LPN's just glorified nurse aids in LTC? Huh?

Jubei · Aug 13, 2005

I'm an LPN in a LTC facility (Ive worked in LTC for about 9yrs, and the facility i work at has a floor that is pretty much the equivalent to med/surg) and i've never been asked, or even "allowed" to work as an Aide, though i have offered to at times when we were short staffed, it just doesn't happen. The RNs and LPNs are interchangable, and as someone else mentioned, sometimes the LPN acts as the charge nurse while the RN passes meds, etc, and sometimes it's the other way around. The med techs are sometimes utilized as aides, but not very often. I did work in a Psych unit once, and there they used the LPNs and the Aides interchangably. This didn't bother me, and it didn't bother any other LPNs i knew at the time, either. It was actually a nice break, at least we got to go home on time when our shift ended. Working as nurses, well, you know how that can be sometimes, you're stuck at work till you've tied up every loose end and all your work is finished, sometimes up to 2hrs after your shift technically ends!

At Laguna Honda (the biggest notorious convalescent hospital in the country with over a thousand patients), LVN's get used as CNA's sometimes.

Jubei · Aug 13, 2005

I am an RN & work in a med/surg floor in a hospital that employs both LPNs & RNs (& CNAs too). The only things the LPNs on my floor cannot do that the RNs can are the following: initially assess a new patient from the ER/direct admit, IV pushes, hang blood, act as charge nurse, & take telephone orders from physicians. I think it's crazy that my hospital doesn't allow our LPNs to take TOs! I don't know who made up that rule.
-Christine

Don't take T.O.'s? Your hospital is old school.

April_LPN · Aug 14, 2005

I work in LTC, only been an LPN since March. We have about equal amounts of LPN's and RN's. We are treated exactly the same. The only thing that an RN can do that we can't is hang an IV bag or flush an IV line. If it weren't for that, where I work you wouldn't be able to tell the difference between the RN's and LPN's. We definantly don't do any of the CNA work though.

nubins397 · Aug 14, 2005

They do hire LPNs here at hospitals too and they do the same job as an RNs..although that can't push IV meds. But it isn't easy to get a job in the hospitals, especially if you have limited experience. The CNA's at the hospital are actally PCTs (patient care technicians) and can do EKGs, BGs, foleys, etc. in addition to ADLs.

same here...

CrazyPremed, MSN, RN, NP · Aug 14, 2005

At the bottom of my screen is an ad which reads "LPN, accredited in 3-12 months"...sorry. I don't want anyone with that little training taking care of me. The hospital here has almost phased out all LPN's. We have them at my SNF but not usually on the subacute/rehab floor. Licensed PRACTICAL nurse....read your state nurse practice act...in my state at least, an LPN can't really be in charge of an RN...the RN always "outranks" the LPN.

Do you honestly think that a person can become an LPN in three months?? Have you ever seen what LPN's are responsible for?? Have you ever worked with an LPN?? When have you seen an LPN try to "outrank" an RN? Please, give your fellow nurses a little more credit. Remember, we're all in this together. :rolleyes:

CrazyPremed

DusktilDawn · Aug 14, 2005

I worked as an LPN (RPN in Ontario, Canada) for 10 years in an acute care setting. I LOVED the work I was doing and the different areas I worked in. I was always proud of being an RPN. The RNs that I usually worked with respected me as much as I respected them. I will always carry those years with me as a NURSE.

At the present job I now have, there are no LPNs. Frankly, I wish there were!!!!

RavenC · Aug 14, 2005

I recently had a couple of nurses tell me that LPN's are just basically glorified aids in LTC settings.
I though that LPN's did mostly the same work as RN's in the LTC setting.
I know that everyone needs to be a team and pitch in and get whatever needs to be done, done. But LPN's as glorified aids? Why go to LPN school then?
What are typical LPN duties in a LTC setting?

Hi

I work in a nursing home (LTC) in Phoenix Arizona. We have CNA's who do the hands on washing, feeding, brief changing and bed making. The LPN's do the med pass,the treatments, take off MD's orders, fax orders to Pharmacy. The unit clerk faxes info related to appointments. The nurse manager, an LPN also, handles all MD related issues as well as calling families when needed. She is the one who attends meetings such as care planning and runs interference for floor nurses when needed. We also have a few RN's who work the floor just like an LPN. Usually when I"m at work, I'm the treatment nurse, but I get pulled to the med cart when we're short. (About 2x a week). As for working as an aide, no way. I suffered through nursing school like the rest of you so I could earn a better pay with less strenuous physical work. Even a double shift as a nurse, (when I get stuck), leaves me having a hard time walking the next day due to arthritis in my back. I did it for years so I know how hard it is, so I make sure to thank our aides. We all know that they're important to us and we couldn't do it without them. I do offer to help, but they can do it better without me at this point. I will help an aide when they ask me, and when doing a treatment, I have been known to change a brief. I don't know of any nurse here that has, or would work as an aide for a regular assignment. Arizona is second to Alaska in nursing shortage, so they need us. If you're looking for a job here you qualify if you have 2 arms, 2 legs, 2 eyes.

Back in New Jersey when I lived there, you couldn't work as an aide if you were an LPN or they would take your license. If an RN worked as an Lpn, she lost hers.

In Pennsylvania, they put you wherever they want you. I did a double (eve- nights) and when the night shift started the nurse came into relieve me and that's when I found out I was the aide. I still got the same pay and respect, but I couldn't walk completely upright the next morning. Of course, when I worked there, an LPN couldn't even cut a pill in half. Only an RN or a pharmacist could.

I think it's disrespectful of an employer who knows you spent time and money on a specialized education, to expect you to not use it. As for hospitals, I've never worked in one, but I hear that the nurse-to-patient ratio is about 6-1 and the nurse has a CNA to help her. In California, I heard the nurses are trying to get it down to 4-1. My ratio is 36-to-1 with 2 aides.

Hope this helps.

RavenC

RavenC · Aug 14, 2005

I worked as an LPN (RPN in Ontario, Canada) for 10 years in an acute care setting. I LOVED the work I was doing and the different areas I worked in. I was always proud of being an RPN. The RNs that I usually worked with respected me as much as I respected them. I will always carry those years with me as a NURSE.
At the present job I now have, there are no LPNs. Frankly, I wish there were!!!!

Hi

You mentioned not having any LPN's at your job. I've heard for years that LPN's will eventually not exist. I've also heard that some states want to train CNA's a little more and let them do meds. Have you heard any of that? Arizona hasn't done it yet.

It's nice to know that you like us.

RavenC

LPN

ktwlpn, LPN · Aug 14, 2005

At the bottom of my screen is an ad which reads "LPN, accredited in 3-12 months"...sorry. I don't want anyone with that little training taking care of me. The hospital here has almost phased out all LPN's. We have them at my SNF but not usually on the subacute/rehab floor. Licensed PRACTICAL nurse....read your state nurse practice act...in my state at least, an LPN can't really be in charge of an RN...the RN always "outranks" the LPN.

THis is a grand example of a prevalent attitude and I attribute it directly to ignorance-Ignorance of the LPN's education and scope of practice. ...If you go to that website you'll see that they help you find ways to get credit for all of your previous accumulated professional experience, career licenses and certifications-they want to help you earn credits through "non-traditional" methods...No one is going to become an LPN in 3 months.....Sheesh-most LPN programs in this area are 18months-ADN is 2 years-By your logic I could say "Gosh-I don't think I'd want someone with so little education taking care of ME in an acute care setting...."

goof1552 · Aug 15, 2005

Just curious, but what is the diff btw an LPN and the diploma RN's? Aren't they both only a year or two of school total?

I can tell you that with all the confusion, even among us nurses, about the different nursing ranks there will always be a messed up heirerarchy. Not that I know the solution, but having jobs that overlap leads to confusion, poor leadership, and graying of boundaries.

I applaud anyone who goes to school, education is the means to a brighter future, I just always wonder about the direction to take. I personally have a BSN, but have been asked many times about the diff. between LPN's vs. RN vs aide education. Most of the time I say I dont really know, other than to say the pay diff is quite drastic between each step.

markjrn · Aug 15, 2005

Just curious, but what is the diff btw an LPN and the diploma RN's? Aren't they both only a year or two of school total?

I've never heard of a one year RN course before.

huganurse1203 · Aug 15, 2005

You described my job to a T.. Couldn't have said it any better !!

huganurse1203

Okay, I'll put my two cents in.
I'm a charge nurse in LTC. Things are starting to change now, but for the past year I was the only nurse on my wing. That wing has 59 residents with various levels of acuity. I have one CMT who does the majority of the med pass. I do a med pass of my own at 4pm and 8pm to patients that have g-tubes, and for the meds that the CMT isn't allowed to pass...and a few pills in between that are time specific. I do several tube feeds, and a dozen flushes per 8hr shift. I have an average of 8 breathing treatments to be done twice a shift, and a number of treatments. There are all the flow sheets (treatment, behavior, pain, ADL's) and daily charting (new admits, readmits, antibiotic, skilled, incidents) along with anything that comes up during the shift. I round the the physicians when they come in, otherwise, when one of the four physicians we deal with calls back with orders from the problems that dayturn called in, I take those off. I do my glucoscans...I think I just have 10 of those now. And of course, there are the falls, the phone, the families, the visitors. Public relations is a big part of LTC.
When I have the time I'll catch a call light. If I'm in the area I'll answer an emergency light or get an alarm that's going off. I also try to feed a patient when I can, but that's a rare occurance. I also have 10 primary care patients that I'm responsible for doing a weekly full assessment on, and keeping track of labs and ppd's.
I'm not a "glorified aide". I have my own duties for which I am responsible, but I'm not above taking someone to the toilet or helping one of my four aides clean, change or transfer a patient.
I've never been asked to work the floor as an aide. In those instances when we're that short staff, the CMT is pulled to the floor, and another nurse called in to help with the med pass. There are a couple of nurses who will volunteer to work the floor on occasion.
Hmmm ~ must have been in a talky mood. I'll stop now.
Chel