LPN vs RN scope of practice commentary in Mpls Star Tribune

HM2VikingRN, RN · Oct 20, 2009

Registered nurses, whom the law calls "professional nurses," won the seniority battle, keeping more wisdom at the bedside. They now face a new corner-cutting threat to their professionalism. The Minnesota Board of Nursing, charged with licensing all levels of nurses, seeing that they meet state educational requirements and protecting the public from unsafe care, is under pressure to allow less-educated licensed practical nurses (LPNs) to do what RNs do now. The chair of the subcommittee drafting the board's proposal is himself an LPN.
...
If there's anyplace that needs an RN's better-trained ability to assess what is going wrong in a person with multiple problems, to decide what is needed, to connect that patient with the right problem-solver and to judge if the solution is working, it's exactly where corner-cutters would like to replace RNs with less-expensive caregivers.

http://www.startribune.com/opinion/commentary/64615677.html?elr=KArksc8P:Pc:U0ckkD:aEyKUiD3aPc:_Yyc:aULPQL7PQLanchO7DiUr

MNA needs to hold the line on this issue.....Another bad proposal from administration

ohmeowzer RN, RN · Oct 20, 2009

nooo this won't happen... legislation would have to be changed , scope of practices rewriten... nope .. i have nothing against LPN's but this will not happen..

Moogie · Oct 20, 2009

I think the last paragraph says it all:

Instead of cutting corners to get around this safeguard of quality care, the Board of Nursing should be pressuring the Legislature and nursing schools to do what is necessary to produce more of all the kinds of nurses needed to assure excellent care of a growing, aging, diverse population with increasing acute and chronic health care needs.

There are many LPNs with sufficient clinical expertise and experience that they could assume a greater scope of practice. On the other hand, there are many who neither want nor can handle additional responsibilities. How will the BON differentiate between which LPNs are capable and which are not? Will every LPN who wishes to be licensed in Minnesota be required to complete courses in which they would learn and practice the additional skills, such as physical assessment? Will practical nursing curricula change to reflect a greater scope of practice? Will current LPNs be grandfathered in without additional education? Will it be incumbent upon the facilities that expect LPNs to function in expanded roles to ensure that every LPN has adequate training? I think that's a huge threat to patient safety: if the scope of practice changes and facilities are permitted to give greater responsibility to LPNs, will those facilities make sure that those LPNs know what they're doing first? Considering how weak many facilities are in terms of providing relevant and high-quality continuing education for nursing staff, I won't hold my breath on that one.

I also don't think this proposal is fair to LPNs, expecting them to take on greater responsibility while getting by paying them what they're currently paid---meaning far less than RNs. Again, what about those who chose PRACTICAL nursing because they didn't, for whatever reason, want the responsibilities that go with being REGISTERED nurses?

:down: on this proposal. It just sounds like the same old, "a nurse is a nurse is a nurse" nonsense we've all heard a thousand times before.

Home Health Columnist / Guide · Oct 20, 2009

from bon:

[color=#996600]nursing practice committee developing assessment and delegation models

the nursing practice committee of the board of nursing is working on models depicting the level of decision making of nursing personnel in the process of assessment and delegation. nurses are encouraged to monitor the work of the committee via this website. additionally, committee meetings are open and nurses are encouraged to attend.

background

in 2005, the minnesota colleagues in caring convened an lpn practice committee for the purpose of addressing perceived differences between practical nursing practice and regulation. after extensive work, the committee concluded there is confusion in the state of minnesota regarding the activities of observation and assessment and the activities of supervision and delegation. the committee recommended clarification of these activities in practical nursing practice and differentiation from professional nursing practice. the [color=#333399]executive summary of the minnesota colleagues in caring lpn practice committee is attached here.

("scope of lpn practice study to identify congruencies and incongruencies among lpn regulations, education, and practice - executive summary," january 2005).

following receipt of the colleagues in caring committee report, the board of nursing directed the board's nursing practice committee to analyze the recommendations and determine a plan to implement the recommendations. in october 2008, the nursing practice committee submitted a report to the board of nursing regarding their work. the report included models intended to clarify and distinguish roles and scopes of practice in the areas of assessment and delegation. the report of the nursing practice committee to the board is attached here. [color=#333399]("the nursing practice committee report.")

none of the links on that page working...links did not open --"internal error" message...shot off email tp bon requesting links to be fixed. karen

TheCommuter, BSN, RN · Oct 20, 2009

I've been a practicing LPN/LVN for nearly 4 years, and am scheduled to graduate from an RN transition program in a few short months.

Here's my $0.02 on this issue. I'm not going to assume any added responsibilities to my already loaded workload without the higher licensure or additional monetary compensation. In other words, I would not attempt to even function as an RN if I'm not being paid or licensed to do so. My whole reason for being in school is to attain the RN license, be paid what I am worth, learn something new, and expand the opportunities that are available to me.

Although I dislike the biased tone of the article's author, I agree with some of its points.

noc4senuf · Oct 20, 2009

I do work in MN and know that since they have been working on this for several years already, it is not going to change any too soon.