NY RNs fighting unfair management tactics and unsafe patient conditions

Chico David, BSN, RN · Dec 8, 2008

The constant effort by the industry to replace RNs with less costly - but also less qualified - caregivers is a never-ending fight. Every year in the California legislature, we have to beat back a half-dozen or so proposals to allow some other provider to take over some part of the RN scope of practice.

LYN/LPNs have a valuable role to play in nursing care and the work they do should be respected and honored (and adequately compensated) but they are not interchangeable with RNs and should not be used to replace RNs.

lindarn · Dec 30, 2008

The constant effort by the industry to replace RNs with less costly - but also less qualified - caregivers is a never-ending fight. Every year in the California legislature, we have to beat back a half-dozen or so proposals to allow some other provider to take over some part of the RN scope of practice.
LYN/LPNs have a valuable role to play in nursing care and the work they do should be respected and honored (and adequately compensated) but they are not interchangeable with RNs and should not be used to replace RNs.

At least NY and California State Nurses Associations have actually taken a stand against the replacement of RNs with lesser educated personnel, and the de skilling of the professional practice of RNs.

Here in Washington State, about ten years ago, WSNA just told the RNs to bend over and take it, and caved in to the Nursing home and the ALF industry to allow the use of unlicensed assistive personnel, (Medication Aides) to take over medication administration in these facilities. A hospital here is advertising for a CMA as a "DIABETIC EDUCATOR", of all things! If nurses don't stand up and take a stand, ten years from now, RN jobs will be few and far between, and our professional practice will be de skilled to the level of HS dropouts. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Lovetobenurse · Dec 30, 2008

I am RN in Indiana and I am faced with the same challenge,at our facility,all the three units managers are LPN,even on subacute units,RN are required to work on those units under LPN. should RN work under LPN? and if we allow this to continue,some of who love to work in long term will no say. any suggestions will be helpful. I know there are LPN out there who want to jump out their seats and tell me what I heard before. the principal of scope of practice is where I am coming from,and by the way i was lpn for many years.

Chico David, BSN, RN · Dec 30, 2008

I am RN in Indiana and I am faced with the same challenge,at our facility,all the three units managers are LPN,even on subacute units,RN are required to work on those units under LPN. should RN work under LPN? and if we allow this to continue,some of who love to work in long term will no say. any suggestions will be helpful. I know there are LPN out there who want to jump out their seats and tell me what I heard before. the principal of scope of practice is where I am coming from,and by the way i was lpn for many years.

The first concrete suggestion is to find out what your state law is. I have no idea what the landscape in Indiana is like as far as your state nursing association. Some are effective and aggressive at protecting RN practice. In other states, as a previous commenter noted, not so much. But that would be the place to start - go to the ISNA web site and get the phone number, call and see if they have something like a "nursing practice specialist".

It's perfectly possible that this situation is illegal but the law is being ignored/not enforced.

I have to say that a quick look at the ISNA web site does not make me all that optimistic, since it is an organization that represents both RNs and LPNs and the policy positions they mention are pretty wimpy looking. But I'd still give them a try.

If there is no help there, you might talk to your board of nursing - the state agency - and see if they have any position on it. It's an illustration of what a difference the quality of your state association makes. This situation would not exist in California.

allnurses Guide · Dec 30, 2008

I would write the Indiana Board of Nursing and ask specifically whether an LPN may clinically supervise an RN.

In my state they may not.

Indiana Nurse Practice Act - http://www.in.gov/pla/files/ISBN_2008_EDITION.pdf

jsrRN · Dec 30, 2008

Another bill that we defeated in California thia year would have allowed dental assistants to administer conscious sedation! The attacks on our scope of practice are constant. It takes collective action to have enough power to push back effectively.