"LPNs should be done away with altogether"

Sandwitch883RN · Feb 21, 2009

Nurses are great no matter what the title behind the name. All nurses should have the ability to critically think, assess, treat, make prudent judgement calls. So when folks post about how they are an LPN or know LPN's that can work circles around RN's I find that confusing. Should'nt all nurses be able to possess these skills regardless of title? However the difference is lenght of education. I am an L&D nurse and have the knowledge and skill to deliver babies. However I dont have the education or title that allow me to do so. So when nurses say they have the hands on years of experience that is great but doenst mean you can work beyond your scope. If you want to increase you scope of practice increase your education. I am in the process of going back to school for the RN-BSN bridge program. I am not satisfied to stay at the educational level i'm at. I'm still a good nurse with hands on experience and still do a good job, but I would like to do more. So therefore if I choose to be able to do the skills I want to do I need to continue with education. I guess what i'm trying to say is just because you know how to do something doesnt mean you are qualified to. No matter how good you are at it or how competent . I dont mean that judgementally, its just a fact.

Sandwitch883RN · Feb 21, 2009

This seems to be a major theme in the tensions between professions in health care. There can be a *major* difference between a person's formal degree and their level of skill and expertise. No matter how little formal training person may have had, if they are skilled, hard-working and stay in the same area, they will likely know more about what's what in that particular area than anyone else... yet still getting paid much less than others in the same area with more formal training and "higher" licensure. So you have a nurse making $45,000 saving the butt of a physician who makes in the six digits. You have an LPN making $18/hr who can "run circles arounds" an RN making $28/hr. You have a tech making $12/hr having to walk a nurse making $20/hr through what to them is a routine procedure. It's understandable that an MD, RN, LPN, tech won't be expert at everything and if they are new, won't be expert at anything! It's also understandable why the person who is more skilled in their role gets frustrated that someone less skilled than they are gets paid so much more. In these cases, the reason the other gets paid more isn't because they are more skilled. It's because they have earned the licensure that allows them practice a certain set of skills. And that set of skills often includes some of the skills that a lower paid colleague does more often, is much more skilled in, and will likely remain more skilled in because that's their specialty. And that causes tensions.
Just tossing thoughts around!

Very well said! I was trying to say it that way but didnt do as well in my explaination!

MissBehavin · Feb 21, 2009

Wow this is such a hot debate at the moment. First of all I LOVE the few LPNs that work at my hospital. For the majority of them you would not know that they were LPNs instead of RNs. In fact my best friend is a LPN on a Neuro floor at a major hospital.

I really dont think most nurses think badly of LPNs, however there are many that do not want to have to take the time to properly supervise them (ie; do the assessments, IV push meds ect.). The majority of the hospitals in the Phoenix area are no longer hiring LPNs. (not because they are badly trained but because they feel it is unsafe for a RN with a full patient load to have to supervise, assess and give meds on the LPNs full load of patients). In fact if you want to work in a hospital in AZ, you must get hired as a CNA/PCT first (most hospitals state that they will try to honor your education and promote you as you continue on), so you then make the transition from CNA to LPN.

Talking with my friend (who FYI is an amazing LPN, and will make a amazing RN), she feels pressured everyday to work outside her scope of practice, and says she rarely feels covered. She does her own assessment and then asks a RN to do the offical assessment (most of the time they are mad, because they have their own to do). She has her IV certification (a requirment in AZ to work in a hospital) but she still cannot push meds. This is frustrating to her and the RNs because most of her patients have narcotics and other drugs that must be pushed.

Okay as for people saying their training is not as good, I think they should just say not as long. Yes, their are some programs that should be shut down (same goes for RN programs though). Here in AZ most of the community colleges required you to have the same prereqs-coreqs for LPN as RN. In fact most of them are the same program. To be an LPN all you had to do was complete the first two blocks (of four) and take your test. Then you could choose wether or not you wanted to continue to the next 2 blocks. So in essesce the quality of the training is the same! The RN just has more of it.

pagandeva2000, LPN · Feb 22, 2009

I really dont think most nurses think badly of LPNs, however there are many that do not want to have to take the time to properly supervise them (ie; do the assessments, IV push meds ect.). The majority of the hospitals in the Phoenix area are no longer hiring LPNs. (not because they are badly trained but because they feel it is unsafe for a RN with a full patient load to have to supervise, assess and give meds on the LPNs full load of patients).
Talking with my friend (who FYI is an amazing LPN, and will make a amazing RN), she feels pressured everyday to work outside her scope of practice, and says she rarely feels covered. She does her own assessment and then asks a RN to do the offical assessment (most of the time they are mad, because they have their own to do). She has her IV certification (a requirment in AZ to work in a hospital) but she still cannot push meds. This is frustrating to her and the RNs because most of her patients have narcotics and other drugs that must be pushed.

What I find interesting is that if there are CNAs on the floor, the RN is responsible (even moreso) as well, so, I am trying to understand the problem with working with an LPN. If there is no LPN there, the RN still has to do those same things...medicating, assessing and supervising...even with CNAs on their team. This is why I always supported team nursing...there is enough at the table for all to partake without being completely dumped on.

geocachingRN · Feb 22, 2009

anomalous statistic: In my ADN program a total of 4 LVN's were brought in and none could complete the program. In previous terms, I'm told that the LVN's have 50% failure rate for the LVN-RN. Don't know why there is such a high failure rate.

pagandeva2000, LPN · Feb 22, 2009

anomalous statistic: In my ADN program a total of 4 LVN's were brought in and none could complete the program. In previous terms, I'm told that the LVN's have 50% failure rate for the LVN-RN. Don't know why there is such a high failure rate.

I am just speculating, but I wonder if these were LPNs that graduated a long time ago from vocational schools. What I have noticed is that some have a false sense of security with the "We do everything RNs do", but without always knowing the "why". Some think that they will be revisiting old subjects, but in actuality, many times, they are, in fact, obtaining advanced knowledge in a fast pace, and maybe they couldn't keep up? Again, I am just speculating. Then again, there are some classmates from my 2006 program that have stated that when they entered into the bridge program, some of them had the same LPN instructors and felt they didn't learn much different. I suspect that because both programs, the LPN as well as the bridge were new, they pushed the students in order to validate their program was successful.

Fiona59 · Feb 22, 2009

anomalous statistic: In my ADN program a total of 4 LVN's were brought in and none could complete the program. In previous terms, I'm told that the LVN's have 50% failure rate for the LVN-RN. Don't know why there is such a high failure rate.

What do you mean "were brought in"?

Didn't they meet the educational requirements?

You just don't walk into a bridging programme. You have to meet all the pre-requisite courses and have the practice hours.

In addition, people fail their second and third year courses in nursing school all the time.

geocachingRN · Feb 22, 2009

What do you mean "were brought in"?
Didn't they meet the educational requirements?
You just don't walk into a bridging programme. You have to meet all the pre-requisite courses and have the practice hours.
In addition, people fail their second and third year courses in nursing school all the time.

ADN programs are often structured so that LVN's can enter the program at the 3rd semester requiring only one year of additional study. This is done on a space available basis usually and one or two space are available. So yes they have more than met the admission requirements, but since I do believe they have been out of school for awhile and are still trying to work full time, the commitment is too much.

lpnflorida · Feb 22, 2009

Two Sites that I have looked at online. One had 100% pass rate of LPN to RN, another site was 94.3% .

http://www.dlsii.com/landing/asn_info_g.htm

http://lpntorn.weebly.com/

Just goes to show easy to post an anonymous percentage rate of LPNs passing it does not in my estimation make it accurate though. Every LPN I have known who has started their RN program has passed it. Actually , I can think of one who ended up setting it aside due to economic issue, but intends on completing at a later date.

mina123 · Feb 22, 2009

What I find interesting is that if there are CNAs on the floor, the RN is responsible (even moreso) as well, so, I am trying to understand the problem with working with an LPN. If there is no LPN there, the RN still has to do those same things...medicating, assessing and supervising...even with CNAs on their team. This is why I always supported team nursing...there is enough at the table for all to partake without being completely dumped on.

No the problem for an RN supervising an CNA VS an LPN is not the same. Rn's are still supervising LPN's who are Licensed professionals. Everytime an LPN asks us to do an IVP meds it takes time away from my pt load, especially if u have a pt who is on q2 hr ivp dilaudid. Anytime an LPN gets an ER admission we still have to do your entire assesment, put in standared of care and do care plans for that particular pt meanwhile my ER admit is just chilling in his/her bed! Now supervising an Cna is easier all they are asking me is to help them with big,obsese pt's or pt's who can't turn themselves. Big difference in supervising an LPN and a CNA. Also when i am doing your IVP meds if anything happens to your pt it becomes my responsibility therefore MY LICENSE!!!!!!!!!!!! Which if u say you really worked hard for so did I! When u are asking me to do a Lasix IVP on your pt u better me ready to give me your pt's blood pressure and his/her k level. Lots of LPN's just say "I don't know", Do u see where this frustation comes from??????????????

meluhn · Feb 22, 2009

Dark rainy, I was the one who originally offended you and Maybe the reason you started this thread, which btw I have been following on and off. To tell you the truth I just didn't want to go there and really get into it with you and sound like a high and mighty jack-ass that is putting other people down. I still stand by my original statement that RNs come out of school as better nurses however, I am only basing that on my own experience as an LPN at one time and now as an instructor in an LPN program. I do not want to argue and put you down, just want to give credit where credit is due. That being said, it sounds like your program is very tough and hopefully you will come out of yours more prepared than I came out of my LPN program. Good luck to you, No hard feelings (on my part anyway). 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.

MAISY, RN-ER, BSN, RN · Feb 22, 2009

If you have read some threads about LPN education at some schools in NJ you'd wonder how any can become functional nurses. One program in which the students were complaining about was charging big bucks(approx $20K) and then the students sat around doing self-study modules when they weren't at clinical.

I don't know about anyone else, but my ADN program was viscious! I can't even imagine trying to self-educate and pass boards!

I think as long as there are different levels of care and education we will continue to experience problems with jobs, employers and with each other. I too believe that education must be continued, you can never know enough! Clinical experience is not enough, you need to speak with others, debate problems and see through other's eyes learning through their nursing experiences.

No other field considers themselves experts after 1 year, 2 years, 4 years, 6 years or whatever. Continuing education is required to keep current and to expand one's mind. It is the only way as a group we will ever have power. I am tired of "just a nurse", I am damned proud of my career, and academic accomplishments. I am graduating with honors in May and will continue onward!

CNA's make nursing students feel stupid because their skillsets are so good and practiced-but through education the student moves on. LPNs in many states have a full scope of practice or like NJ a limited scope of practice-their years of experience and knowledge gleaned from doing isn't used to its potential-I believe a bridging should be the natural step and required. Those hospitals and facilities that wouldn't require it like to pay you less for your skills!

I may be wrong, but many of those who respond with LPN licenses seem to have functioned in full capacities-perhaps they can't understand how diminished the role is here in NJ. I have known some wonderful LPNs whose jobs have become little more than that of a CNA while functioning in the hospital role. It's a pity, what a waste of knowledge.

I just wish nursing could make up it's mind and we could all get together!

JMHO

Maisy