Published
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...
Jennifer
~slightly confused and frustrated LPN student
I would like to share my experience on this topic. I worked as a CNA while I attended LPN school. The program was rigorous because the material was all new to me. I worked as an LPN while I attended LPN to BSN school. Working as an LPN allowed me to apply classroom education to clinical experience. I am so pleased with the track that prepared me to be the nurse I am today. Anyhoo, if I had it to do over again -- I would do it exactly the same.
I do not agree with the statement that only a person who is RN trained can be educationally, functionally and "Smart" enough to be a nurse--or to have the passion and concern for others along with knowledge it takes to handle situtations that arise in different cultures----
I have been in nursing 34 years with training RN students who are making more per hour than the LPN
practices, ethics, the LPN is taught in 1 year to 14 months to do -----
students who go without a break between classes as the RN students receive----
The LPN student has no do overs in school --if they do not pass the exams---as the RN student----they are dropped out of the program
the LPN student is taught the same labs values,anatomy,systems as the RN student--they are taught the same skills insertation of catheters, (all types) dressings, and the what if's ---
the State Nursing Boards need to reconize that LPN students are professionals and have always been ---
not to inbreed into the RN training and minds that because a person chooses to become an LPN does not mean they are not capable to being a very proficient and capable nurses-----
some 30 years ago when I first hit the floor, all the other RN's snubbed me...
an older LPN took me under her wing and taught me more than I ever learned in classes in just a few months....back then LPN's did everything an RN did except the IV push meds....which didn't make sense to me and still doesn't.....
I believe most things could be taught to a monkey....it takes experience on the floor to become confident and knowledgeable, which just as many LPN"s have as RN's....I say.....leave those nurses alone !!!
Wow, in VA where I practice as an LPN we do just about everything RNs do. I have been nursing for 9 years. I work on a Med-Surg/Tele floor and I work alone, yes, that's right alone, unless I have more than 6 patients. Which, by the way, is a staffing rule that is rarely followed, but that's another topic. I have taken care of up tp 8 patients with no help. I do admissions, initial assessments, shift assessments, care plans, and much more. My floor is secured, meaning that my patients are inmates on a lock down unit of the hospital. There are 2 officers there with me. I routinely get patients that should be in ICU but aren't because that would require extra officers. I've have very serious and ill patients and I'm comfortable with that. They have sent them to me with blood sugars over 1000, elevated ammonia levels on patients and they are nonresponsive when I get them. I am ACLS certified and I've also had extensive infusion training that I acquired elsewhere. I can take care of PICCs and access mediports. I do my own IVP meds. There are a few I can't do under state law, but I can push morphine, dilaudid, and demerol to name a few. The only time I need to call an RN to my floor is to hang blood, but I would have to call someone to my floor for that anyway since it takes 2 people. I am very knowledgeable and a seasoned nurse. I went to nursing school through a local hospital LPN program. It was an excellent school and I can hang with some of the best RNs. I actually make great pay right now because of my experience and I was started out making what some of the RNs make. I'm happy where I am. I will get my BSN one day but only so I can move up into management. I do not however, believe that all LPN schools are created equal which is why you have state boards that should get rid of the ones who skimmed by through bad nursing programs. I belive that LPNs are a great asset to the health care community and I'm proud to be one.
So how much training is minimally *enough* for LPNs? for RNs? If experience is the main thing, what's the minimum requirement for getting jobs that will allow you to get the experience? Is it one year of training like for LPNs? Maybe even that is more than is really necessary. Is the additional year or more of education (both nursing and pre-reqs) for RNs all essentially extraneous since the learning really starts AFTER getting the license and starting a job? Why bother with the two different programs and licensing if it's experience that's counts? Why not have ALL nurses take the same initial training? If LPNs have the same responsibilities as RNs - and in some places the practical reality is that they do - then what's the deal there? Are LPNs being taken advantage of by not being paid for the high level of responsibility they are undertaking? Are LPNs being asked to perform a higher level of care than they are trained and licensed for? (not that they can't DO it, you might be a great brain surgeon but without the proper credentials, you won't be allowed to get a job as one) Or maybe RNs are being overtrained for the reality of their work? Perhaps LPN training would be more than adequate for many RN roles.
These are not rhetorical questions. They are questions I ask myself and others because I'm not sure what the answers are.
Of course a person doesn't need an RN license to be able to expertly carry out the repsonsibilities of an RN. But they do need an RN license to be able to get a job that requires an RN license.
To me, the problem is when the RN and LPN job roles overlap to such a great extent that the LPN job role practically mirrors that of an RN. In that case, what IS the difference? Often, not much. But legally, the facility is REQUIRED to have an RN (such as to rubber stamp LPN assessments). So the facility reluctantly shells out for the minimum number of RNs and hires LPNs to fill the rest of the nursing roles. THAT can cause problems because the RN might otherwise have nothing more to offer professionally in that role, and in fact, may never match the competency of some of their LPN colleagues. Yet they still likely qualify for higher pay and more advancement opportunities. That's bound to lead to tensions.
I took both LPN training and RN training. I'm sorry, but taking socialogy, psychology, a foreign language perhaps, and English Comp. for an associate degree doesn't qualify as superior to an LPN with 22 years experience. I remained an LPN because the place I worked for, wanted to cut my salary from an experienced LPN to a rookie RN, out of training. I couldn't afford it and loved the work at the time, and still don't regret it. I've trained RNs over the years, because of their lack of skill in certain areas (Ex: ventilators/trachs., wound care). We're all rookies at first. But to say that LPNs are somehow inferior to RNs and need to be done away with, is total insanity. If you must get rid of LPNs, then take your experienced ones and grandfather them in as RNs. I remember in nursing school, we all snickered at the RN students who did nothing but observe for 4 hours, while we LPN students did 8 hour nursing care in hospitals. We were much more capable, on graduation, to care for patients than new RNs.
This sounds like one person feels superior to the next person, I am in RN school and feel lucky to be there; however, I don't feel like that I am better than the houndreds whom get turn down every year, I just know how to prepare and take test. It does not make me smarter, its just make me a better test taker. As an RN we can never look down on anyone or anything. I hope I never met a RN who thinks that she or he is smarter than me, because of my job. The skills we have as Rn's are tought to us, we wasn't born with it. The best thing for people to do, is to help and respect others co-workers, no matter what their job is, now imagin, how you feel when a doctor walk by you thinking he is better, just cause he is an Doctor.
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
Some NAs have been warm bodies for 3 weeks in a classroom and then set upon patients. I've worked with many who have great pride for the work they do, and others who are the opposite. Because of the lack of information they get, any "teaching" they do (and I've heard some outrageous misinformation given by them to patients as facts). So getting more education for them, is essential. However many have limited reading skill and others some difficulty with logic and professional obligations. A good many haven't completed High School or attained their GEDs, so it would take a good deal longer (which is time away from earning and their families, which might hinder their progress). They were never intended to work without close supervision by Registered Nurses in facilities.......
Their pay scale has remained quite low.
LPN/LVNs are usually better prepared for a college curriculum. However the levels of courses for them differ greatly. Their preparation for their work occurs in some High Schools, and community colleges, even in private vocational schools. However, over the years they have achieved respect for their abilities, and have assumed greater responsibility. Some rose to the challenge, others went elsewhere. Their pay scale rose with their responsibilities and efforts of unions, until they now receive $2./hour less than R.N.s many places.
R.N.,s have some college preparation, some have 4 years of University and a degree, others have 2 years at a Community College and varying numbers of credits for University 4 year programs. Without their University degree there is little chance of climbing the career ladder to work in administrative roles in large acute care hospitals. Experience decrees the increases bin the rates of pay less educated R.N.s have, such as AAs, so they're more likely to stay in one place a good while. Degreed R.N.s have greater job opportunities, and often work shorter periods of time in one place as they achieve better positions elsewhere. However Nurse Practitioners and others who have their MA don't always earn substantially more, except for those with their MA in Hospital Administration.
It seems to me that all levels of caregivers are needed and I'd hate to see any level abolished, especially when they have honed patient care and organizational skills, according to their preparation. It is important that all have individual goals for development of greater capacities, and work toward achieving their personal potential, professionally. Achieving Certificates in their specialty is a path that needs to be followed more, and maintaining currency essential. Evaluations need to be partly based on the desire to improve, and add to their knowledge rather than wholly performance oriented, to instill the desire to keep learning; and discern decision making processes for future planning.
I've written this with the purpose of building on what we have and achieving better and higher understanding of the multitude of changes in our field that inevitably occur.
Jennifer,
As many of nurses have already stated, often LPN/LVN have more clinical experience, where RNs have more theory based knowledge. The truth is the more education any nurse masters, LPN/LVN, RN, etc. more beneficial for you and your patients. I as a LVN in texas, working in pedi home health as a Vent trained nurse with a RN a phone call away, feel quite respected and appreciated by my patient's, their families, and my supervisors. You are already in the program, build your knowlegde base by utilizing the awesome RNs, LVN/LPNs, MDs, that you come in contact with during your clinicals, and upon your first job. I feel blessed to been around all nurses with 30 years experience, 1 year experience, etc, I will warn you some nurses eat their young, however, most often though their a great network of support when they see your passion and caring. Your future coworkers can help protect your license, they've lived it. Hang in there, nursing school is tough, don't stop learning, get that RN license as well.
kim, LVN, and RN grad in December.
PedsAtHeart, LPN
375 Posts
I don't know where you all are from that LPN's are "useless". I think we LPN's are quite an asset. I know where I live (Oklahoma) we can do pretty much what an RN can do, except some of the extra paperwork and depending on the facility, a few other things. But overall, we start IVs, give meds, injections, everything. I know that when I was in LPN school we were much more advanced in our clinical skills than a lot of the RN students that were there with us, and they were getting ready to graduate! Granted, I went to an awesome school with lots and lots clinical hours, and I know there are good and bad in LPN and RN schools, but I felt just as prepared coming out with my LPN as the RNs I knew, some felt LESS prepared that I. So, do I think LPNs should be done away with? NOT AT ALL. We are a valuable part of the time and I think all facilities should take advantage of us and our skills. And one thing that really gets to me is when people say "Oh, your an LPN, thats a nurse's assistant right?" Nope, sorry, wrong on that one!