I have just completed an LPN refresher after 24 years out of nursing. I couldn't believe the difference in the training. I took a very good physical assessment course. All LPN's in Manitoba must have this course to be licensed. RN's doing the refresher don't have to take it,but it is a part of the RN course here now I believe. I also start IV's, add meds to them, give blood, I.M's, SC, and all oral meds. We also catheterize now. These are all changes since I first took the course. I would say that the government is getting good value for their dollar in Manitoba. Cathy