"LPNs should be done away with altogether"

[missjennmb]

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

[romie]

Putting a drug through a 50 cc bag and running it through a pump. That is even more irresponsible! At least Donna said to me, Hey, Mrs. Jones needs morphine and I checked her allergies and asked Donna about Mrs. Jones vitals. What if she ran chemotoxic meds through a 50cc bag because the "RN was too busy"? We never let anyone just arbitrarily run drugs through 50cc IV bags in my state. That is more irresponsible than if the LPN was to run it by me first. Mixing drugs in a 50 cc bag of what I'm assuming you think is normal saline (what if it had KCL in it? And the LPN was too lazy to check it?) is part of the realm of PHARMACY in my state. Now the "dumb LPN" is acting like a PHARMACIST in my state and mixing and dispensing drugs. Jeezus! What hospital allows you to arbitrarily mix drugs and IV solutions? What state?

[romie]

Seriously, You would trust anyone to "put a drug in a 50 cc bag?" 50 cc of what? How do they even know it is normal saline or D5W or lactated ringers? How they even know that the drug is even compatible with the 50cc bag of "whatever"? Seriously? What if a nurse/LPN started running a 50 cc bag that had KCL and they were already Hyperkalemic and had phlebitis? We don't mix whatever we want in 50cc bags in my state. That is the job of the Doctorate prepared Pharmacist!

[jadelpn, LPN, EMT-B]

I am not at all getting this into a LPN vs. RN battle. Not trying to argue, and you clearly asked the question. I have touched a raw nerve and I apologize for that. But in my opinion, you are putting your LPN in a prediciment if she is asking you to push a med that she knows is not within her scope (per you stating it is not in your hospital's policy) and asking her to do it instead. Should she get caught doing this, it could be both of your licenses. I would not in my practice delegate to a CNA to stop someone's fluid and disconnect the IV for a shower, for instance. How you choose to practice is your responsibility, and you are certainly well educated to make that decision, no argument there. But is the LPN comfortable doing it this way? If so, perhaps trying to change the policy should the (or any) LPN show compentency could blaze a trail for this LPN to do more than the current hospital policy allows. And a 10cc saline mixed with the morphine in a syringe through the pump as a secondary would perhaps be more appropriate, but in Massachusetts we are across the board not allowed to push meds, therefore, I am not "up" on the specifics of that practice.

[nursel56]

your argument is nill. my state rn law clearly states that i can delegate to a professional who i have evaluated and who has a returned demonstration of safe practice. jeezus! i have a masters degree and i am not going to argue with with a diploma prepared nurse about my ability to delegate to donna. you don't even know or understand my state nursing practice act. which state are you basing your practice in? i'm from a different state. i was simply trying to say something nice about good nurses who happen to be lpns.

thank you! every nurse should be proud of his or her own worth but it wears on us to hear stuff constantly negative drip drip drip . .

[tikilpn2]

That was the most ill put way to get your point across-- you've mentioned the masters did not go over our heads no need to put down the diploma nurse :) lol geesh!!! That statement just made me say "eww"

[tikilpn2]

that message is for romie! in case clarification is needed.... again "ewww":cool:

[Practicalone, LPN]

I have to say I agree with jadelpn, Donna came to you to ask you to give this med because she KNOWS her scope of practice. Why would you want to risk your license and hers for one simple error. And yes as an RN you can deligate to the staff below you LPNs, LVNs, MAs & CNAs, but why deligate something to them when it is our of their scope? and as an LPN myself, if an RN asked me to do that, I would be really upset. I would think you were intentionally trying to get me fired. CYA,CYA

[nursel56]

Dorky hospital policy says Donna can't do IVP meds. She comes to me and says, "I think Mr. Jones needs some morphine, can you do it for me?" Like the good sport she is. I turn to Donna and say, " You give it, you know him better than me and have been doing this longer than me. I'll sign off on it. I got your back you have mine." Am I crazy? Mind you, I wouldn't do this with just any LPN or RN for that matter.

(emphasis added)

It seems people here don't realize the difference between hospital policy and scope of practice. Donna and Romie might get fired for violating hospital policy, and LPNs giving IVP meds might be OK in their state scope of practice. They are not the same thing. Some states are very restrictive and some are not. Some hospitals state that LPNs "cannot assess patients" which does not mean it is out of the scope of practice for an LPN to assess patients and LPNs assess patients in many environments. It's up to us to know our state scope of practice and the policies and procedures of the place we work.

[HazelLPN, LPN]

Your argument is nill. My state RN law clearly states that I can delegate to a professional who I have evaluated and who has a returned demonstration of safe practice. Jeezus! I have a Masters degree and I am not going to argue with with a diploma prepared nurse about my ability to delegate to Donna. You don't even know or understand my state nursing practice act. Which state are you basing your practice in? I'm from a different state. I was simply trying to say something nice about good nurses who happen to be LPNs. I'm not getting into this LPN vs. RN battle. It's old and tired and dosen't belong on this thread.Now if I say that only BSN prepared nurses should be allowed to practice you will get upset too. Why are nurses so divided? I have over 15 years of higher education at prestigious and very exclusive private universities. I know my nursing practice act. You can't please everyone. Jeesuz!!

:down:Putting down diploma prepared nurses won't get you far in nursing. Do you think that getting a diploma was easy? I trained for 2 years in a long gone Catholic hospital based diploma LPN program...with nuns mind you!. What you learned about that morning in class you revisited after lunch in the afternoon during clinical. In the evening, you further reinforced what you learned by working as a student nurse alongside an experienced nurse. When you went to sleep, you had dreams about what you learned that day because you lived at the hospital! It was constant nursing day in and day out. Diploma prepared nurses are worth their weight in gold, and don't you ever forget it.

Mentioning your "15 years of higher education at prestigious and very exclusive private universities" won't get you very far in nursing either. As Canadian singer Shania Twain says "that don't impress me much." It sounds like bragging to me, which I detest and tune out. You prove yourself by your actions and how you treat others, not by tooting your own horn.

What will get you far in nursing (besides refraining from making unwise comments about diploma prepared nurses and trying too hard to impress) is not violating hospital policy, which could result in termination or loss of your license.

Best to you,

Mrs H.