LPN vs RN - serious question about differences

[jjjoy]

I know this is a touchy subject and I don't want it to become a flame war. As someone with RN training and no LPN experience, I'm still honestly confused by these two different nurse licenses.... so here goes...

Many say "a nurse is a nurse" but that's not always the case. There is different designation and licensing for RNs and LPNs. And facilities often advertise "LPN openings" - but if a nurse is a nurse, why would they ever advertise for just LPNs? Wouldn't it just be a nursing job which either an LPN or RN could fill? And then other positions would be RN-only.

Unless an RN has been an LPN, it IS confusing to RNs what LPNs are and aren't legally qualified to do and why they aren't legally qualified to do certain things yet often function in an almost identical role RNs (eg only can't do initial assessments and hang blood in acute care). We all know that many LPNs have great assessment skills and technical skills and critical thinking skills. A patient wouldn't recognize any difference between a good LPN and a good RN. In that case, "a nurse is a nurse."

But then what more exactly did the RN learn in their program to allow them to qualify for significantly more pay than LPNs in most facilities? Why ISN'T an LPN allowed to do an initial assessment or hang blood? It wouldn't take that much extra formal training to bring them formally up to speed on these tasks and include that in their scope of practice. So what more does the RN education have to offer in regard to actually practicing nursing in most settings?

[pagandeva2000, LPN]

I do believe that the training and critical thinking skills differ between the two, and I was able to see it when I was in LPN school and my best friend was in the RN program in the same school. We were both taking Maternal Health and Pediatrics at the same time, but when she offered to share her notes with me, I saw a major difference in the text, assessments and her frame of thought.

My state (New York) does not require that we be IV certified or to hang blood, but it can be a requirement for the facility that we work for to do so. However, we cannot hang blood independently; we must sign off with an RN.

I do think that there should be a clearer scope of practice in a sense, because it is ambigious to me, and plenty of times, in my clinic, I was the first to interview a new patient in our clinic, where it should be an RN. I think that I function better as an LPN because there is something about being the person to make the final decision in regards to nursing care that clearly makes me uncomfortable. I am cool where I am. But, I have also seen many RNs do things that are clearly wrong. And what makes it a funny place for LPNs to be in is that we work under the auspice of an RN, however, we have a license of our own, and are expected to make a nursing judgement of some sorts. What makes it difficult is when the RN who is dead wrong may attempt to force us to do something that we know is clearly incorrect.

[S.N. Visit, BSN, RN]

hi. i'm just "reviving" this thread because i was about to start one that is very similar.

my questions: what is the typical training of a lpn? i know it varies state to state and program to program, but is it generally 1 year, 2 years? if it is 2 years, i cannot understand why someone wouldn't just do a adn program? unless it is just the competativeness to get in? my lpn program was 12 months......rn was an additional 12 . my program was tiered meaning everyone took the same classes for a yr and graduated as practical nurses , some exited while others like myself continued on for the rn degree.

it is my understanding that lpns make less money and must be supervised by rns; is this true? it is indeed true in iowa

i searched nursing jobs as part of my career research and was surprised to find that many jobs posted a starting pay for lpns of let's say $19 an hour, but for a rn applying for the same position maybe $23 an hour....it this pretty normal that for (seemingly) the exact same position a rn would get paid more just by virtue of being a rn? yes, but the rn is held to a higher responsibilty by being responsible to not only their self, but for the lpn & uap as well. even though it may seem the same job, i can pretty much bet it's not

also, can lpns work alone on a shift, or does there always have to be a rn to "supervise" them? i know it all varies state by state but i'm just looking for general information here. on my floor, there must always be an rn

thanks, and i mean no disrespect to either profession by my questions, i sincerely do not comprehend the difference other than title and pay.

no disrespect taken! i was confused too, until about the middle of my nursing program

[pagandeva2000, LPN]

Hi. I'm just "reviving" this thread because I was about to start one that is very similar.

My questions: What is the typical training of a LPN? I know it varies state to state and program to program, but is it generally 1 year, 2 years? If it is 2 years, I cannot understand why someone wouldn't just do a ADN program? Unless it is just the competativeness to get in?

It is my understanding that LPNs make less money and must be supervised by RNs; is this true?

I searched nursing jobs as part of my career research and was surprised to find that many jobs posted a starting pay for LPNs of let's say $19 an hour, but for a RN applying for the same position maybe $23 an hour....it this pretty normal that for (seemingly) the exact same position a RN would get paid more just by virtue of being a RN?

Also, can LPNs work alone on a shift, or does there always have to be a RN to "supervise" them? I know it all varies state by state but I'm just looking for general information here.

Thanks, and I mean no disrespect to either profession by my questions, I sincerely do not comprehend the difference other than title and pay.

Most typical LPN programs are between 9-12 months; the ones that are 24 months (at least on my side of the world) are part time ones, but the hours amount to the same. Yes, we make less money, and we have to be suprevised by an RN. However the facilities may be different; maybe the RN may be available by telephone, for example. I have worked alone on a home care case, but I was to call the agency RN if there was any difficulty (never experienced it, so, I had no reason to contact her). Some require that at least one RN is on the grounds as a supervisor, making it very possible for the LPN to be the only nurse on the floor.

There are many reasons why a person may choose an LPN program over an RN; the main one being what you mentioned, the competitiveness to get in. Other reasons are that people wish to see if they can handle nursing at all, graduating quicker, not being able to pass the college level pre-requisites for the RN programs, wishing to work faster, or like me, who does not desire to become an RN. Also, some states allow an RN student to sit for the LPN exam at some point during their program, so that they can work as nurses while continuing their RN degree.

In most cases, vocational schools train LPNs in the necessary skills to function in their title, but there are more bridge programs that are allowing people to continue with their education to become RNs.

While it is true that we work under the auspice of an RN, we are also under the auspice of a physician, dentist, physician assistant or nurse practitioner, but we are not autonomous, so to speak.

An RN would definitely get paid more because of her advanced education, unless she holds both, her LPN and RN license, which I know plenty of people that do this. But the disadvantage of this is that you are held to the responsibility and accountability of the HIGHER license if something goes down, because you are supposed to KNOW.

In my hospital clinic, for example, I usually work the late clinic, but I can't do it alone...I must have an RN present with me in case there are any problems.

[pagandeva2000, LPN]

I do think that RN programs should take more time to explain the role of the LPN. Many of them assume that we can do EVERYTHING that they can do because we are also nurses. It has caused some confusion for many. Because the RN is the manager of care and will be the main person delegating, it is better that they clearly comprehend the disciplines.

I have seen LPNs do many things that they are not supposed to do, such as IV push, hang blood without an RN, even relieving the triage nurses for lunch (because we are not supposed to do initial assessments). Because we also hold a license, I think this is a mistake for the LPN to do. Everything is okay until something happens. The first thing to occur would be that the BON would ask the LPN what made her do something out of her scope of practice, and question the RN about the delegation of that assignment to someone not legally able to perform a certain function. I worked as hard for my license as the RN did, and will not lose it by doing something clearly not within my scope because I can't justify it.

[jseitzinger]

I was an LPN for 7 yrs before becoming an RN and I never really thought there was much difference until I was an RN. My education was much deeper and my critical thinking was amazingly different once an RN. I was a darn good LPN, but I was more task oriented, where as now I see the big picture, can see more of the deeper issues and underlying conditions and how they relate to the here and now of a pt's status. It's also a very legal issue, accountability and responsibilty and so on.

I am 48 and want to be an RN (Yes age bugs me) but would it be better to start with an LPN license and then work into a RN?

[Penguin67]

Rather than enter into discourse on this board that might step on a toe or two, I would simply suggest doing two things to investigate the difference between the scope of practice between RN and LPN.

1. Look at your state's nurse practice act. It clearly spells out the difference. (Or in many cases, not so clearly!) The utilization of LPNs varies among states, and some state still refer to an LPN as an LVN.

2. Look at the curriculum plan (available online) for LPN and RN programs. Look at the courses that are taken and the amount of time it takes to complete the entire program.

These are objective things that should answer some, if not all, of your questions.

[ChrisFIVTSN]

I recently completed my LPN program and immediately returned to complete my RN. I have learned that distinguishing between these 2 roles involves understanding role differences as they relate to scope of practice as specified in each state's nurse practice act. For example, in the state of Indiana, an RN performs the initial patient assessment; the LPN can perform their own assessment, but the initial assessment must be performed and documented by an RN. The registered nurse performs an independent assessment of the patient, whereas the LPN performs an assessment in conjunction with the RN or other members of the healthcare team.The registered nurse is responsible for formulating the nursing diagnosis - in regards to planning care. The registered nurse is also responsible for establishing the care plan and initiating nursing actions to provide care. The LPN is responsible for implementing the care plan and nursing actions initiated by the RN. The RN can delegate nursing measures to the LPN, however, the LPN can only accept those delegated nursing measures that are within their scope of license/practice.

[florianslove]

As an LPN Unit Manager at a skilled nursing facility in South Florida on the day shift often the only RN available is the DON. Our MDS coordinator is also an RN, however, she hasn't practiced as a staff nurse in so long, she is unable to answer any questions regarding care. I am IV certified, I can start IV's (not midlines), hang anti-biotics, and do flushes. We don't hang blood in our facility, so that isn't an issue. When we have an admit, whoever the floor nurse is can do the initial assessment, I will usually verify MD orders, order meds, etc..

Our ADON is an LPN. I haven't worked in a hospital setting since being in South Florida but that seems to be where the major difference is. In fact, most hospitals here hire very few LPN's. I am seriously considering going for my RN, I already have a Bachelor's in another field, and am 4 credits away from a Master's in Health Administration, however, I don't know if it's worth it.

Long term care facilities and SNF's in my area seem to really allow LPN's to grow and experience challenging opportunities. I guess it's up to where you want to go with your career. In closing, I have the utmost respect for the RN's I work with, I trust them and depend on their knowledge. I also work with some outstanding LPN's who I would trust with the care of my child or parents. In my world a nurse is a nurse, some are just better than others, regardless of designation.

Roxann

[APRN., DNP, RN, APRN, NP]

Check out the following links for some information that the federal government has listed for the differences between RN and LVN/LPN.

Bureau of Labor Statistics for RN: http://www.bls.gov/oco/ocos083.htm

Bureau of Labor Statistics for LVN/LPN: http://www.bls.gov/oco/ocos102.htm

[ckalaska]

Hi,

What do you mean the training "stinks" for the LPN program? I am researching schools now and am debating between private vs public schools. Any advise?

Thanks

[momudm]

I have to decide between a LPN and an RN program in the next 3 weeks I need the pros and cons very quickly

[momudm]

If anyone out there could help it would be greatly appreciated!!!!