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...
Specializes in LTC, Wounds, Med/Surg, Tele, Triage.
Let me tell you that there is something to be said for LPN's that later become RN's as I have done. When I first went to LPN school I was young and had never worked in health care (I was right out of high school). The LPN program looked like a great way to gain professional skills while I decided what I wanted be when I grew up! LOL. But after getting my license and working awhile I quickly realized that there is so much more to learn and that I wanted to know it! That's when I decided it would be to my benefit, as well as the patients I care for, to further my education. I have been an RN for 6 months now after working as an LPN for 5 + years. My LPN experiance has been priceless to me. It gave me the bedside experiance that I did not get in either of the programs LPN or RN. The act of simply walking into a room to meet a patient and/or family can be very intimidating to a new student, grad, or nurse. As far as education goes....nurses must make a commitment to themselves to NEVER stop educating themselves. Never stop learning. It's all what you make of it and what you value. The more you know... the more you can help those you service. Make the most of your LPN experiances~they are no less important than RN experiances. Good Luck...
Specializes in LTC, Wounds, Med/Surg, Tele, Triage.
In response to Mina123..An RN making a proper assignment should take these medications into consideration before assigning an LPN to that pt don't you think? Or perhaps LPN's should not be permitted in these high acuity areas since they cannot perform critical tasks and are not trained to monitor pt's on these types of meds, as you stated, the RN becomes responsible since she/he pushes the meds. I think there is a place for LPN's but probably not in critical care/acute.
Specializes in Community Health, Med-Surg, Home Health.
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??????????????
I am not in your situation (meaning I am not an RN), so, of course, I don't know all of the aggreviation you could possibly experience. In addition, I never felt that RNs did not work hard for their licenses. The question I wish to pose, however...is this the ENTIRE fault of the LPN? She/he did not make these rules up independently. Many of them expected, upon graduation to be able to perform much more than they are allowed to...many learned more than they are allowed to practice from what I see here. I definitely support your stance when you say that the LPN should give you all of the information you need in order for you to do your Lasix (and every other skill you have to perform, for that matter). But, the LPN may be asking for you to do the IVP medication because she isn't allowed to due to policy and procedure, or scope of practice (at least this is what I see based on your post and my knowledge). Now, the LPN should be held accountable for obtaining and sharing all critical information with you. Is that being enforced? Are they being held to task by not informing you? If not, then, that, to me, is an administrative issue. Because the LPN is a licensed person, who works under the auspice of the RN, she should be held responsible...not to just walk away and say "Heck, I don't know". What I see here is a break down of team work by that LPN saying to herself "Heck, this is not my responsibility to push the Lasix, so, what difference does it make to me if you know or not". That, is wrong. What I want to know is if this is enforced during orientation/training and being reinforced about the domino effect of what happens if the communication breaks down between the health care team.
I do see your frustration and I am sorry that you have to experience this. I see this every day and this is why I don't want the title...I do believe in my soul that they put too much on RNs simply by virtue of their title alone, not taking into consideration of the pressure being placed on a human being who has frailties, fear and fatigue like everyone else. What I am saying is that I still strongly believe that these disciplines still CAN work effectively, as a team, if it were not for the confunsion of the state, administration and blurred policies/procedures that are ineffective. All I can say personally, is that if I worked with you, I would want to know what is expected out of me, and I would do my damnest within my scope of practice to be able to make some of that load a bit easier for you to bear. It would not benefit me to have a superior nurse angry at me for something that can be avoidable.
Specializes in Community Health, Med-Surg, Home Health.
In response to Mina123..An RN making a proper assignment should take these medications into consideration before assigning an LPN to that pt don't you think? Or perhaps LPN's should not be permitted in these high acuity areas since they cannot perform critical tasks and are not trained to monitor pt's on these types of meds, as you stated, the RN becomes responsible since she/he pushes the meds. I think there is a place for LPN's but probably not in critical care/acute.
That is a point, also. The bottom line is whether there are only CNAs or LPNs around, there has to be an RN assessment done first, to determine what can be done for which patient (and by whom). Again, I am not an RN, but I think that sometimes, creativity may have to take over if the staffing is tight...at that point, maybe I would say that I have to push certain medications, but the LPN can do most of the 'mundane' things, with instructions to inform the RN of abnormals, such as lab values, etc...(something we are trained to do).
I have to say that I totally understand the stress that an RN may encounter...observing this even as a CNA lead me to make the choice I did. I know I can't handle all of that...but, I still believe that even with this, we can work together without this 'throw them to the woods, they're useless' mode of thought.
Specializes in Cardiac, Maternal-child, LDRP, NICU.
I definitely agree that an LPN should not be working in an acute care setting wherenow a days, there mostly are IVP meds. And for this particular reason hospitals have stopped hiring LPN's. But If I have an LPN who is willing to learn; wants to know the WHY'S before why something is being done I will be the first RN to explain everything to you. Heck my nursing assistant and unit sect who are currently nursing students ask me all the time if something i am doing ;if it is worth learning,to call them and show them. And on many occasions i have; i love to teach if ONLY you are willing to learn. AND no it's not an LPN'S fault at all as pagandeva2000 you say it's the state board's fault, its where they have mixed all the duties of LPN'S and RN's together and this whole thing is now so out of control that nobody knows what they are doing anymore!!! I know most LPN's rather just do there own IVP or there initial assesment, actually all this does not make any sense at all. If you are capable of doing care for a pt for entire 12 hr ofcourse you know what the hell you are doing!!!!!!! Any lpn can do an ivp or assesment its not brain surgery but as you say it;s not the LPN'S FAULT its the system fault and we don't get angry we just get frustated in the system on how it is managed!!!!!!!!!!!!!
I would love to have an LPN work with me. I am the only nurse among several tech where I work, and techs are not even allowed to put an O2 cannula in a pt's nose or turn on a concentrator for the pt.
If there were an LPN, it would free me from having to drop what I'm doing and run across the unit to turn on a concentrator, or give a prn med.
I would love to have someone to discuss pt care issues with, and give me their input to help me make pt care decisions, too.
Specializes in Cardiac, Maternal-child, LDRP, NICU.
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!!!!!
Specializes in Community Health, Med-Surg, Home Health.
Not sure if grandfathering everyone into the BSN is the correct way to go for several reasons...this means more schooling. Now, before I get flamed, allow me to say that while this is not a negative, this can ice out many because they have been out of it for so long that they may not be able to catch up and succeed scholastically. Do you then say to a viable working person who has contributed to our taxes and nursing care for years "Oh well, this was mandatory, you didn't make it" and out you go?
I am more for allowing those who decided to earn an honest living rather than cheat the economy of our tax dollars or ripping people off in the streets the chance to continue with their vocations with dignity. In addition, I am not sure if the arena is that attractive for the bedside nurse at this moment...the conditions will not change (which ran many nurses away from the bedside in the first place). Heavy patient loads, little clinical experience of value in many cases, the bullying of collagues, administration, patients, families and lack of nursing support from the incumbant ones... I mean, a person with a degree may STILL run.
I am a proponent of furthering education for those who are interested. Problem is that with today's conditions are so dismal that many are saying that they STILL are not practicing what they were trained for.
Specializes in acute rehab, med surg, LTC, peds, home c.
Maisey,
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.
The problem really lies in the consistancy of programs-LPNs from one program may be great, and others may turn out-self taught from books students. Some current workers may be ready to be RNs, others not.
I agree with the others that the BONs are to blame for the confusion of job roles; that hospitals prey on nurses the way they do is despicable. Asking an RN to work with an LPN with experience, or assigning an LPN that may come from a corrospondance course is asking for two very different reactions. The problem is that you know what the RN has to know, and expect a learning curve from a newbie; but the ADN has 4 semesters of clinicals. The new LPN/LVN is a complete unknown and has only a year for book and clinical time. (at least in my neck of the woods) and the experienced LVN/LPN has a limited scope of practice. A sure nightmare anywhere assessment, and narcotic pushes are the norm!
Again, I think it's hard for those of you who are fully functional as LVN/LPNs in your states to see the predicament posed by them in a state with limited practice. I also am surprised to hear some don't want the responsibility of an RN. If RN was required, all nurses would be at the same operational level, making hospitals a safer place and nursing more effective. My core group of patients should not suffer because you are limited in your scope of practice-waiting while I provide elements of care to your patients. It isn't safe, it isn't right, and hospitals get away with murder paying such low rates for your hard work!
Granted that LVN/LPNs are not in the hospitals anymore where I live (except those grandfathered) LVNs are the main components of LTC facilitates. With the retiring baby boomers, if anything, we will need MORE LVNs, I don't think LTCs could afford to primarily hire RNs, and in this setting, LVNs are nearly equivalent to RNs as far as what is needed for patient care.
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.
I am not sure if you are talking about the program that was recently looking for instructors in northern NJ, if it was, I was looking at those ads too! According to the job heading the coursework is laid out in modules, I wasn't sure what the instructor really did or how they fit in with teaching programs. Also, a BSN was acceptable as an instructor in that school which while I have run across questionable MSNs who can only read out of a book and not explain themselves, I still find lack of an advanced degree disturbing.
The other problem I have with the programs is where are these people going to get jobs? If you look at what we are experiencing now, why should any facility hire an LPN when there a million RN new grads that need an entry level job and will take whatever money is offered right now? This is especially true here in NJ where LPNs have such a limited scope of practice. Just think of all the LTC that can get RN next to their nurse staffing daily, instead of LPN. Imagine all of the BSN kids that have graduated and are still looking, better yet! NJ postings with numbers of BSN, ADN which to me will = 0 LPNs as long as the job market is tight!
I wish you good luck in your position, perhaps you will be able to change the atmosphere in the school. I just wonder what the state, unemployment and those offering grants to displaced homemakers and those needing a helping hand would say if they knew how much a waste of money this type of program is, what a shame! Without prior training positions as clinical technicians are available in my ER, $14.00/hr benefits, and tuition reimbursement.
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mudd68
82 Posts
Let me tell you that there is something to be said for LPN's that later become RN's as I have done. When I first went to LPN school I was young and had never worked in health care (I was right out of high school). The LPN program looked like a great way to gain professional skills while I decided what I wanted be when I grew up! LOL. But after getting my license and working awhile I quickly realized that there is so much more to learn and that I wanted to know it! That's when I decided it would be to my benefit, as well as the patients I care for, to further my education. I have been an RN for 6 months now after working as an LPN for 5 + years. My LPN experiance has been priceless to me. It gave me the bedside experiance that I did not get in either of the programs LPN or RN. The act of simply walking into a room to meet a patient and/or family can be very intimidating to a new student, grad, or nurse. As far as education goes....nurses must make a commitment to themselves to NEVER stop educating themselves. Never stop learning. It's all what you make of it and what you value. The more you know... the more you can help those you service. Make the most of your LPN experiances~they are no less important than RN experiances. Good Luck...