Not a real nurse??

LPNer · Apr 3, 2005

I agree to a certain extent but when you go to school to become an LPN you are made aware of your scope of practice. LPN to me is a ground level entry point into nursing. The career ladder you speak of is hard to achief at an entry level position unless you employ upward mobility--and that would be into an RN program. Practical nursing is meant to be just as it sounds and unfortunately it has no real career mobility within itself. Professional nursing, as the board calls it, has several levels indeed. I do understand your frustration but I really don't see how there could possibly be many levels to LPN scopes when they are basically all predefined. I knew going into LPN practice that my practice was one with limited mobility unless I did a bridge program. While I understand I don't agree.
Karen

LPNs had a lot more carreer mobility when I became an LPN in the 70s. An LPN was the head nurse of the ER where I went to school. I was offered the charge nurse postiion in the ER of a small hospital in Ky in the early 80s. (I didn't want to work ER than or now.) I have been the charge nurse on a med/surg unit in a hospital. Yes, we did, at one time have a lot of carreer mobility with bascially the same scope of practice as we have now; minor changes have been made and THAT has taken our mobility away.

LPNs at a lot of hospitals did not have "limited" IV responsiblitlies. We had the same IV responsibilities as our RN co-workers. The scope was changed and now I don't know the things I used to know! I am told that because I am onlyl an LPN I am not capable of learning anything new to expand my responsibilities unless I return to college. I don't have the abilities I used to have, where did that knowledge go? Oh I know, I don't have a degree to prove it!

Please. LPNs have not always been treated as second class nurses. We have been whittled down by the BON (mostly RNs) to put us in our place and to prevent us form taking jobs that could better serve the professional status of RNs. How would the professional nurses insist on their value if technical nurses can are permitted to function to their full capacity in the hospital?

GN1974 · Apr 3, 2005

The problem is acuity is higher now than before. Technical nurses should not be equal to professional nurses. You are wanting a similar role minus the formal education!!! I disagree that the BON is putting you down--I believe it is trying to ensure the public has the most knowledgable professional under the circumstances(an RN for ICU, etc), to ensure safe and effective care. I realize that education does not always produce great nurses--but you will find this in anything in life. Just because a teacher has the education and certification to teach does not mean he/she will be a great teacher...what has changed since the 70's is sicker patients in the hospital and for shorter stays. Patients seen in ICU in the 70's are seen on general floors today. Technology, research, advancement in medications have all made the lifespan greater and have also made the patients in today's ICU's and general floors a heck of a lot sicker than a few decades ago. I refuse to debate this further and will end on this note...Practical nursing is just how it sounds...PRACTICAL. It is an entry level self confined profession with the option of transitioning into professional nursing (where there are multiple levels). LPNs are valuable in several settings but we will continue to see their scope ever narrowed as acuity rises. Today is not the same as even 10 years ago...and LPN's have made advances! I remeber not being able to do anything with IV's 10 years ago in the midwest...we weren't even taught IV skills really! IV thereapy certifications have cropped up every where these last few years. Colorado even has 2 levels of IV therapy certs for LPN's--a basic and central line course. Don't tell me there haven't been expansions in the practice of practical nursing! I am thankful I have gone on and wish all others the same wish to succeed if they chose to go on. I believe advancement into greater and expanded scopes comes through formal education. I don't think it is fair to expect to have a similar role as an RN without advancing the same way they did--through formal education...we all learn on the job (doesn't mean I should be a NP!)

Karen

LPNer · Apr 5, 2005

The problem is acuity is higher now than before. Technical nurses should not be equal to professional nurses. You are wanting a similar role minus the formal education!!! I disagree that the BON is putting you down--I believe it is trying to ensure the public has the most knowledgable professional under the circumstances(an RN for ICU, etc), to ensure safe and effective care. I realize that education does not always produce great nurses--but you will find this in anything in life. Just because a teacher has the education and certification to teach does not mean he/she will be a great teacher...what has changed since the 70's is sicker patients in the hospital and for shorter stays. Patients seen in ICU in the 70's are seen on general floors today. Technology, research, advancement in medications have all made the lifespan greater and have also made the patients in today's ICU's and general floors a heck of a lot sicker than a few decades ago. I refuse to debate this further and will end on this note...Practical nursing is just how it sounds...PRACTICAL. It is an entry level self confined profession with the option of transitioning into professional nursing (where there are multiple levels). LPNs are valuable in several settings but we will continue to see their scope ever narrowed as acuity rises. Today is not the same as even 10 years ago...and LPN's have made advances! I remeber not being able to do anything with IV's 10 years ago in the midwest...we weren't even taught IV skills really! IV thereapy certifications have cropped up every where these last few years. Colorado even has 2 levels of IV therapy certs for LPN's--a basic and central line course. Don't tell me there haven't been expansions in the practice of practical nursing! I am thankful I have gone on and wish all others the same wish to succeed if they chose to go on. I believe advancement into greater and expanded scopes comes through formal education. I don't think it is fair to expect to have a similar role as an RN without advancing the same way they did--through formal education...we all learn on the job (doesn't mean I should be a NP!)
Karen

I don't remember anybody in this thread thinking that an LPN should be the same as an RN. As mentioned in your post, LPNs have two levels of IV certification. This is the type of certifications I am talking about. But it should not be limited to PIV and CIV.

My own hospital does not add restrictions beyond what the BON restricts us to so I am very lucky in my position as an LPN. However, so many other hospitals have so many restrictions on LPNs that they do not even hire them anymore. What a waste of manpower.

My thoughts are, if the state qualified LPNs for more through certifications, then certain hospitals would be more likely to hire LPNs.

Pt acuity is higher than ever before and inexperienced LPNs should never enter the "units" and quite frankly, only select LPNs could ever be qualified to work there competantly.

I do not want to make LPNs "like" RNs. We are a separate and proud class of nurses. We are qualified to work in med/surg, ortho, bariatrics, sub-acute care, hospices, etc. LPNs should be achnowledged for the training and abilities they do have and each individuals ability to build on that education to further his/her carreer with one quater or so classes that add to his/her resume proving competancy in certain areas, just as the IV certification does now.

diane31681 · Apr 12, 2005

i'm from ga and lpn has almost the same responsibility as rn. with the exception of blood transfusion which require an rn. i must say the pay in mass is pretty good, i make $30k a year. i'm thinking about starting my own business, rght now i just need the capitol to ger it started. i have worked in the dia;ysis for 10 years and this is my passion, so wish me luck i refuse to let a title stop my goal in life.

just wondering.......lpn's in other states just wondering what lpn's can & cant do in other states.... im in mass.
been a nurse for 8yrs now :balloons: and have done alot in my "short" career
so far. ive been a wound nurse, mds nurse, add-on nurse and a shift supervisor in an 150 bed snf/ltc facility as well as being a cna instructor(state certified) and of course a floor charge nurse. currently im a floor charge nurse (myself and the other nurse are charge (ltc unit) ) i have 23 pts on my wing ..total of 43 on the unit with 6 cna's
total for my 3-11 shift... how are the ratio's elsewhere? how is the pay in other areas? i made just over $55k last yr with very little overtime...
like i said....just wondering.................
i was also reading the beginning of this thread and i'm like...........what ???? lpns cant do assessments? md orders? im thinking , are these ppl from mars? the only thing i cant do as an lpn is sign the rap's and pronouncements....im sure there is a bit more , and iit depends on the facility....

bluesky, BSN, RN · Apr 12, 2005

I also find it humiliating and frustrating but I can tell you that the RN's where I work aren't too happy about it either. I don't blame them.
Just think, we take the MD order, write it in as one and then an RN has to sign it. What if we wrote it up wrong? Wrong med, wrong dose, wrong pt?????
I, in no way am trying to say that we as LPN's aren't capable of taking an order, I am saying that I would never want to sign off on it unless I was the nurse talking to the doctor. Doesn't matter to me if it's an lpn or rn.
It is demeaning to us as lpn's to have to do this. I have to wonder what will be next?
JUDE

Thank you! I reallly would hate to have to countersign everything...

Mariannsi · Apr 14, 2005

I was a 3rd Semester student in an RN program and was suppose to graduate in Dec. 04. But as life does sometimes throw you a curve ball, changes in my life have forced me to take another road. I feel fortunate that I've completed 3 semesters in an RN Program and because of that I am eligible to become an LPN. I respect all nurses and am proud that I will be taking my boards shortly - as an LPN. In the future, I will be able to earn a reasonable income until I can complete my RN Degree. (RN - BSN!!!)

ham22 · Apr 16, 2005

When I am in the capacity of charge nurse on my LTC unit , I find it humilliating and frustrating that I have to find an RN to sign off on my MD orders , and if we have a fall only they can do the assessment. No wonder they treat us as if we are not " real " nurses.

I was able to do assessments on falls at my old facility. But then again, Lpn's were the only ones that actually worked the floor. Management made the Lpn's do everything they could.

Anyway, as far as being treated like we are not "real nurses" that is a very sore subject with me. I think the thing that bothers me the most is when someone asks what I do and I tell them that I'm an Lpn and they are like "Uh, well, when are you getting your RN? " or "Oh, I really think you should get your RN." and most of them are people that are not even in the medical field and know nothing about nursing. I even had one person say to me "Oh, you're just a Little Pretend Nurse." Talk about offensive! :angryfire

But, these are things we sometimes have to deal with. I know how hard I worked for my license and i am very proud to be an Lpn. I know that i am a very caring and honest person and I am good at what I do. I just think of that when someone tries to belittle me as a professional. it helps get me through.

deegale · Apr 16, 2005

I also find it humiliating and frustrating but I can tell you that the RN's where I work aren't too happy about it either. I don't blame them.
Just think, we take the MD order, write it in as one and then an RN has to sign it. What if we wrote it up wrong? Wrong med, wrong dose, wrong pt?????
I, in no way am trying to say that we as LPN's aren't capable of taking an order, I am saying that I would never want to sign off on it unless I was the nurse talking to the doctor. Doesn't matter to me if it's an lpn or rn.
It is demeaning to us as lpn's to have to do this. I have to wonder what will be next?
JUDE

IN THE LTC WHERE I WORK LPN'S DO EVERYTHING RN DO EXCEPT START IV IN FACT THERE ARE MANY TIMES IN AFTERNOON AND MIDNITE SHIFTS THERE ISN'T EVEN AN RN IN THE BUILDING

Indy, LPN, LVN · Apr 20, 2005

Hi, first I have to apologize for "beating the dead horse." I am quite confused by this entire issue. Some background: my mother was an LPN, she influenced me to become a nurse. I do remember how frustrated she was with her pay and job opportunities, but I also remember how vigilant she was when it came to medications; if she didn't know what was on a family member's prescription she would look it up. If it wasn't appropriate, back to the doc's office we'd go! She refused to work in hospitals in our local area and never stated why.

Now, I have to admit, I would have considered the LPN program at the school I'm attending, except that the ADN program was "only" two years. I thought it would keep me from ever entering the debate about continuing my education if I just went ahead and got an RN license. BOY was I wrong! I've heard about why I should get my BSN, or MSN, or PhD, or heck, become doctor... at least once, from every faculty member I've encountered. And "just" two years has turned out to be over three including prereqs and core classes. I could indeed have been very close to a BSN but I'm so burned out I don't care what it says on my diploma as long as it's got MY name on it!

What is bringing me back to this issue currently, is my interest in union formation and in following the news with the CNA's ratio fight in california. I like the idea of unions in facilities and settings where they are needed, but I bristle at the thought of not including LPN's in such unions. So... I remember reading somewhere that LPN's were "created" when RN licensing was first standardized... it may have been on a thread on this board. Something about grandfathering in those who didn't do well enough on their tests at the time?

Ok, that's all well and good for then, but now... it seems impractical to me to have such levels of nurses in light of the way they are actually treated. It's demeaning and worst of all, it's divisive of the nursing profession in general. I also get a little upset that facilities want to push their LPN's back to school by slowly phasing them out of areas in the hospital, or in some cases locally, just outright taking them out of specific departments. I'm also a bit sensitized to the rhetoric we hear, bit by bit and sometimes in class, that's not very flattering of our LPN population IN OUR CLASS. I wonder, when we RN's get our masters degrees, do we lose all sense of tact?

Anyhow. How would I heal this situation if I were god? The only thing I see happening to help LPN's lately is the push to send 'em to RN school. I got an idea. Why not do another run of grandfathering-in, via NCLEX? Take experienced LPN's (I don't know how experienced, making this up as I go) and force facilities or states to pay for, and pay them to attend, a 6 month or so course of whatever is deemed they need to know to pass, and run 'em through mass NCLEX testing. Those who pass, congratulations. I realize such an idea would offend some very qualified nurses out there- trust me, that is not my intent! I just think, if they did it once, why on earth can it not be done again? I'm not utterly convinced the two categories should exist as separately as they do, to begin with, hence that line of thinking.

If such an idea were viable, I do think RN's should get involved in making it happen IF LPN's wanted it, because we should be more unified in our profession. Why would we not want the rest of our nurses to be recognized, paid, treated and represented as we are?

Ok, I'm back to the books now. Thanks for listening to me vent.

-Indy

lizscott nurse · Apr 22, 2005

When I am in the capacity of charge nurse on my LTC unit , I find it humilliating and frustrating that I have to find an RN to sign off on my MD orders , and if we have a fall only they can do the assessment. No wonder they treat us as if we are not " real " nurses.

I work in Ohio and at my present position do not need an RN to sign off on anything. I work solo as a charge nurse in a 31 bed unit. In my last job

we needed RN's to do dental assessments only. When I worked in a hospital rehab we weren't allowed to do assessments or take orders. I've worked with some wonderful RN's for whom I have great respect. I can imagine it

must be frustrating to have to hunt down an RN to sign off on the work you

did, but probably no less for her. The only time I felt slightly inferior was

while working in the hospital an RN referred to me as "only an LPN".

I have been treated with respect by the majority of RN's I've worked with.

I have always felt I could ask questions and dicuss a case without fear of

being put down. Just remember you are a real nurse and very important

to the patients/families you work with. Having an RN co-sign your orders

doesn't take anything away from the importance of what your do.

purplemania, BSN, RN · Apr 22, 2005

yes, you are less qualified to take orders. You chose to be that way when you stopped your education. I am limited by my choices too. Either go back to school or lobby congress to change the laws.

Marie_LPN, RN, LPN, RN · Apr 22, 2005

yes, you are less qualified to take orders. You chose to be that way when you stopped your education. I am limited by my choices too. Either go back to school or lobby congress to change the laws.

Jeez!:uhoh21: