RN program; not much credit given to LPNs!!!

[amjowens]

I just graduated from a LPN program, PROUDLY! I learned so much, and am very thankful for the year. I know my LPN program has prepared me well for the kind of nurse I want to be (patient-centered, not just "theory"-centered).

I started a regular RN program last week. I don't tell people I'm an LPN, but it's getting out since I'm at the same school I did the LPN, and some instructors know me. I just wanted to start off on "equal" terms new RN students (no LPNs here) and didn't want people to think I'm "different".

These new RN students generally have no health care experience. I'm talking, we're learning to make beds, learning which end the probe goes on the thermometer, etc. No problem here, but the problem I'm having is their opinion of themselves as the "leader" in the clinical setting. There are LPNs at the clinical site, and EVEN our instructor overlooks the LPN. She tells us to go to the RN for ANY questions. Let me tell you, I KNOW the LPN is the one who knows what's going on with the patient, as I saw HER doing all the meds, interacting with the patients, etc. It's not the set-up that is bothering me, rather the overt disrespect that is given to the LPN by our instructor in front of these students who walked in without an opinion of LPNs. Walking out, our instructor is leading this group of RNs on step one of the path of the negative labelling of LPNs. Our instructor clearly gave the role of the RN, the role of the nurse tech, and then said that she's surprised that LPNs are still here at the hospital. I just had to ask, who do we go to if our all-mighty nurse (she wouldn't acknowledge the LPN as "nurse") goes on break? Can we go to the LPN if we have a question?? NO!!! She said to go to another RN! I know for a fact that the LPN and RN don't take lunch the same time, and the RN doesn't even give a report about patients to any other RN, as she knows that the LPN is overseeing the patients.

I'm just seeing that the LPN identity crisis (at least in my region) and blatant disrespect starts right on the first week of nursing school. If these students only realized that many people who aren't RNs have a bit of wisdom to share, those students might have a chance of getting in on it. What a shame, and how enlightening, yet disappointing, for me to see.

[SuesquatchRN, BSN, RN]

Yup.

Keep your head down and your powder dry.

[flightnurse2b, LPN]

i start a bridge program later this year and i am afraid i will need to put a big zipper on my mouth. i am going to try and schedule my clinicals though outside of the hospital i work at because i would rather not have anyone know i am a paramedic and a LPN.

just lay low and bide your time.... you're working towards those initials!

[BabyLady, BSN, RN]

I don't think it was a slam against LPN's, with your instructor asking you to go to the RN for any questions...there are differences between the role of an LPN and an RN and as you get further in your studies, you will eventually pick that up. Your clinical instructor is preparing you for a leadership role.

LPN's are not discussed in our program...they aren't bashed either. Right after the start of our program the instructors passed out information on the differences between an RN and an LPN.

The LPN's don't struggle with the technical aspect of clinicals and testing and they know drugs very, very well...however, where they seem to fall short on our exams (and get the same grade as the rest of us) is in higher-level critical thinking decisions...and their practice of "how it's done" in their facility vs the NCLEX hospital that doesn't exist...messes them up on exams.

[flightnurse2b, LPN]

I don't think it was a slam against LPN's, with your instructor asking you to go to the RN for any questions...there are differences between the role of an LPN and an RN and as you get further in your studies, you will eventually pick that up. Your clinical instructor is preparing you for a leadership role.

.

i think the OP, as an LPN, clearly knows there is a difference between the roles. believe me when i tell you that in practical nursing programs, the "RN ONLY" concept is drilled into your brain.

there is absolutely nothing wrong with going to an LPN for a question about anything. i don't know how by discrediting someone's knowledge is preparing anyone for a leadership role. one of the things that any nursing instructor should tell student nurses is to utilize ALL available personnel in their clinical setting. it may just be the CNA, the LPN, the unit secretary, the transporter... whose been there for yrs and who knows the ins and outs.

it's frustrating, believe me, and you will not understand how hard it is to have your cohorts think you do things but don't know how to do them or critcally think. you will not know how discouraging it is to pick up on something but bc of your "scope" have to bring it to the attention of an RN and feeling like a little kid saying "ooh me, pick on me, i know the answer!". it makes you feel very small.

let the woman vent. we obviously know our scope and are trying to expand it by going back to school.

[amjowens]

I don't think it was a slam against LPN's, with your instructor asking you to go to the RN for any questions...there are differences between the role of an LPN and an RN and as you get further in your studies, you will eventually pick that up. Your clinical instructor is preparing you for a leadership role.

LPN's are not discussed in our program...they aren't bashed either. Right after the start of our program the instructors passed out information on the differences between an RN and an LPN.

The LPN's don't struggle with the technical aspect of clinicals and testing and they know drugs very, very well...however, where they seem to fall short on our exams (and get the same grade as the rest of us) is in higher-level critical thinking decisions...and their practice of "how it's done" in their facility vs the NCLEX hospital that doesn't exist...messes them up on exams.

Thank you for your perspective, but parts of your comments are exactly what is demeaning. As for the critical thinking, this is common thinking regarding LPNs. I'm sure some LPNs are challenged by critical thinking, but TRUST ME (!!!), there are a few RNs who are challenged just the same. The more accurate, without the "labelling", might be, critical thinking is part of nursing, and with the more education a nurse assumes, the more critical thinking practice the nurse will have. But, instead, it's more of a "they fall short...in higher-level critical thinking decisions."

As for the delegation and leadership concept, I see your point, but disagree. Delegation involves centering care around a patient, and utilizing the skills of each person involved in the patient's care. To not acknowledge a "team member" is what I was talking about. I have a very clear understanding of the role of the LPN, and it is what it is. For ex., I wouldn't expect a RN to complain about not being able to practice "medicine" as a physician, and I'm not complaining that the LPN can't, for example, determine the nursing diagnosis. I just, again for example, wouldn't appreciate that the physician wouldn't acknowledge the RN and her role, and to do so blatantly in front of her and perhaps a bunch of med students. It just would be demeaning and concerning for the future (the med students observing this). See my point? Anyway, the whole hierarchy game is a pretty big and deep thing, and something that isn't exlcusive to LPNs, I suppose.

[Theauthentic]

Well I give you credit: LPNS you guys are great and RN's cannot deny that without you we would be ripping our hair out!

[SuesquatchRN, BSN, RN]

... and I'm not complaining that the LPN can't, for example, determine the nursing diagnosis.

Who wants to determine that crock that no one uses anyway? The first thing you do is look at the medical diagnosis and then click the care plan for that.

Does anyone really think that the LPN doesn't know to keep the HOB ^ for dyspnea and why? And is incapable of flipping through the Mosby's and finding "COPD" and then reading the ND's listed?

When I was an LPN I found it infuriating that RN's got really annoyed when Iventured an opinion. Heck, I was thrilled at my aides helping me. "Sue, Joe's leg doesn't look right." Raging phlebitis. "Thanks, S. You're right - that ain't right!" Call the doc, decides to admit directly, and the RN on duty upstairs starting giving me crap about who we can "get away" with not having an RN. I explained that we clearly did - her. Bite me.

Man, I have never seen a more pathetic hierarchy. "Oh, I have TWO years of school while you only have one. You must be a trained chimpanzee."

[BabyLady, BSN, RN]

Thank you for your perspective, but parts of your comments are exactly what is demeaning. As for the critical thinking, this is common thinking regarding LPNs. I'm sure some LPNs are challenged by critical thinking, but TRUST ME (!!!), there are a few RNs who are challenged just the same. The more accurate, without the "labelling", might be, critical thinking is part of nursing, and with the more education a nurse assumes, the more critical thinking practice the nurse will have. But, instead, it's more of a "they fall short...in higher-level critical thinking decisions."

As for the delegation and leadership concept, I see your point, but disagree. Delegation involves centering care around a patient, and utilizing the skills of each person involved in the patient's care. To not acknowledge a "team member" is what I was talking about. I have a very clear understanding of the role of the LPN, and it is what it is. For ex., I wouldn't expect a RN to complain about not being able to practice "medicine" as a physician, and I'm not complaining that the LPN can't, for example, determine the nursing diagnosis. I just, again for example, wouldn't appreciate that the physician wouldn't acknowledge the RN and her role, and to do so blatantly in front of her and perhaps a bunch of med students. It just would be demeaning and concerning for the future (the med students observing this). See my point? Anyway, the whole hierarchy game is a pretty big and deep thing, and something that isn't exlcusive to LPNs, I suppose.

I think you were reading too much into my post...nothing I said was demeaning in any way and I didn't say a single word where I suggested nor said that LPN's were not valuable, knowledgable, or not a critical part of the healthcare team.

Just as you got a certain perception from my post...I got a certain perception from yours...you seemed to take great offense that the instructor specifically told you to go to the RN if you had any questions as if that, in of itself, were demeaning to LPN's.

You have to remember...clinicals is school...it's not a work environment. You are in an RN program so your instructor wants you to get your assistance from another RN...what is odd/strange/demeaning about that?

Of course you are going to go to pretty much anyone that is qualified to answer any nursing/medical question you have when you are working. I don't really care if someone has an LPN or RN after their name when I am at the hospital...if I think they can help me or answer my question..I ask and trust their experience.

Delegation/Leadership is only one part of an RN's training...I never stated, nor suggested, that they weren't supposed to utilize the entire roster of the healthcare team...I disagree with you that it's not important...it's important enough to where I have to take an entire class on the subject that is separate from my regular nursing classes.

There is a whole thread here somewhere on this board where there was this huge debate on if an LPN with so many years of experience even needed to go to school to become an RN or should they be permitted to just challenge the NCLEX...I came across it recently...several LPN's that had completed RN coursework all said the same thing...you don't think there is a difference in what you do...until you go.

I have never been to LPN school...so I have no idea of what that whole scope of training is like nor pretend to. I just know what I have seen and what I have been taught.

In my mind they are both nurses..and to me, that is all that is important.

[flightnurse2b, LPN]

I think you were reading too much into my post...nothing I said was demeaning in any way and I didn't say a single word where I suggested nor said that LPN's were not valuable, knowledgable, or not a critical part of the healthcare team.

Just as you got a certain perception from my post...I got a certain perception from yours...you seemed to take great offense that the instructor specifically told you to go to the RN if you had any questions as if that, in of itself, were demeaning to LPN's.

You have to remember...clinicals is school...it's not a work environment. You are in an RN program so your instructor wants you to get your assistance from another RN...what is odd/strange/demeaning about that?

Of course you are going to go to pretty much anyone that is qualified to answer any nursing/medical question you have when you are working. I don't really care if someone has an LPN or RN after their name when I am at the hospital...if I think they can help me or answer my question..I ask and trust their experience.

Delegation/Leadership is only one part of an RN's training...I never stated, nor suggested, that they weren't supposed to utilize the entire roster of the healthcare team...I disagree with you that it's not important...it's important enough to where I have to take an entire class on the subject that is separate from my regular nursing classes.

There is a whole thread here somewhere on this board where there was this huge debate on if an LPN with so many years of experience even needed to go to school to become an RN or should they be permitted to just challenge the NCLEX...I came across it recently...several LPN's that had completed RN coursework all said the same thing...you don't think there is a difference in what you do...until you go.

I have never been to LPN school...so I have no idea of what that whole scope of training is like nor pretend to. I just know what I have seen and what I have been taught.

In my mind they are both nurses..and to me, that is all that is important.

the OP was offended that her instructor did not acknowledge the LPN, not only as a not a resource, but not as a nurse, is the way i read into it. and silliness like that is why alot of RN's come out of school looking at LPN's thinking that we are no more than a glofied CNA, which is a comment one of my co-workers made to me. i really feel like i have to be 200% on my game, at all times, and work extra hard to be a good nurse, because i feel like i have to prove my worth sometimes. i'll never forget when my boss was touring a new nurse to our unit was going around the desk saying "this is susie, jenny, kaye, julie... they are the nurses. and this is alli. she's the LPN." i was like thanks, chief.

i think it will be hard for you, as ADN or BSN student, to understand where the OP is coming from. you can't really understand why she is offended, and i don't expect you to, either.

this is not a question of whether or not we know the difference, like i said before, we obviously do.

[BabyLady, BSN, RN]

the OP was offended that her instructor did not acknowledge the LPN, not only as a not a resource, but not as a nurse, is the way i read into it. and silliness like that is why alot of RN's come out of school looking at LPN's thinking that we are no more than a glofied CNA, which is a comment one of my co-workers made to me. i really feel like i have to be 200% on my game, at all times, and work extra hard to be a good nurse, because i feel like i have to prove my worth sometimes. i'll never forget when my boss was touring a new nurse to our unit was going around the desk saying "this is susie, jenny, kaye, julie... they are the nurses. and this is alli. she's the LPN." i was like thanks, chief.

i think it will be hard for you, as ADN or BSN student, to understand where the OP is coming from. you can't really understand why she is offended, and i don't expect you to, either.

this is not a question of whether or not we know the difference, like i said before, we obviously do.

I just think that the OP was being overly sensitive b/c she is an LPN. Almost hypersensitive to what the clinical instructor was doing.

When I'm at the hospital, I can't tell, unless I look at a name tag really, really hard, who is the RN vs the LPN....to me, it doesn't matter unless it's something I specifically have to find an RN for...which is a rare event.

What the OP is not "getting", is that she is in SCHOOL...she is NOT at work when she is in clinicals. She has the role of a student...not that of an LPN when she is in clinicals. The purpose of an RN program is to teach you how to be an RN.

Our school does the same thing...but because I have never been an LPN and I am relatively new at working in healthcare, I have absolutely zero bias against other workers in the hospital...we have also, been told, "If you have a question about something, please as the RN on duty."

Again, because I have never been an LPN....I didn't take this as a slam against the LPN's at all....I just figured, "OK..this is an RN program, so yeah, I'm going to go to the RN if I need help." I just figured that was part of the educational process.

We have NEVER been told a single, negative thing about LPN's. In fact, we have been taught that LPN's will most likely have more knowledge about drugs than many RN's b/c especially in Med-Surg (I can only speak for hospitals in our area), usually the LPN's work the floor and have an RN charging.

I still think the OP was reading WAY too much into the instructor's actions, just like she assumed that I was also slamming LPN's just b/c I'm in an RN program...and I never did such a thing.

But to suggest, "Oh yeah, this is where the discrimination starts!!! In school! I saw it happen!"...seriously...I mean...seriously...that's just over the top, and it's exactly what the OP was doing, and assuming that the events occurred as the OP described...that isn't what I saw at all.

Then again...I have no biased against LPN's either...which means, I wasn't LOOKING for something discriminatory.

[amjowens]

I just think that the OP was being overly sensitive b/c she is an LPN. Almost hypersensitive to what the clinical instructor was doing.

When I'm at the hospital, I can't tell, unless I look at a name tag really, really hard, who is the RN vs the LPN....to me, it doesn't matter unless it's something I specifically have to find an RN for...which is a rare event.

What the OP is not "getting", is that she is in SCHOOL...she is NOT at work when she is in clinicals. She has the role of a student...not that of an LPN when she is in clinicals. The purpose of an RN program is to teach you how to be an RN.

Our school does the same thing...but because I have never been an LPN and I am relatively new at working in healthcare, I have absolutely zero bias against other workers in the hospital...we have also, been told, "If you have a question about something, please as the RN on duty."

Again, because I have never been an LPN....I didn't take this as a slam against the LPN's at all....I just figured, "OK..this is an RN program, so yeah, I'm going to go to the RN if I need help." I just figured that was part of the educational process.

We have NEVER been told a single, negative thing about LPN's. In fact, we have been taught that LPN's will most likely have more knowledge about drugs than many RN's b/c especially in Med-Surg (I can only speak for hospitals in our area), usually the LPN's work the floor and have an RN charging.

I still think the OP was reading WAY too much into the instructor's actions, just like she assumed that I was also slamming LPN's just b/c I'm in an RN program...and I never did such a thing.

But to suggest, "Oh yeah, this is where the discrimination starts!!! In school! I saw it happen!"...seriously...I mean...seriously...that's just over the top, and it's exactly what the OP was doing, and assuming that the events occurred as the OP described...that isn't what I saw at all.

Then again...I have no biased against LPN's either...which means, I wasn't LOOKING for something discriminatory.

I really appreciate this site because the "OVERLY SENSITIVE" types of topics that aren't appropriate at school or work can USUALLY be discussed freely here, and people help with their opinions. The first thing I did was thank you for sharing your perspective.

My topic is "RN program; not much credit given to LPNs". I gave my examples, where new students didn't even know LPNs were "real" nurses, and then the instructor adding she couldn't believe the hospital even used LPNs, to when the unit recognizes the LPN to be in charge of patients while on the hour lunch, but the instructor says the students may not confer with her about the patients during the break. I am, in fact, aware of the world outside school. It's not good for LPNs right now. Nurse Techs are more clearly understood and utilized, it seems, than LPNs. MY OPINION here is that NTs pose no threat, whereas LPNs are SOMETIMES seen as a threat, as they can truly function (in most states) NEARLY the same clinically as a RN.

One thing we WERE taught in LPN school was the value of therapeutic communication, and part of this includes staying on topic and not extending beyond the facts and examples someone shares. I meant nothing personal by this thread, I was merely giving my experience, and seeing that it made sense as to what's going on at SCHOOL to lead to what HAPPENS in the "real" world.