Rn, Lpn, & Cna

RNsRWe, ASN, RN · Jun 16, 2007

I am currently a nursing student in an accelerated BSN program and I start my clinicals in a few short weeks; however, I have a quick question.
When a unit has CNA's, LPN's, & RN's.. how is the word divided? I understand there is a very large scope of practice variance between the RN & CNA and that the CNA's main job duty is to perform primary care tasks. But what is the main functional difference between the LPN and RN while on the floor working together?

Can be slight or huge. Depends on the individual State BON as well as the facility's policies. For instance, in some places, LPNs can do IV pushes and administer blood products. In others, they can't go near them. Some places find LPNs working with PICC lines, other places don't let them do the dressing change, hang meds on them, flush or anything else. I don't believe they can do initial admission assessments anywhere, but I may be wrong. In cases where the LPN cannot perform certain functions, the RN "paired" with them, or covering them, will do them. Some places simply don't have LPNs working there at all, because of the limitations of scope of practice. Sometimes it's no problem at all because of the workings of the floor or unit.

You'd have to look at the scopes of practice in each State you're curious about to really know the answer.

By the way, not every aide in every facility must be a CNA (actually certified); sometimes PCT (patient care tech) is the designation. And in any case, although they do "primary care tasks", you can bet your bottom dollar you will be doing all of them, too. Sometimes delegation isn't practical, sometimes it takes several people to accomplish the task.

pepperann35 · Jun 16, 2007

Can be slight or huge. Depends on the individual State BON as well as the facility's policies. For instance, in some places, LPNs can do IV pushes and administer blood products. In others, they can't go near them. Some places find LPNs working with PICC lines, other places don't let them do the dressing change, hang meds on them, flush or anything else. I don't believe they can do initial admission assessments anywhere, but I may be wrong. In cases where the LPN cannot perform certain functions, the RN "paired" with them, or covering them, will do them. Some places simply don't have LPNs working there at all, because of the limitations of scope of practice. Sometimes it's no problem at all because of the workings of the floor or unit.
You'd have to look at the scopes of practice in each State you're curious about to really know the answer.
By the way, not every aide in every facility must be a CNA (actually certified); sometimes PCT (patient care tech) is the designation. And in any case, although they do "primary care tasks", you can bet your bottom dollar you will be doing all of them, too. Sometimes delegation isn't practical, sometimes it takes several people to accomplish the task.

Hi! I am an LPN. I am the night shift supervisor at a LTC/ rehab center. I can do anything an RN can do except IV push meds or mix IV meds. I do many of the initial assessments and check over all of the admissions that come in on the days I am there. I just get paid less.

RNsRWe, ASN, RN · Jun 16, 2007

Hi! I am an LPN. I am the night shift supervisor at a LTC/ rehab center. I can do anything an RN can do except IV push meds or mix IV meds. I do many of the initial assessments and check over all of the admissions that come in on the days I am there. I just get paid less.

Thanks for posting this....I had forgotten about the increased scope for LTC vs hospitals! We can't have LPNs in charge, or have them do initial assessments on admissions, but in LTC you can. It seems that in LTC, there's quite a bit more autonomy for an LPN than in a hospital, and that's a nice thing. Or, at least, it's certainly the case if you looked at my hospital.

The pay is always a sore point with the LPNs where I work, but they also know that they are doing about 3/4 of what we do, so....there's a reason.

pepperann35 · Jun 16, 2007

Thanks for posting this....I had forgotten about the increased scope for LTC vs hospitals! We can't have LPNs in charge, or have them do initial assessments on admissions, but in LTC you can. It seems that in LTC, there's quite a bit more autonomy for an LPN than in a hospital, and that's a nice thing. Or, at least, it's certainly the case if you looked at my hospital.
The pay is always a sore point with the LPNs where I work, but they also know that they are doing about 3/4 of what we do, so....there's a reason.

It's not a sore point with me, and I respect the RN's (and other LPN's)I work with. But, in my facility we do the same work and, in my opinion, we ALL deserve higher pay for this important job we have. The starting pay for new grads is not bad, but over the years, the salary does not grow with experience like most other fields, and it should.