As an offshoot to the News article about nursing education, an opinion was brought to the board that LPNs are not adequately prepared to care for patients, and that their education is not strenuous like an RN program is. Having been in the field for awhile, what is your opinion on the differences between LPNs and RNs, other than the legally different aspects (LPNs cannot do initial assessments or IVs in my state for instance)
I'm not looking to start trouble, but rather discuss the topic in an area other than an unrelated thread.
Differences in LPNs vs RNs (educationally, functionally, intellectually)
Best way to combat any possible negatives of the above
Advice for an LPN student (who is too far through her program to just throw it out and start over in an RN program - already applied for an LPN to RN program starting Jan 2010)
Should I really expect to run into attitudes in the workplace about my not being worthwhile as an employee and a care provider because I chose the path that I have? How do you handle it if you do?
There is a local small rural hospital that pays incredibly well for LPNs right out of school and who has been trying very hard to recruit us during clinicals... am I going to be inequipped to care for patients there because of my education? I would never want to get into a situation where patient care was compromised because my education was lacking somehow...
I had clinicals 2-3 times per week (full days) depending on the semester, I also did externships and worked as a ER clinical technician. Personally I think anyone entertaining nursing as a career should have a mandatory amount of hours to perform in some medical capacity. The time wasted indoctrinating people to sick patients is ridiculous but necessary.
Then again, this goes back to making sure all programs are equal. Graduating a nurse without clinical time is equal to failure waiting to happen. How sad for the student and the patients.
Specializes in Community Health, Med-Surg, Home Health.
I had clinicals 2-3 times per week (full days) depending on the semester, I also did externships and worked as a ER clinical technician. Personally I think anyone entertaining nursing as a career should have a mandatory amount of hours to perform in some medical capacity. The time wasted indoctrinating people to sick patients is ridiculous but necessary.
Then again, this goes back to making sure all programs are equal. Graduating a nurse without clinical time is equal to failure waiting to happen. How sad for the student and the patients.
From what I have seen, the hours are documented, but the quality of those hours are questionable at best (from the programs in my area). I know for a fact that my program lied their buns off about the hours of clinical time we actually obtained. They still didn't have a place able to accomodate us for the first 7 weeks of my program, so, they used two days to force us to come into school in full uniform to just sit there. There is one LPN program that was more valuable, but hard to get into (it was about $850 for the entire program, so, of course, it was highly competitive). They sat for lectures for two weeks and went to the units for two weeks for the entire program. You can see the difference between how they functioned versus mine. Some of those instructors also worked as clinical instructors for my program and they were completely shocked at our lack of experience and knowledge of medications so late in the term. But, there was nothing they could do but continue to play the game.
Maybe this should be titled "Bad Schools Should Be Done Away With Altogether"...that may be more appropriate...
Specializes in Community Health, Med-Surg, Home Health.
re: Your Nursing Student friend: "...Told me that she didn't remember what she did last week because she was creating beautiful care plans and learning the theory..."
Oh LORD IN HEAVEN; is this STILL the way/focus of RN programs? :crying2:
(I've been out of the hospitals for the past 8 years so haven't had much interaction w/any student nurses or new grads; I had been hoping that RN programs were providing more bedside and less "make it all look good on paper in theory" in their training.)
Will the ANA NEVER Get their Priorities Right? They are the ones that push/lobby for what is important in nursing programs; and as far as I'm concerned, have done little to address the realities of how we nurses can PROVIDE the CARE the patient needs without being stressed for time to document, document, document.
The last few years I worked in acute hospitals, I remember joking when stressed and trying to catch up on documenting when call bell rang during the night;
"Don't those darn Patients know they are interferring with my paperwork/documentation? :angryfire How can I ever get it done if they NEED something else????"
Sad, but true.
I guess that is still the growing trend. My friend is also discouraged from getting her BSN because it will only be an additional $1500 a year added to her yearly salary, yet, she will owe thousands of dollars. She said that she doesn't plan to rush into it. I suggested to do the Excelsior Program since she is really self-motivated, and I can see her being an excellent administrator.
I have even had nurses confront me with documentation issues. I work in a clinic that is very crowded and demanding. I tend to document as I go, because I type quick, am good with organizing my words in a short span of time. I was told several times that I should wait until the end of my day to document everything. That makes no sense to me. I would rather document as much as I can and leave a few to the side if an emergent situation occurs, then, maybe remember what has to be done for about 2-3 patient versus the 30 that I may have seen per day. This way, I can remember to mention pertinent things that can get me into trouble later on. I do know that you can't do everything all the time, but sometimes, not documenting certain things isn't safe. I can't even count how many times I have almost medicated a person for the second time in my clinic because a nurse didn't document that she gave clonidine and the patient is waiting another hour before the pressure is checked again (a person that doesn't understand English, by the way).
Sometimes, the more you have to document, the more trouble it leads to. Like you said, the patient is screaming for your help, there is only 1/2 hour left to your tour, and 6 more detailed notes to get together before the next shift comes in screaming their buns off about why this patient wasn't tended to.
how many hours of clinical for RN or LPN student . do any student nurses do 50/50 theory/practical the uk student nurse requirements.
i worked a 37.5 hurs week on wards for 21 week each year over 3 years.
my hands on experiences has taught me as much as the knowledge behind it r me seeing something occur carcinogenic shock made the the ER made a lecture come to life.
The only solution to this existing problem i think is to do what they have done in other asian countries. Make the nursing program 4 years mandatory that is u have your BSN, and that's it. NO RN's no LPN's just BSN. The whole confusion of what an lpn,Rn, or Bsn can do is resolved. Ask any philipino nurses who have recently come to america Do you know what an LPN is? And they will look at you like ? In countries like india and philipines there is no such thing as lpn, rn its only nursing degree with a BSN. Ofcourse to do this and avoid the present nursing shortage that means for the congress to grandfather all present lpn's to Rn's and RN's to BSN. And then we start a fresh batch of students of nursing only with mandatory 4 year degree program. I don't even know how this whole lpn/rn thing started here in states. Some genius sitting in congress was like hmmmm let me think we can start an lpn school with one year so these nurses can work in our nursing homes and such, then we will make a 2 year program throw them some more knowledge,care plans , iv meds and we got a whole new bunch of nurses to work for our hospital system and make us millionares. And we all fell into this whole scheme of lpn vs Rn. So in my opinion to resolve this whole conflict for god knows how long its going on stop all the BS and make BSN mandatory and grandfather people who already were screwed for all this time!!!!!
Let's just bring you up to speed. The LPN designation is roughly the equivalent of the EN that used to be found in the UK and throughout the Commonwealth nations.
The LPN came in to being due to the nursing shortage in post WWII North America. The number of PNs in my province is increasing year by year.
Not all BScN eduations are equal. Last year, my province hired a group of BScN's from the Phillipines. Their education wasn't assessed until they arrived here. Turns out their BScN was only the equivalent of the education recieved by PNs here. YUP, you're reading this correctly. They were only permited to work as LPNs and that was after an introduction to Canadian nursing at the local nursing schools. Even when they hit the floor, these "experienced RNs" did not have the skills of a local new grad.
Not all PN educations are equal either. Either here or the US.
The PNs educated in my province replaced the RN diploma students. Diploma RN is not an option in Canada. For most PNs returning to uni for three years is just not an option. We don't have employers that will pay for the course of study.
IVP meds aren't done on the units of my hospital. They are only permitted to be done by certified RNs in the ICU, NICU, ER, and Dialysis units. If the patient is that ill that they need IVP meds they don't hit the floor. But then it may be a cultural thing especially when it comes to IVP morphine. PCA's and epidural pain relief isn't that common either.
I do hope that someday you get your RN and I would be curious to hear your thought s on the matter at that time.
Its not "someday" its December 2010, but regardless, thank you. I'm sure I'll know a lot more as a new RN than I will as a new LPN because the rate we are learning, my knowledge and abilities increase by the week. Its not the same as real world learning, but I can definitely understand that an ADN gives more educational background than an LPN certificate, and I'm sure a BSN is more educational than an ADN, but that doesn't make us "bad" or our programs less intense or less educational, just shorter. Things I couldn't comprehend or just knew on a basic level in November I feel like I can fully understand patho/etio/nursing interventions/expected diagnostic tests/complications/ect on now, just a few months later. I know its just "book work" and I really stand by how difficult and thorough our program is, but I think its very much a great education. My LPN program is the first educational anything in my entire life that has challenged me, and I have made somewhat of a career of education, and that says something to me. I have flown by with ease when many classmates failed out and struggled, in many different arenas, so if its hard to me, I have trouble feeling that its "just me". Not trying to brag, just saying that I have something fairly solid to compare it to, so that is why I feel that its not something ANYONE could do without incredible amounts of studying and dedication. Maybe its b/c my teachers are RNs and our program is fairly new so the fate of the program rides on our successes, and maybe its because the administration not only allows them to fail out however many students they want, but actually ENCOURAGES failing anyone who even remotely might not pass the NCLEX, so they are scared, and acting accordingly.
I just started teaching at an LPN school in NJ and let me tell you there are major problems with the school. Like you said, my students, before I started, were made to self study for weeks at a time because there was no instructor and no clinical sites. The whole program frankly is a joke and the students know it. Many of them are disgusted that they paid $22,000 for a program so poorly run. Others just take advantage of the fact that no one is enforcing the rules. It makes for a very frustrating work situation and a poor education for the students. This is the problem with schools that are run by franchise education companies like the one I work for. The only students that are getting a decent education are the motivated ones that make the most of the program. Other students are totally innappropriate but are slipping by anyway. I am talking real low-lifes that need a psych eval. They accept lower scores on the entrance exam so that they can fill the seats. Students are allowed 5 tries to pass the med test. Grades are manipulated in order to keep them passing through the program and keep the money coming in. Discipline problems and absenteeism is tolerated without regard to the law b/c the administration only cares about their bottom line. To kick people out would decrease their profit. I think the problem is the greed factor and the fact that corporate CEOs are running the program-not nurses! Needless to say, I am having a real ethical dilemma working for such a crappy school. I would like to see this situation improve but I don't really know how to go about it.
In any avenue, this is horrendous. I actually withdrew from University of Phoenix after 1 class specifically because of this kind of "fill a seat and here's your A" mentality. I hadn't realized nursing could be this way because of how much stress is put on being able to excel at the licensing exams, but schools like this should be shut down, because (obviously from some of the conversations on this board) this kind of program gives a really bad name to all LPN programs. My program is a fraction of the cost of this one (maybe $6000 at most?) and done through a public community college. Maybe thats the difference? I don't know. There are a lot of things about my class that I wish I could change, and things i hope to do differently when I teach someday (thats my ultimate goal) but I would definitely not say that our education is not strenuous enough or that anyone at all can breeze through it. After giving the PAX test 7 or 8 times to get enough students to fill the seats (every testing filled up with 20 students and only 1-3 passed in each sitting) we still lose atleast half of our 16 students every year. Halfway through we're down to 12 already, and this is a program record. Last year they were down to 7 or 8 3 months ago.
I think that expecting nurses to all be BSNs is unrealistic, because not every nursing arena requires that kind of education, and even those that do, would have dangerous working conditions, if they had to only hire nurses with a BSN. I don't know enough about those countries, but I would really have to see how well staffed they were and how much of their population is well served by the medical community (many people in other countries simply dont go to the doctors very often and rely on herbal routes and midwives ect more often than not) plus how big the actual population is and what services are rendered. There are a lot of factors that are necessary to figure out how many nurses are needed, and if you have a choice between 1 MSN with 28 patients or 1 BSN with 14 patients or 2 ADNs with 7 patients or even 1 ADN and 2 LPNs, and YOU were the patient, which would you prefer??? Its a balancing act I dont envy, and if the patients are ICU I can understand needing a higher level of care, but as a BSN do you really want to fluff the pillows of a flu patient in the hospital for monitoring or a whole wing of a nursing home worth of patients who just need vitals checked and their meds passed by someone knowledgable to watch for side effects of something they've taken every day for the past 10 years 90% of the time?
Anyways :) I value my LPN education, will value my ADN education, again with my BSN and my MSN as well. :) I consider myself very lucky to have chosen a career path that allows me to go step by step towards helping other, because there is no way that I could have chosen it otherwise given my family commitments and personal life. :)
The LPN is a better trained CNA that gets stuck doing RN level work at times. They need to increase CNA training and pay them better, cut out LPN like several countries have, and have CNA's and RN's Just my opinion
Specializes in LTC, pediatrics, psych and hospice.
I have been an LPN for 14yrs, many yrs in LTC which contains a high level of skilled care also, i've cared for some acutely ill patients as well as long term geriatrics. In my 14 yrs i've learned from some great LPNs as well as some great RNs .......i believe i am an excellent nurse, my clinical skill are beyond reproach i have gotten many compliments from doctors as well as my supervisors.
I believe LPNs are just as important as RN's and should not be discriminated against as much as we are....We are all nurses because we care.
the lpn is a better trained cna that gets stuck doing rn level work at times. they need to increase cna training and pay them better, cut out lpn like several countries have, and have cna's and rn's just my opinion
Mahoganybbw I agree, there are excellent LPN's, I would say most of them. My thought is, Do we really need 3 levels of Nursing, CNA, PN, RN. LPN's are often doing a combination of a CNA's job, and an RN's job.
Would we not be better off with a highly skilled CNA, and RN's. This might help remove some of the abuse LPN's are faced with
The LPN is a better trained CNA that gets stuck doing RN level work at times. They need to increase CNA training and pay them better, cut out LPN like several countries have, and have CNA's and RN's Just my opinion
:crying2:
today, 01:33 pm 
re: "lpns should be done away with altogether"
MAISY, RN-ER, BSN, RN
1,082 Posts
I had clinicals 2-3 times per week (full days) depending on the semester, I also did externships and worked as a ER clinical technician. Personally I think anyone entertaining nursing as a career should have a mandatory amount of hours to perform in some medical capacity. The time wasted indoctrinating people to sick patients is ridiculous but necessary.
Then again, this goes back to making sure all programs are equal. Graduating a nurse without clinical time is equal to failure waiting to happen. How sad for the student and the patients.