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Lvn/Pn vs RN

Posted
by winter415 winter415 (New) New

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.

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

Specializes in Med/Surg, Ortho, ASC. Has 17 years experience.

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.

AtHomeNurse

Has 16 years experience.

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

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

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.

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

Specializes in Internal Med, Primary Care, Ambulatory. Has 15 years experience.

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

Specializes in HH, Peds, Rehab, Clinical. Has 4 years experience.

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

Specializes in HH, Peds, Rehab, Clinical. Has 4 years experience.

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

Specializes in Internal Med, Primary Care, Ambulatory. Has 15 years experience.

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.

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

Specializes in LTC and Pediatrics. Has 3 years experience.

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.

BDOGGRN

Specializes in Internal Med, Primary Care, Ambulatory. Has 15 years experience.

Agree with the need for making patients aware of who their "caregiver" is, but let's be real: patients rarely ask for an "advanced practice registered nurse" or a "certified medical assistant" or "certified nurse assistant" or "physician assistant-certified" in any real situation-they ask for the "nurse" or "doctor" even if their needs can be met by other types of personnel. Are patients really expected to know the billions of initials we have tacked to staff badges? It's not as if there are only a handful of initials/credentials-there are billions!!! I thought I illustrated the litany of alphabet insanity in my previous post.

Also, I am highly annoyed by the lack of support provided by fellow nursing staffers to other nursing staffers on this site-if people are looking for help, answers, or simply camaraderie, from any peers, this site would be a LAST resort. How can we possibly help patients/clients when we can't even help each other...

I understand what you are saying and yes, there are many initials that come with the education; I agree there are patients who don't ask in advanced for a NP or PA; but I know many who do ask. When patients ask for a doctor or nurse, they might get a physician assistant or medical assistant. I blame the practices for not correcting patients in regards to misleading the patients to believe that a medical assistant is a nurse when they are not or that a physician assistant is a doctor when they are not. It's illegal for MA's to indicate they are nurses and so many do as well as other employees of the physician practices. I just feel patients need to be made aware who their caregivers are and the differences. I applaud and hold the highest regards for the nursing profession. My daughter is in nursing school and I know how hard it is for her. Patients don't understand they can speak up and ask questions in regards to their medical care. I've seen so many patients throughout the years who believed they were treated by a doctor and they were not. Patients need to be made aware and understand they can ask questions.

BuckyBadgerRN, ASN, RN

Specializes in HH, Peds, Rehab, Clinical. Has 4 years experience.

Remind us please, which initials are after YOUR name?

I understand what you are saying and yes, there are many initials that come with the education; I agree there are patients who don't ask in advanced for a NP or PA; but I know many who do ask. When patients ask for a doctor or nurse, they might get a physician assistant or medical assistant. I blame the practices for not correcting patients in regards to misleading the patients to believe that a medical assistant is a nurse when they are not or that a physician assistant is a doctor when they are not. It's illegal for MA's to indicate they are nurses and so many do as well as other employees of the physician practices. I just feel patients need to be made aware who their caregivers are and the differences. I applaud and hold the highest regards for the nursing profession. My daughter is in nursing school and I know how hard it is for her. Patients don't understand they can speak up and ask questions in regards to their medical care. I've seen so many patients throughout the years who believed they were treated by a doctor and they were not. Patients need to be made aware and understand they can ask questions.

BDOGGRN

Specializes in Internal Med, Primary Care, Ambulatory. Has 15 years experience.

Oh BB, always so accusing and confrontational in your posts-please let nurses nurse, without nasty comments or accusations from their peers!

This is an issue I have run into more and more

frequently, and I am a little confused as well... And upset that because of my experience I'm feeling mistrust towards LPNs. I have worked with wonderful lpns who offered me alot of knowledge and different view points on how to treat and manage my patients care, and on the flips side I have met LPNs who when pressed demonstrated they didn't really have any idea what they were doing (like listening to a patient's heart on the wrong side)

I'm sure this is true for RNs as well, I just haven't experienced it yet, even with new RNs.

I have been wondering if it has anything to do with the graduate program they are coming from and amount of education received there? (I only suggest that because in VA it feels to me like there are alot of 14week long programs where as the registers Nursing programs in this area are well know and established and have really strict curriculums) ... I'm afraid that maybe in my area in particular there is a hit or miss system of education? ... I would love to have insight into a typical lpn course program

egglady, LPN

Specializes in Geriatrics. Has 25 years experience.

In my 20+ years of being an LPN, I have never been disrespected by a RN. I have learned a lot from them, and in turn I have had new grad RNs thank me for helping them out with things new to them. The way I see it is that we are all in this together, a team. Perhaps it's all in attitude or confidence.