Lvn/Pn vs RN

RNsRWe, ASN, RN · Oct 13, 2015

Some people appreciate teamwork, and recognize that each level of licensure brings something to the table. And others don't. Some RNs delegate well and treat LPNs well....and some don't. Some LPNs take delegation well and treat RNs well....and some don't. Really all there is to it, I think! :)

roser13, ASN, RN · Oct 13, 2015

I believe nurses are nurses regardless of the "scope of practice".
We are all here to service care.
My question or curiosity is... why do some RN's (I am not saying ALL) treat LVN's like they are a burden to them? Like LVN's are the unnecessary hired help, I don't get it.
It's kind of sad.

As has been said by PP, you can certainly make a case for the reverse. In my experience (and only MY experience), some LVN's appear to bear grudges against RN's and resent that the RN is in a position to delegate. It really goes both ways, but I have seen this be the case more often than your example.

JustMeRN · Oct 13, 2015

Agree with the two previous, but also wanted to add scope of practice does matter. Scope of practice is the legal limit of your abilities. LPN's have a different scope of practice that RN's. And that's ok. An RN and an LPN are not the same thing, so I don't agree with your assessment of "a nurse is a nurse". And for the record, different doesn't mean better, just different. I think you will find people at all levels that look down on whoever is below them, and plenty who will not. That's the way the world works I think.

TheCommuter, BSN, RN · Oct 14, 2015

When I was an LVN, some RNs suffered from the 'RN-itis' syndrome (read: "I am better than LVNs) and treated LPNs/LVNs accordingly.

When I first became an RN, some of my LVN coworkers carried chips on their shoulders and occasionally acted as saboteurs.

Therefore, bad behavior goes both ways and comes from nurses with all levels of education and licensure. We are not responsible for other peoples' behaviors. We can only dictate how they treat us. Good luck to you.

jadelpn, LPN, EMT-B · Oct 14, 2015

Looking at it from a different perspective, it all depends where you work, and what scope you are allowed to practice in where you work.

There are some facilities that will dance around the limits of what an LPN can do, because LPN's are paid less than an RN.

Every state is different in what they say an LPN can and can't do. My state has very little limit--the only thing an LPN can not do is clinically direct an RN. Otherwise, it is completely facility based.

Interestingly, this is where some facilities with use the LPN to their advantage--because the LPN training is so hands-on clinically based, they will use LPN's as "mentors" to "show" a newer RN how to do clinical skills. And quite frankly, mostly those of us who have considerable time in, and our pay level is up near where a newer RN would be, or well over. This was not the case always, as any number of RN's were ASN/ADN's and had a considerable more clinical skill, therefore was a non-issue until I would say the last 6-7 years or so. And I am speaking of smaller, more community based hospitals. Now it is seemingly the ADN's who are taking on the role, as they CAN clinically direct another RN. More bang for the buck.

Then any number of smaller community hospitals have been bought up by larger companies. At that point. it became a matter of wanting all BSN's. Healthcare has changed. And with that change comes an alternate level of thinking that goes beyond bedside clinical skills. And that way of thinking needs documenting. For reimbursement purposes. Which most BSN's could recite in their sleep after years of theory, evidence based practice, care plan bru-ha-ha has been hammered into them. And yes, they have a couple of years of general education stuff. But that prepares them for their nursing portion which far exceeds that of an LPN as far as what it is that facilities need for income generating. And the more theory and other intangibles that a BSN can come up with, the less of a cost to the facility.

For instance, if an LPN says that a person needs a more specialized wound care treatment--has discussion with the MD about it, it is a go, the facility can balk at the cost of said treatment. As they are going to be reimbursed for "X" amount of dollars regardless if it is a bandaid or a specialized bandage. If an RN says "we can have this done at home". The patient is educated, discharge planned and discharged--at a lower cost than a pricey treatment. The RN thinks at a different level than the LPN. And so it goes.

Marketing strategies that include all sorts of certifications, acknowledgements and various accolades that is meant to increase patient volume. And this is done at the level of thinking that a BSN could do in their sleep.

LPN/BSN is like apples and oranges. LPN's have a place in healthcare. Most will tell you (myself included) that they can put a foley in in their sleep. An RN can site EBP that talks about hospital acquired infections specific to foleys, and write policy regarding their use, that they then present to non-nurse administration who see this as a dollars and cents thing.

Many can tell you all about various medications, how to give them, and how Mrs. Such-and-So will take them. All about wounds, and quick tips on how to successfully dress them. What an RN can tell you is mechanism of action, EBP, a patient education plan, followed up with an LPN's thought process on discharge planning.

I often think that delegating is a naughty word. If facilities were clear on the parts that are LPN and the parts that are RN beyond the "you can't push meds" business, it would be a harmonious team. But facilities don't care if the team is harmonious, just that it APPEARS to be harmonious in front of patients and families.

Bottom line, it is all about the intangibles and what that can do for a facilities bottom line. And those intangibles are taught ad nauseum at the RN level.

BDOGGRN · Oct 23, 2015

Good grief! Why not get past the initials, since most patients/consumers don't understand them anyway? The general public doesn't know the various credentials and scopes of practice for the alphabet soup of health care professionals! I'm a long-time healthcare worker who has trouble understanding this litany of letters: MA, CNA, DPM, MD, DO, RA, DON, ADON, FNP, APN, RT, OT, PT, LCSW, LPN (or LVN if west of the Mississippi River?), RN, BSN, ADN, ASN, PA-C, APRN, PCT, PSR, CNS, BC, DC.... Patients/consumers/clients would need a "navigator" or "advocate" to figure out any of this!

BuckyBadgerRN, ASN, RN · Oct 25, 2015

Your belief is just that, YOUR belief. States have varying scope of practices in place for a reason. LPN's in my state aren't allowed to hang blood, or the first ABX. Just because YOU believe that you are of equal duty-sharing, you are not. LPN's are not allowed to do IVP meds. If your patient needs this, yes, I must stop what I'm doing to do this for your patient. I hardly think it's a "burden", but it is what it is.

I believe nurses are nurses regardless of the "scope of practice".
We are all here to service care.
My question or curiosity is... why do some RN's (I am not saying ALL) treat LVN's like they are a burden to them? Like LVN's are the unnecessary hired help, I don't get it.
It's kind of sad.

BuckyBadgerRN, ASN, RN · Oct 25, 2015

I believe only TWO states use the term "LVN". Hardly everything west of the Mississippi....

Good grief! Why not get past the initials, since most patients/consumers don't understand them anyway? The general public doesn't know the various credentials and scopes of practice for the alphabet soup of health care professionals! I'm a long-time healthcare worker who has trouble understanding this litany of letters: MA, CNA, DPM, MD, DO, RA, DON, ADON, FNP, APN, RT, OT, PT, LCSW, LPN (or LVN if west of the Mississippi River?), RN, BSN, ADN, ASN, PA-C, APRN, PCT, PSR, CNS, BC, DC.... Patients/consumers/clients would need a "navigator" or "advocate" to figure out any of this!

BDOGGRN · Oct 25, 2015

I believe only TWO states use the term "LVN". Hardly everything west of the Mississippi....

Thanks for pointing that out, BB. That really helps clear things up.

hayest · Nov 2, 2015

We don't get past initials because there are differences in the Initials! You made a true statement, most patients do not understand, but they need to learn. Physician Offices, Hospitals, other facilities need to make it clear who will be the caregiver to a patient.

quiltynurse56, LPN, LVN · Nov 2, 2015

In my state, I can not do anything IV wise or do admission assessments. In the LTC facility I work in, we don't have IV's. I can get IV certification after having worked so many hours and taking a class.

Only one of our RN's seems to look down on the LPN's (I am west of the Mississippi btw). Otherwise, we all work together and help each other out.