LVN for more than four years prior to becoming an RN. I had already possessed college level writing skills during my days as an LVN because I attended college preparatory courses throughout high school and completed English 101/102 at the local community college.

My friend earned a bachelor of science degree in public health from a private nonprofit university prior to becoming an LPN. Trust me when I say that she had accrued more than 120 college credits prior to attending a practical nursing program at a local community college.

Also, many LPNs have studied at universities and earned degrees instead of certificates or diplomas. Have you ever heard of the associate of applied science degree (AAS) in practical nursing? Multiple colleges and universities offer this practical nursing degree program. Click on the links below to read of such programs:

http://www.msugf.edu/advising_planning/ProgramForms/0809/0809_LPNAAS_fillable.pdf

M State

North Dakota State College of Science: Nursing : Practical Nursing

Practical Nursing - A.A.S. Degree - Dakota County Technical College

allnurses Guide · Apr 22, 2013

Great post, Commuter! :up: People might want to take a look at how nurses are educated in Canada, as their system is somewhat different from that in the US.

Downsouthlaff, I just reread your post and honestly, I think you put forth a good faith effort and did not mean to disparage either RNs or LPNs and that saying that somebody is "down to earth and more everyday, but highly knowledgeable" is not a bad thing and I think I know what you were getting at there.

I think probably the question is unanswerable in a general sense. People themselves are very different. They bring a myriad of unique qualities, prior education post-high school, and cultural experiences with them. They become nurses like the people they are, which is for the most part, a good thing.

The standards set by the education process are to make sure that whatever type of personality one comes in with, they meet minimum standards for practice under the license they earn.

For me, I try to take people as they come, no matter what their degree or the letters after their name. This has helped me avoid embarrassment on one hand and expecting a level of expertise based on my notions of what a person with advanced education would display in their technical and interpersonal selves while in the work environment on the other.

I've felt like a doofus for unconsciously talking down to someone I assumed lacked expertise and been left holding the bag for expecting a higher level from someone based on their degree. Hope that makes a little bit of sense.

AndyBRN · Apr 23, 2013

It's actually quite a bit different here in Canada, in terms of education for RN vs. RPN.

RPNs are educated at a college level for 2 years. The program is more skills-oriented, with less focus on research.

RNs are educated at a University level for 4 years. RNs receive either a Bachelor's of Science in Nursing (BScN) or a Bachelor's in Nursing (BN). Prior to 2005, RNs could be educated in colleges and receive a "diploma" so to speak. After 2005, RNs had to attend an accredited University and obtain a Bachelor's Degree. Pre-2005 RNs can bridge their diploma into a Bachelor's Degree, should they wish to pursue their Master's. There are also accelerated RN programs for individuals for have prior degrees and courses completed to use toward their Nursing degree. These programs are 2 years long. Offered by institutions such as University of Toronto.

RNs focus on broad, theoretical knowledge, coupled with clinical rotations. Rotations in clinical practice cover the continuum of care, focussing on long term care, acute care, specialized areas and community health.

In a purely economic sense, it's better to be an RN. On Ontario, an RPN caps out their hourly rate a whole 3 dollars below the starting rate for an entry-level RN.

From a practice standpoint, your options as an RN far exceed that of an RPN. Master's Degree, Nurse Practitioner, Extended Class RN and Advanced Practice Nurse, just to name a few.

AndyBRN · Apr 23, 2013

I willl mention however, that most institutions generally will maximize the scope of practice for both RN and RPN.

Main differences I've seen include:

- IV push below the drip chamber (RN only)

- Acute Care Areas such as ED, ICU, CCU (RN only)

- Higher acuity patients on general care areas (RN only)

Other than these limitations, the skills in practice are actually quite minimal. I have met a number of RPNs who are incredibly skilled and knowledgeable. It matters on person, not on their degree.

Pangea Reunited, ASN, RN · Apr 23, 2013

In some areas, depending on experience, RNs and LVNs are very similar. In others, they are not. I'm in California. LVNs here aren't allowed to give IV meds or even to "assess" a patient without an RN co-signing for them. They are allowed to "collect data". That's not to say that LVNs are not capable of doing these things, but they're not legally allowed to.

Those two things alone create a huge difference in practice, IMO.

allnurses Guide · Apr 23, 2013

It's best if people check their state's scope of practice for the most accurate information on the differences. In California, LVNs can become IV-certified and administer medications other than IVP, including hanging blood products. They do, in practice do assessments independently, in environments like home health and LTC.

Facility policies may further restrict what LVNs are allowed to do, but there is a difference between that and scope of practice.

AndyBRN, thanks for explaining the details about nursing education in Canada! I knew there were differences, but not the details. :up:

DoGoodThenGo · Apr 23, 2013

It's actually quite a bit different here in Canada, in terms of education for RN vs. RPN.
RPNs are educated at a college level for 2 years. The program is more skills-oriented, with less focus on research.
RNs are educated at a University level for 4 years. RNs receive either a Bachelor's of Science in Nursing (BScN) or a Bachelor's in Nursing (BN). Prior to 2005, RNs could be educated in colleges and receive a "diploma" so to speak. After 2005, RNs had to attend an accredited University and obtain a Bachelor's Degree. Pre-2005 RNs can bridge their diploma into a Bachelor's Degree, should they wish to pursue their Master's. There are also accelerated RN programs for individuals for have prior degrees and courses completed to use toward their Nursing degree. These programs are 2 years long. Offered by institutions such as University of Toronto.
RNs focus on broad, theoretical knowledge, coupled with clinical rotations. Rotations in clinical practice cover the continuum of care, focussing on long term care, acute care, specialized areas and community health.
In a purely economic sense, it's better to be an RN. On Ontario, an RPN caps out their hourly rate a whole 3 dollars below the starting rate for an entry-level RN.
From a practice standpoint, your options as an RN far exceed that of an RPN. Master's Degree, Nurse Practitioner, Extended Class RN and Advanced Practice Nurse, just to name a few.

IMHO the path Canada choose was brilliant.

When RN education and licensure was moved to what is a BSN (four year degree here in the USA), the two year ADN or diploma graduates became "RPNs" but have a much more expanded scope than what many USA states give for LPNs.

Fiona59 · Apr 23, 2013

I work and was educated in a different part of Canada from the previous poster.

In my province the BScN only became mandatory in 2009.

The education of PNs is based on the old college diploma RN course. First year English, Psych, Sociology and a couple of electives are included in the work.

In my province LPNs work in NICU, the ER, and Cardiology. On the units, the nurses are assigned the bed not the patient and if you have a fresh ICU discharge and you are an LPN you don't get to switch patients. You get on with your job. Assessments be it admission or discharge are the responsibilty of the nurse caring for the patient. The only RN that supervises me is the Charge who also supervises the RNs working alongside me. I carry my own malpractice insurance and am responsible for my actions and care of my patients.

There is a theory in my province that RNs and their union are pricing themselves out of the hospital with their continuing wage demands. The degree was brought into existance so that RNs could advance into management roles. Fortunately or not (depending on your viewpoint) the system only can absorb so many managers.

libran1984, ASN, RN · Apr 23, 2013

At Pangea reunited- or anyone for that matter;

What differentiates assessment and data collection. If my understanding is correct, an assessment involves the possibility of an intervention- what kind of intervention is that?

When a pt requests pain medication due to pain & then the LPN/LVN administers the pain medication (via the route allowed by scope of practice and provider's order) is that an assessment? Or is that data collection? If it were an RN, is that an assessment or data collection?

When I took my NCLEX-PN, I was asked to identify multiple breath sounds. I "data collect" the pt has rhonchi, rales, wheezes, etc and report to the provider for further orders... Is that an assessment or data collection?

If a nurse (RN/LPN) cannot administer meds under our own license then the word assessment is pointless with regards to pharmacological intervention.

What about interventions regarding repositioning. Does the LPN have to report to the MD to obtain orders to reposition a pt to prevent skin breakdown? Of course not. So what, I repeat, is considered to be the difference between an assessment and data collection?

A pt has a potassium of 6.3. The nurse will of course immediately notify the doctor and implement appropriate protocols, but what will be the difference? The LPN and RN will both check for CP, heart rate, auscultation, mentation, etc. Is it assessment or data collection?

It seems to me a nurse's hands are always bound by the physician. They say an RN is independent while an LPN is dependent. If both are under the supervision of the physician then what is the real difference?