LPN vs RN

LongislandRN23 · May 25, 2011

In as much as hospitals and acute care is concerned, I wouldn't be too sure about that. My hospital doesn't hire LPNs any more. All current LPNs are treated as advanced practice techs (so to speak). The other hospitals I've worked at also told all LPNs to get their RN within a certain time frame or be prepared to lose their jobs or practice as CNAs if positions were available. All this has occurred in different states, so it's not just one particular location.
And if you consider that CNAs (in some areas and with training) are allowed to draw blood and take a course that will allow them to pass meds, CNAs are on a path to become cheaper LPNs.
So, you have a glut of BSNs and possibly CNAs who can do essential LPN functions at a cheaper hourly rate.
Where does that leave LPNs? Bridging to get their RN.

We'll see what happens, I dont think LPNS are going anywhere anytime soon.

LongislandRN23 · May 25, 2011

http://www.bls.gov/oco/ocos102.htm#outlook

Job Outlook

Employment of LPNs is projected to grow much faster than average. Overall job prospects are expected to be very good, but job outlook varies by industry. The best job opportunities will occur in nursing care facilities and home healthcare services.

Employment change. Employment of LPNs is expected to grow by 21 percent between 2008 and 2018, much faster than the average for all occupations, in response to the long-term care needs of an increasing elderly population and the general increase in demand for healthcare services.

Demand for LPNs will be driven by the increase in the share of the older population. Older persons have an increased incidence of injury and illness, which will increase their demand for healthcare services. In addition, with better medical technology, people are living longer, increasing the demand for long-term healthcare. Job growth will occur over all healthcare settings but especially those that service the geriatric population like nursing care facilities, community care facilities, and home healthcare services.

In order to contain healthcare costs, many procedures once performed only in hospitals are being performed in physicians' offices and in outpatient care centers, largely because of advances in technology. As a result, the number of LPNs should increase faster in these facilities than in hospitals. Nevertheless, hospitals will continue to demand the services of LPNs and will remain one of the largest employers of these workers.

Job prospects. In addition to projected job growth, job openings will result from replacement needs, as many workers leave the occupation permanently. Very good job opportunities are expected. Rapid employment growth is projected in most healthcare industries, with the best job opportunities occurring in nursing care facilities and in home healthcare services. There is a perceived inadequacy of available healthcare in many rural areas, so LPNs willing to locate in rural areas should have good job prospects.

joanna73, BSN, RN · May 25, 2011

I wouldn't be surprised if you start seeing less and less demand for ADN, but LPNs will continue to have job prospects. Many places don't have Diploma programs anymore (Canada, Australia, UK), so I can see newly graduated (not people who are currently working as an ADN) ADNs facing less opportunities, because they are sandwiched in between BSN RNs and the LPNs. LPNs continue to have a wider scope of practice and they are more cost efficient from an employer's perspective.

eriksoln, BSN, RN · May 25, 2011

I wouldn't be surprised if you start seeing less and less demand for ADN, but LPNs will continue to have job prospects. Many places don't have Diploma programs anymore (Canada, Australia, UK), so I can see newly graduated (not people who are currently working as an ADN) ADNs facing less opportunities, because they are sandwiched in between BSN RNs and the LPNs. LPNs continue to have a wider scope of practice and they are more cost efficient from an employer's perspective.

I wonder about this myself. What will the future hold for all the different degrees of nursing? I don't think the answer/reality of it will be anything like what we predict. ADNs disappearing sounds logical, but IDK. Does the flow of time/decision making EVER follow "logical" trends?

Things I feel strongly about with regards to the future of nursing:

1. LPNs as a whole will not be "faded out" or eliminated. In fact, the number of positions may increase even. What may happen is the number of places where they generally practice may reduce. To put it simply: I see a trend towards LPNs being the #1 position holders in places like LTC, but the idea of them being phased out of acute care settings to continue at the same time. But, the need for LTC help will far outweigh any position losses from acute facilities that stop hiring LPNs.

2. ADNs will continue to exist, but the separation between ADNs and higher degrees will become wider. I can see ADNs being put in a position where they are considered the #1 choice for acute care setting bedside care positions, but are not given any opportunity for advancement. I think to advance to any position outside of "staff nurse" will require a BSN. Hence, the need for ADNs will be reduced, as the number of acute care/hospital positions decreases.

3. Further, the separation between ADNs and higher degrees will be reflected in pay/benefits, not just job opportunities. Hospitals DO want more BSNs on their units. One of the biggest complaints of bedside BSN nurses is that they do the same job for the same pay as an ADN. I think, in an effort to make having a BSN more attractive, hospitals will work towards making having a BSN more attractive. Shoot..........thats happening right now. Hospitals are trying to pressure people to get their BSN by simply not hiring ADNs. The more competitive job market is allowing them to do this without paying for it. Eventually though, they'll see more is needed and they will make an effort to "sweeten the pot" for BSNs.

I don't think any degree of nursing is going away or is going to be "faded out". I do believe though that we will become more segregated. LPNs work here, ADNs there.....................BSNs start here but move up the ladder, MSNs do this.

joanna73, BSN, RN · May 25, 2011

For example, where I live (Canada) MSN is pretty much required now for education, and Advanced Practice Nurses. It never used to be this way, now it is....more and more. At the very least, they are giving preference to people enrolled in an MSN for those roles. On the other end, LPNs are hired over RNs for many positions. In the end, employers will dictate what they want.

Fiona59 · May 25, 2011

Erik, the ADN no longer exists in Canada. RNs are required to hold a degree. LPNs require two years at College (it's in effect in several provinces).

Our future appears to be different from the American. LPNs are becoming the bedside nurse on more and more units (NOT just LTC, I'd walk away from nursing if I ever had to go back there as would many co-workers). The degree is heading more and more towards management.

eriksoln, BSN, RN · May 25, 2011

Erik, the ADN no longer exists in Canada. RNs are required to hold a degree. LPNs require two years at College (it's in effect in several provinces).
Our future appears to be different from the American. LPNs are becoming the bedside nurse on more and more units (NOT just LTC, I'd walk away from nursing if I ever had to go back there as would many co-workers). The degree is heading more and more towards management.

"The degree is heading more and more towards management." Eh? You mean BSNs and MSNs doing away from the bedside roles and LPNs being at the bedside?

Hmmmm. For that to happen down here, the nursing boards and facilities would have to drop their definition of the primary difference between "practical nursing" and "registered" nurse: Assessment. By the book, thats what an ADN (and higher degrees) does that an LPN isn't allowed to do, assessments.

I think it will boil down to w/e is most fiscally prudent. The facilities will decide what the cheapest route to go is, make their internal policies work in such a way to facilitate change towards how they want it, then the nursing boards will follow suit.

joanna73, BSN, RN · May 25, 2011

Since when do LPNs not do assessments? That's news to me.

eriksoln, BSN, RN · May 25, 2011

Since when do LPNs not do assessments? That's news to me.

You didn't know that? That the "book definition" difference between an RN and an LPN is "assessing"? Thats not news really, thats old. That's what's supposed to drive the scope of practice and decide what an LPN vs. an RN can do.

At most facilities, LPNs can't do the health/history portion of an admission assessment. That doesn't mean facilities don't allow it, but it's technically not ideal.

Care plans can only be developed by the RN (or higher degree) personnel for the same reason.

LPN documentation is supposed to reflect noted changes in condition, symptoms etc..............But they can't "assess".

You honestly don't know this?

joanna73, BSN, RN · May 25, 2011

Perhaps its a little different where I'm from. The main difference between RNs and LPNs is that RNs are able to accept the more complex patients and/ or take over when the patients condition is less predictable (theoretically). I'm sure LPNs would beg to differ that they don't assess. Assessment forms the basis of your practice and decision making. And...does that mean then that facilities which employ mainly LPNs aren't assessing? That makes very little sense.

eriksoln, BSN, RN · May 25, 2011

Perhaps its a little different where I'm from. The main difference between RNs and LPNs is that RNs are able to accept the more complex patients and/ or take over when the patients condition is less predictable (theoretically). I'm sure LPNs would beg to differ that they don't assess. Assessment forms the basis of your practice and decision making. And...does that mean then that facilities which employ mainly LPNs aren't assessing? That makes very little sense.

Mind you, this is the "classroom" definition I'm putting out there, not my personal view on the matter of assessments. We all know the ocean that lies between the book version of nursing and RL practice. But you had me worried. I was thinking to myself "I didn't make that up, that was taught to me, in class."

http://www.livestrong.com/article/115373-difference-between-rn-lpn/

This one describes the differences pretty well. It's what I was told was the primary difference. Note the last portion of the second paragraph noting how the initial assessment must be done by an RN and said RN develops the plan of care............then an assessment must be performed by an RN every shift, with LPNs being allowed to then reassess as the shift progresses.

Not many facilities follow this word for word, it'd cost too much. They wouldn't be able to give RNs working with LPNs full assignments. Hence, the essence of "Only RNs can assess" is lost, and we have lawmakers like the one's in Florida saying LPNs can do EVERYTHING except IV pushes and digital fecal extractions. LMAO...............I don't think those people understand what the schools are saying about the differences between an RN and an LPN.

Mrs. SnowStormRN, RN · May 25, 2011

None of us can predict the future. Who knows, in the future the minimum requirement for nursing may be a BSN in general and ADNs and LPNs may be obsolete. As for now, I take it one day at a time. I continue with the education to open up job prospects. Good Luck all!