LPN vs. RN

sbkio1 · Apr 9, 2012

I am An LPN here in Florida .WE ARE REAL NURSES.We do a great deal of Pt care.When i worked in a critical care Med/Surg Hospital the ONLY thing i did not do was hang blood!I do assessments and take orders.I have learned a lot from years of experience.Experience is one thing LPN or RN that will make you an educated "real" nurse.I get that RNs sometimes don't view us as REAL nurses...They went to school a lot longer than we did and in most situations their licence is on the line as well if they are supervising LPN's.One thing for sure ...not just everyone makes a good "Nurse" I think with the economy we are faced with these last two years more and more people are getting in to the health care field because that's were the work is! Unfortunately everyone who goes to school to be a nurse is not a good candidate!We are special people!

prettymica, ASN, BSN, MSN, LPN, RN, APRN, NP · Apr 9, 2012

I became an LPN like some of the posters above. I had no background in healthcare. I applied to both RN and LPN school but I was chosen by the LPN program. It was also free(financial aid) I did have to move about 1 hr from home and my rent was taken care of by family. At the time when I began (jan 2008), I would look in the paper and people were begging for LPN with no experience and offering sign on bonus (ex.10,000) but fast forward to nov 2008) all that was gone and so were the great opportunities to work just about anywhere, any specialty. As a student I even had the opportunity to sit in a meeting of nurses who were basically being told cuts are coming so get it together if you want your job. I even had a job waiting for me when i graduated, that fell through and it was off to the nursing home I went. I cant see myself working there for 40 plus years( no offense to anyone who does) so I signed back up for classes @ a CC about 1hr and half from home( reputation for the best bridge program) to finish off my pre reqs. I want to more opportunities to work in any area and I eventually want to teach nursing students. I will be finished with my bridge program may 2013 :)! But its back to school I go, NP all the way!!

CloudySue · Apr 9, 2012

Why don't LPNs go back for their RN? Because life happens. Not every person has the luxury of living off their parents while they go for their sweet BSN at a private expensive college. Not that this is the case for everyone, of course, but the attitude I get of "why don't you go for the education that is 1000% more expensive and takes 400% as long" comes from young people who have no concept of trying to study for huge, major tests in between changing diapers and breastfeeding. Ever get up for clinicals at 4:30 am after being up half the night with a sick kid? Childcare is expensive, even for people who are working for a living. When I took out loans for my nursing program, I had to request more than twice as much, because I had to pay for daycare for two small children. Yes, paying for childcare is more expensive weekly than community college.

Practical nursing programs are NOT easy. I have my BSEd and nothing in my 4 year teacher education program was anywhere near as hard as that 12 month PN program. Of course, back then I DID have the luxury of living with parents and had no other obligations. But education theory is not as complicated as medical science. LPNs did not spend a whole year practicing enemas on fake plastic butts in lab. We learn assessment, and we DO study the "whys" of everything as well, and we study L&D, pharmacology, peds, med/surg, mental health, OR, etc. we just don't go in as deeply (studying every ailment under the sun) as RN programs do. But trust me, they squeeze as much of it in as they possibly can! We are not stupid or ignorant to what nursing is and why we do what we do.

And now... why don't I go back for my RN? Surely I want to, after all, I've been an LPN for nearly 3 years, I must be bored and resent being underpaid! Well, now my kids are in school, and they are growing rapidly. I've already missed a whole year of their life and I don't want to miss any more. I get paid enough to take them on vacations, buy them nice clothes, and keep a roof over their head with all the amenities. I am not so greedy that I want to squander the next year or so ignoring them again and going back into poverty (after all, if I'm in school full time I cannot work full time, and don't you try to tell me that I can). When I work 12 hour shifts overnight and sleep while they are in school, I make enough with overtime that I make way over 45K a year and still be home with them to help them do their homework and make their dinner, and enjoy some life with them. LPN's are not just LPN's, they are people busy living their lives, enjoying what their life has to offer. Frankly, I'm sick of school. Right now I'm not even in the mood to sit for my CPR recertification, let alone be another nursing instructor's whipping girl for another year. I like my life, I live well with the money I make, and this is why I'm "just" an LPN. Maybe some day I will go back, when my girls are in high school and want nothing to do with me. Until then, I wish people would stop thinking "She's so smart, why does she remain a lowly LPN?"

Because I AM smart. That's why.

mazy · Apr 9, 2012

I agree that this is a very sad thread, and even sadder given how many threads we have going on this site about how we are all nurses and need to pull together and respect each and every one of us in order to advocate for the profession of nursing as a whole.

As far as the "use" of LPNs, I find that question jarring. Who is it that is going to be "using" us? RNs? Are we there to be used by RNs? Is the question here about how RNs are supposed to use LPNs as if they are merely there for the RN to be able to do the job?

LPNs are nurses. We are not there for the convenience of the RN. We have a specific scope of practice and independent job responsibilities that are of use to the continuum of patient care, not just to the RN.

As far as assessments, this is a question that keeps coming up. So what I can say is that LPNs are taught to do assessments, they are taught ADPIE, I spent an entire clinical rotation on a med-surg floor doing assessments. So we ARE taught to do those.

In addition, LPNs ARE expected to do assessments on the job all the time. As others have mentioned, in many places LPNs can not do initial assessments, but the reality is that in many facilities, LPNs do initial assessments and then the RN will sign off on them.

As for why people lower themselves to settling for being an LPN, what I can say is what another poster stated, which is that life happens. It may be the case that an LPN hopes to go on to become an RN but can't for financial or personal reasons. Or it is the case that they enjoy their job and feel very useful and satisfied with what they do and don't feel any need to cave into some kind of pressure to become a "Real Nurse."

tainted1972, ASN, RN · Apr 9, 2012

I learned in class yesterday the scope of practice of LPN's and it seems to me very limited. Is there a reason one would chose to become an LPN over an RN?
(i know some do it bc of $ or as a step to RN) but some stay at LPN for 20+ years.
Clarification please. Id like to understand their use and scope a little bit better :)
Thanks in advance.

I have been an LPN for two years. For me it is a stepping stone ( I finish my RN program this august).

As an LPN I can do most of the things that an RN can do. There are some minor differences

someone mentioned assessments.... I can do, and often do head to toe assessments.. however as an LPN I cannot call it an assessment, only RN's can assess.. I collect data for assessment. So in my world it is called head to toe data collection.

RN's write care plans LPN's do not. But we learn how to do them in LPN school.

As an LPN I can start an IV but I am limited to where I can start one and what I can hang. I can hang saline and antibiotics. I cannot hang blood , I can give pretty much any drug via injection, but not intravenously.

As an RN student I can tell you that I have not learned anything drastically new in the RN program. Most course material is the same, just more in-depth. In RN school I am expected to think differently than I did in LPN school. As an LPN I am given orders and I follow them. RN's are trained more to know what orders to expect.

A typical LPN student is an adult who has children, and who has worked as an aide, or STNA. It only takes about a year to become an LPN.

Put yourself in the shoes of a single mom who is an STNA who makes about 10 bucks an hour. She can go to school for one year and double her income. It is much more doable than to expect to go to school for at least two years.

I know several LPN's who have been LPN's for many years and have chosen to not go back to school to become an RN. In all of these cases these LPN's have fabulous jobs that pay well. To start over as an RN they would take a paycut. ( A new grad RN is still a new grad regardless of the years they put in as an LPN).

For those of you who think that LPN stands for pretend nurse.. I am offended, I work in a facility where I am the ONLY nurse while on duty. I am responsible for 22 people. I have had residents "go bad" with absolutely nothing but my hands and my brain to get through it. In a hospital if a pt's blood pressure goes low, you can give IV fluids and call a doc. When that happens in my facility ( and it does, often) I have to give oral fluids and pray. There are no other nurses for me to bounce ideas off of or even an STNA. It is just me. I have had catheters come out, head injuries, broken bones, choking incidents, seizures, respiratory distress and sepsis. I have to assess and decide what course of action to take based on my assessment. I have saved lives because I payed attention. I am a REAL NURSE!

I am working with individuals who cannot tell me what is wrong. Sometimes they come to me saying their belly hurts. I have to rely on my skills as a nurse to decide if it is a tummy ache or something more serious like a bowel obstruction.

BelgianRN · Apr 9, 2012

I don't view it as a sad thread. I've reread pneumothorax's questions a few times and all I get from the word "use" is that it is poorly formulated by someone who is honestly wondering about what an LPN can and cannot do.

As I'm working in Belgium I find the American nursing system with all their abbreviations very alien to me. I often time have to google the terms for all the different nurses you have over there and how to place them in relation to my own role as a nurse. We were told at nursing school in international terms you are an RN since you are registered and a nurse.

And I've often wondered what's the point in having all these different nurses. In Belgium we have two kinds but they do exactly the same etc. only one gets payed more than the other. But I can't tell about my colleagues if they are one or the other type.

So when I first read about the nursing system and threads this is how it went. Apparently there are not just RN's over there, mmmm. They have LPN's (which I honestly thought was about lactation since I read first about LPN's in an OBGYN thread). And then I read about LVN's no clue what they were figured they were the veteran version of the LPN's (or some distinction to the gender), I now figured out they are the same ^^. Then there are also CNA's which I figured was the same as CRNA's kinda like LPN and LVN are the same, but I turned out wrong. Then I came across someone in a thread talking about their BSN I figured it was in reference to all the BS we see in nursing every day. But it turned out it is some super version of an RN so I classified it as a nurse in a superman outfit. So now after a few months I figured out what all the different letters stand for but I'm still nowhere at finding out what the exact differences are (not looking for an answer to that here). All I've seen so far is some mad RN's trashing LPN's some nice RN's telling how great LPN's are. And I've seen some mad LPN's trashing RN's and some nice LPN's telling how great RN's are. And feel free to substitute the letters for any other nursing role out there.

When I was working in another country with a much more elaborate nursing system they had similar distinctions in nursing. And one of type A nurses was complaining that the computer system was against her because she was type A and not type B as she was bashing at the keyboard. I figured the computer just didn't like her very much because she was bashing the keyboard :) and decided to flash her a blue screen in the face.

So let's give Pneumothorax the benefit of the doubt and consider it a poor choice of words from an inexperienced new addition to the nursing core until proven otherwise.

And let's blame the media since all I ever saw before coming to AN was nurses in american shows and they are always RN's I can't recall seeing LPN's. All I recall was a cleaning lady in ER doing a thoracotomy since she was a vascular surgeon in some eastern european country.

DISCLAIMER: I wasn't trying to be rude or malignant to anyone. All I tried was to bring some humor into a thread. I felt the thread was not taking the direction the OP intended it to be and since he/she could be a scared little nurseduckling someone had to speak up ^^. Don't shoot me for trying please I'm sure if we were all working on the same floor we would all get along. Except not with Betty because she doesn't own a toothbrush.

mazy · Apr 9, 2012

I agree, pneuomthorax often posts interesting questions. The wording was poor.

tothepointeLVN, LVN · Apr 9, 2012

And let's blame the media since all I ever saw before coming to AN was nurses in american shows and they are always RN's I can't recall seeing LPN's. All I recall was a cleaning lady in ER doing a thoracotomy since she was a vascular surgeon in some eastern european country.

LOL On one of the episodes of Nurse Jackie they touched on it briefly when I mean old school nurse was in the ER and one of the LPN's she had worked with mentioned he was an RN now. The line "Well you'll always be an LPN to me"

Wild Irish LPN, LPN · Apr 9, 2012

This whole conversation is so sad to me. People all have different reasons for becoming different levels.
Some have a limited amount of money. Children to care for and cannot spare 2-4 years out of their children's lives.
Some have to travel hundreds of miles for one program when another is just a few blocks from home. Some are in a second career, and they only have a few more working years before they plan to retire.
And let me interject they ALL BECOME NURSES! An LPN/LVN is a NURSE!

Amen to that...I am a soon to be LPN Graduate in Colorado....Wanted to get my feet wet before I decided on whether I will pursue my BSN degree...best decision ever....I am Certified in IV Administration and I see very few differences in an LPN role versus an RN role in LTC, which is where I will be working....the pay in colorado is excellent too for LPN's....I would hope that any LPN would not feel like a lesser nurse when comparing apples to apples, we each have our place....I have written endless amounts of careplans and have administered the same meds as my counterpart RN's....I think it is a great place to start, or stay!....I do plan on pursuing my BSN after school and my LPN experience will put me far ahead of those just starting a journey into nursing....

PacoUSA, BSN, RN · Apr 9, 2012

I find it sad that people think an LPN is not a real nurse, and this is coming from someone that is finishing an accelerated BSN in a month. Why you hatin'? At the end of the day, no patient asks what kind of nurse you are. If they make you feel better, they were a good NURSE, not a good LPN or a good RN.

catiern · Apr 9, 2012

First and foremost, LPN's ARE real nurses. One big factor in choosing to become an LPN first is purely financial. One can pay off the RN program by working p/t as an LPN through a pool (which usually pays higher). Also, having the LPN gives you a "leg up" on having the clinical skills and nursing knowledge to become a good RN. There are also a number of LPN-BSN programs out there that appears to give you some credit for class work you've done as an LPN. I think doing the LPN first is also good if you are not 100% sure that the nursing field is the right fit for you. You will have "wasted" only a year of your time, versus 2-4 years. Good luck.

Merlyn · Apr 9, 2012

I learned in class yesterday the scope of practice of LPN's and it seems to me very limited. Is there a reason one would chose to become an LPN over an RN?
(i know some do it bc of $ or as a step to RN) but some stay at LPN for 20+ years.
Clarification please. Id like to understand their use and scope a little bit better :)
Thanks in advance.

I didn't want to be in charge. I like beside nursing and 40 years ago, The LPN did the bedside and the RN's were in charge. Today that is all changed. RN's are doing bedside nursing. And the last job I had, I sometime was in charge. I did pretty good I could kick myself now for not going on to get my BSN. My dumb sister went. Now I am at the end of my career and she is one of the high mucky-mucks, but she's still dumb.