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...
It isn't knowing whether a lab value is off, it's what does that too high/ too low lab value mean regarding my patient and their disease process, how does that lab value affect their medications, if their K+ is low, what possible side effects should I be looking for? If my patient has no fever, say they are even hypothermic, their urine shows some bacteria, their WBC are normal or even a little low - what could that mean?
The answer is urosepsis. In urosepsis, which means bacteria has traveled into the blood stream, a person can be extremely ill, yet have no fever or elevated WBC count - but other people with sepsis can - so what other things do you have to look for? In severe cases, their skin can be pale to gray, cool, clammy or even mottled. In the beginning of sepsis, they may have a fever and be sweaty and flushed all over.
It's knowing these types of things that LPN education lacks. I've know many LPN's who cannot pass their tests to get into college school. VERY MANY. They usually are humbled afterward.
Blessing to you, and good luck in your future endevors!!
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.
I am also in Virginia and my hospital is letting go of all LPNs as of May 1st due to the fact that they can not do just about everything that RNs do as you say. Maybe it's different in corrections? I dunno. LPNs can not do initial assessments, push many drugs that need titration, do any discharge teaching, or hang blood without an RN. We have a few excellent LPNs who have been around forever and some are going back to school and others will work in off-site facilities. I have seen LPNs do many things outside of their scope of practice and no one blinks an eye...not until now anyway. I certainly don't think that LPNs should be done away with altogether but I think that they should not practice outside their scope of practice. Please don't flame me as I have all the respect for fellow nurses.
In general, LPN programs move very quickly and seem more like memorization programs rather than learning programs. I'd say the same for a lot of CNA, MA and Med Tech programs. These programs don't seem to provide a connect-the-dots type of learning. If you don't have an opportunity to use that information with good precepting and mentoring, which continues your education on the job, it doesn't last very long.
I work in LTC, with RNs and LPNs, there's no precepting or mentoring and as a result, you can't troubleshoot patient problems with anyone there, you just have to call the physician and let him/her make a determination.
Like I've posted before. Please don't ever get sick or injured in Canada. We LPNs would have to look after you.
We've had problems with American RNs coming to work who have been rude and abrasive in their treatment of their fellow nurses until the union and the unit manager have sat them down and had the "come to Jesus" talk with them.
Don't slam a group of professional nurses by judging them against YOUR state's educational requirements.
I see a lot of posts justifying why LPNs should be phased out of the acute care settings and I don't disagree. However, this thread is about the LPN title being phased out completely and I do DISAGREE with that sentiment. Yes it's true that patient acuity has increased and that most LPNs do not have the background to take care of high acuity patients but does that mean that the title LPN should be phased out? I think not. There is a need for the LPN in healthcare just as there is a need for the PA, MA, NP etc. Originally there were only doctors and nurses (RN and then LPN) and over the years these titles have been added and all of these healthcare workers have found a niche and are needed. The same is true of the LPN...the title has been around longer than the PA, MA, and NP but it doesn't change the fact that LPNs are a just as needed as RNs. So get over it becuase we aren't going anywhere and I expect that we will be even more in demand as the baby boomers age because LTC/SNF/ALF will never pay for (and don't need) an all RN staff.
I see a lot of posts justifying why LPNs should be phased out of the acute care settings and I don't disagree. However, this thread is about the LPN title being phased out completely and I do DISAGREE with that sentiment. Yes it's true that patient acuity has increased and that most LPNs do not have the background to take care of high acuity patients but does that mean that the title LPN should be phased out? I think not. There is a need for the LPN in healthcare just as there is a need for the PA, MA, NP etc. Originally there were only doctors and nurses (RN and then LPN) and over the years these titles have been added and all of these healthcare workers have found a niche and are needed. The same is true of the LPN...the title has been around longer than the PA, MA, and NP but it doesn't change the fact that LPNs are a just as needed as RNs. So get over it becuase we aren't going anywhere and I expect that we will be even more in demand as the baby boomers age because LTC/SNF/ALF will never pay for (and don't need) an all RN staff.
I never stated that LPN's should be fazed out completely. There will always be a place for LPN's, I'm just not sure the future will be in acute care - unless they work under the RN and assist the RN - no patient assignment alone. Long term care will be blooming as a result of the baby boomers aging. There will always be a place in LTC. I have nothing against LPN's - my best friend is an LPN, and we have had similar discussions. I just think we need to be realistic - the education between the two is NOT the same - and therefore, neither is the law with relation to their practice.
i am again going to make a point that i have made several times before on various threads of different topics but for me it always comes down to this......
do your research before you choose a school or program. they are not all created equally!!!! i think the biggest issue is a general lack of uniform standards of education. because of this you have LPN's that truely are more prepared and educated than some RN's based simply on the programs that they come from. when i was searching for a school i have to tell you i was appalled at the minimal clinical hours required for most of them! so what i am saying without getting too wordy is do your research and find a program that will give you the type of education that will best prepare you for what it is you want to do.
LOL! Some times WE have to laugh and walk away. Even though I am an RN student now,I am proud to be an African American LPN for 12 years with hospital experience. A good example of becoming what ever you want to be is. Our BLACK president. ENOUGH SAID!
Im sorry, but dont you mean our HALF BLACK president?
Im so tired of hearing that... I mean come on... you are a great nurse because you are a great nurse, not because you are black, white, red, green... whatever! Just as he will *hopefully* be a great president because of the person he is, not the color he is... Im glad you are proud to be an LPN... but how would you take it if I were to say "I'm proud to be a white LPN"... yeah doesnt sound as good does it?
I could usually nip that in the bud quickly by asking them questions about their patient labs, meds, pathophys, etc...
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I have to wonder how many RNs would also be humbled by your clear, strong grip of the pathophys. I graduated from a BSN program and while we were certainly exposed to pathophys through the textbook readings and doing our case studies and care plans, it was overall rather cursory. I actually found it quite frustrating because I wanted more depth of understanding of the underlying mechanisms but in order to cover the wide bredth of content being covered and to get our lengthy care plans done and to study effectively to pass the NCLEX-style tests, there just wasn't much time to do much more than get the gist of it and move on to the next unit.
The level of the explanations in the nursing texts were very succinct and didn't go into much depth. It was generally a few paragraphs of pathophys for each condition covered. They also didn't give much context, just lists of common signs and symptoms. I don't see how an average LPN curriculum could be that much less in depth than an average RN curriculum. They often even use the same textbooks.
I imagine that some LPN programs are essentially at the same level of RN programs core curriculum for med-surg. And I can see why they'd feel frustrated at the limits imposed upon their scope of practice. Other programs might not be as rigorous, scraping by providing the bare minimum of instruction and giving rise to the overused explanation that LPNs aren't taught critical thinking skills and don't know the why behind the nursing tasks they do.
I know you didn't but I am referring to the title of this thread which is "LPNs should be done away with altogether" All this other stuff is OT IMHO. I was just giving my two cents about the original question.
I never stated that LPN's should be fazed out completely. There will always be a place for LPN's, I'm just not sure the future will be in acute care - unless they work under the RN and assist the RN - no patient assignment alone. Long term care will be blooming as a result of the baby boomers aging. There will always be a place in LTC. I have nothing against LPN's - my best friend is an LPN, and we have had similar discussions. I just think we need to be realistic - the education between the two is NOT the same - and therefore, neither is the law with relation to their practice.
Im sorry, but dont you mean our HALF BLACK president?
Im so tired of hearing that... I mean come on... you are a great nurse because you are a great nurse, not because you are black, white, red, green... whatever! Just as he will *hopefully* be a great president because of the person he is, not the color he is... Im glad you are proud to be an LPN... but how would you take it if I were to say "I'm proud to be a white LPN"... yeah doesnt sound as good does it?
OK now jump on me...
Nah, Obama is black. According to every law and consideration EVER implemented in America. Ever. If I came home with your daughter you would see the black boyfriend. Not the half Irish boyfriend. LOL
As to doing away with LPNs altogether... That's just ridiculous. Babs, I have also seen RN's that were not able to interpret labs. Just like some LPNs can. It's not the education, it's the person. Now the law does make a difference in the scope and facilities are reacting to that but to claim the LPN education is rushed but the ASN one isn't or that the 4th year of the BSN makes it superior over the 3 years of ASN is nonsense.
What exactly did you learn in 4 years that I am not learning in 3? PLEASE DON'T SAY MANAGEMENT. You CAN'T learn management skills in school. Anyone that thinks you can isn't a good manager. You only learn that by actually managing and getting mentored while you do so. Also, don't say critical thinking. In that one extra year of school from LPN to RN you did NOT learn how to think better. Critical thinking is a skill that is DEVELOPED. Not learned. It doesn't develop in school either and it ISN'T limited to nursing.
To the person downing on trade schools, the most difficult and technical professions in this world ALL require a lot of OJT. Doctors? OJT. Any technical profession, Network Security, Programming, almost all types of engineering? OJT. Do you really believe that that minimal time and I do mean minimal that we spend in clinicals teaches that?
OK. Having been an LPN for 16 years, and worked in all areas of nursing, I find it offensive that some people would actually believe that I am not capable of working in an acute care setting independently. Just as an FYI, I have worked as a travel nurse, on many ortho floors, and for the past 3 and 1/2 years in an acute care setting, with ventilator, resp. failure pts, traumatic brain injury pt's, etc. I was a wound care nurse for years. In many of these settings, including the one I work now, I have been placed in the Charge position many times. I think maybe people should stop looking at the initials behind the name and start looking at the intelligence and competency within the person. Anyone can get additional training, you just have to have the desire. I am as advanced as you can get, still being an LPN. I work with central lines, ventilator patients, and I am ACLS certified. I have many friends that are RN's that do not have the level of training and experience that I have. I think there are untrained persons in both levels of nursing. I know, because I see it frequently. So before deciding that LPN's are useless except for LTC's, maybe you should get out into the world and see what some of them are capable of.
Babs0512
846 Posts
It isn't knowing whether a lab value is off, it's what does that too high/ too low lab value mean regarding my patient and their disease process, how does that lab value affect their medications, if their K+ is low, what possible side effects should I be looking for? If my patient has no fever, say they are even hypothermic, their urine shows some bacteria, their WBC are normal or even a little low - what could that mean?
The answer is urosepsis. In urosepsis, which means bacteria has traveled into the blood stream, a person can be extremely ill, yet have no fever or elevated WBC count - but other people with sepsis can - so what other things do you have to look for? In severe cases, their skin can be pale to gray, cool, clammy or even mottled. In the beginning of sepsis, they may have a fever and be sweaty and flushed all over.
It's knowing these types of things that LPN education lacks. I've know many LPN's who cannot pass their tests to get into college school. VERY MANY. They usually are humbled afterward.
Blessing to you, and good luck in your future endevors!!