Please explain the difference

Trauma Columnist · Jun 20, 2008

Hi and welcome. Will move your post to the General Nursing forum to get more answers.

Thornbird · Jun 20, 2008

It's not so much about difference in nursing tasks per se. It is in responsibility. LVN/LPN training is geared to preparing "bedside" nurses who can meet the needs of relatively stable patients including giving meds and doing treatments or to take care of more complex patients jointly with the RN. The RN is prepared to use a higher level of knowledge to care for more acute patients such as Intensive Care and to supervise other members of the health care team including the LVN/LPN. The RN is responsible for the overall plan of care for the patient and making sure it is properly implemented and that there is ongoing evaluation of the outcome so that adjustments can be made. The LVN/LPN always works under the supervision of an RN. In some states and some settings (home care, nursing homes) the supervision may be looser and the RN may only be required to be available by phone. In other states the RN must be physically present in the same building to supervise the LVN/LPN.

As far as skills go LVN/LPN's usually have some limitations on IV therapy. They may not be able to insert an IV. They are never allowed to "push" IV meds, that is to inject it directly rather than running it from a diluted bag. They usually can't change adult trach's. Opportunities for administrative positions is limited to a varying degree depending upon the state. "Assessment" is considered an RN only skill with the LVN/LPN "making observations" to "contribute to the assessment". How this is interpreted also varies. Some states allow the LVN/LPN to perform "basic assessment" and the RN to perform advanced or complete assessments. I think the latter is a better description of what the LVN/LPN is actually doing regardless of semantics. The actual practice of nursing is regulated by individual states and the state you live in determines exactly what the scope of practice is for each level of nursing. Most times you can find this information on the internet as nursing boards normally have websites.

Daytonite, BSN, RN · Jun 20, 2008

not meaning to be contemptible, but i am blunt. i really am nice to work with. however, i am an rn. i tell you what i want you to do because i am in charge of managing the patient's care. you do it.

http://stats.bls.gov/oco/ocos083.htm - about registered nursing
http://stats.bls.gov/oco/ocos102.htm - about lpn nursing

on a kinder and more practical note, facilities need to have rns input on the chart documentation. this is either a medicare or jcaho requirement. federal law title 42 (this is medicare conditions of participation for hospitals) is very clear about stating that an rn must be the one to assess and plan the care for each patient and that it must be included in the medical record (chart). jcaho expands on that and wants rns involved in the management of the care. in order for acute hospitals to take in and bill for the services provided to medicare patients, the bread and butter of most hospitals, they must have jcaho or medicare accreditation which means they have to abide by those laws/rules. consequently, acute hospitals lean toward hiring rns--it's just more economical and efficient. lvns/lpns are utilized in nursing homes and long term care a lot as charge nurses.

3Angels · Jun 20, 2008

By stating you are going to be an LVN I assume you are in the southern states. I am an acute care LVN in Texas and truthfully there is very little difference in my duties as a floor nurse vs the duties of the RN's. After completing hospital certification I do IV push meds, insert new IV sites etc... All new admissions require an RN assessment but I always do an initial assessment anyway (how will you know if there is a change if you don't?)

Will be upfront with you the hospital I work at quit hiring LVN's about 2 years ago, depending on what you want to do your choices may be limited. Good Luck in school but check into an RN program if you want to work in a hospital.

classicdame, MSN, EdD · Jun 20, 2008

LVN's duties may be similiar to RN's on the floor, but are limited or not allowed in some hospital areas, depending on state laws and local standards. We do not have anything but RN's in ICU, IMC, L&D, Nursery and Pediatrics. In my state the RN is responsible for initial assessment in the acute care setting, for care plans and for planning education.

Happy2CU · Jun 20, 2008

Ditto to what the above posters said.

Also, you will have considerably less employment options as an LPN as opposed to an RN. Depending upon where you work, you may perform many of the same tasks as an RN, but for considerably less money.

I'm an LPN and if I had to do it all over again, I would have gone directly for my RN.

mianders, RN · Jun 20, 2008

not meaning to be contemptible, but i am blunt. i really am nice to work with. however, i am an rn. i tell you what i want you to do because i am in charge of managing the patient's care. you do it.
http://stats.bls.gov/oco/ocos083.htm - about registered nursing
http://stats.bls.gov/oco/ocos102.htm - about lpn nursing

years ago when i was a new rn, i worked in a small rural hospital where a lot of the time i would be the only rn in the house. i worked with some exceptional lvn's that taught me what it was to be a nurse. i have not seen them in years but have worked with many lvn's since that have exemplified what it is to be a nurse. i hope your attitude to the many nurses that are lvn's is not what your comments suggest.

msjam54 · Jun 20, 2008

Hello,

Msjam

I thank each and everyone of you who responded. I just wanted to know some thing about what I may be facing, given though different medical facilities, may not operate the same.

I really don't think I want all the high strung, high risk, adrenalin rushing

responsiblitites RN have, even though being an LVN, has risk also, doing the right and correct things, for the patient.

Again, Thank you all so much!

Msjam

leslie :-D · Jun 20, 2008

Years ago when I was a new RN, I worked in a small rural hospital where a lot of the time I would be the only RN in the house. I worked with some exceptional LVN's that taught me what it was to be a nurse. I have not seen them in years but have worked with many LVN's since that have exemplified what it is to be a nurse. I hope your attitude to the many NURSES that are LVN's is not what your comments suggest.

what did daytonite say wrong?

why, do we always have to preface and qualify any statements with, "yes, we know how valuable lpn's are?"

i'm certainly not going to compare myself with an apn.

i know my responsibilities as well as my limitations.

i also know that ea group has something unique and meaningful to offer.

i'm just not understanding these consistent dynamics. :confused:

leslie

CHATSDALE · Jun 29, 2008

evryone has their place in health care

a doctor has the right to give an order for care and expect that the nurse [rn/lpn] will carry it out

the rn has the right to expect that care given will be up to standards and that any change in a condition will be reported

the cnas also have their duties which are limited by the amount of training they have had and the experience

working as a team will result in good care

msjam54 · Jun 29, 2008

Thanks You, very much chatsdale, for your input. I appreciated it.

Msjam