RN's and LVN's-same job/same pay?

[msmerrie, RN]

I recently quit a nursing job that hires LVN's and gives them the same pay as RN's.  I was given the impression that having a RN license was the minimum requirement for this job. When I started five years ago, we had seven RN's and no LVN's (before I quit, we were down to three RN's and two LVN's). When I mentioned this, I was told that the new contract wording stated that "RN's were preferred, but LVN's were acceptable". It wasn't like they were trying to save money by phasing out the RN's. I could understand that.  These LVN's were getting the same pay as the RN's.

This really didn't bother me in the beginning.  We essentially did the same job. I had my own case load and I was being paid a good RN's wage for the area I live in.  The problem came about when one of the LVN's recently took a leave of absence and I was asked to take on some of their workload while they were gone. Not much shocks me these days, but when I started to really take notice of just how poor this LVN's work was, I was truly shocked and unfortunately the other LVN was not much better. I felt I had no choice but to bring my concerns to leadership. 

Long story, short: the retribution was swift and the bullying I endured since then was unlike anything I have ever experienced in the 20 plus years I have been a nurse. Which, by the way, 9 of those years I was an LVN. 

My question is, have you ever been in this type of situation and what did you do? Also, is this something new, LVN's getting the same pay rate as RN's?  I have recently seen job postings where LVN's and RN's can apply for the same job. Any feedback would be appreciated. Thank you. 

[JBMmom, MSN, NP]

When I started in long term care, I believe that the LPNs and RNs were paid the same when working the same positions. When RNs were put into charge or supervisor roles they would be paid more. 

I'm not sure that the situation you encountered was really a RN vs LPN issue it was just a situation where you encountered a nurse, who happened to be a LPN, that was not a very good nurse. Could have just as easily been another RN that didn't meet your standards. It's unfortunate that you encountered backlash from bringing forward concerns, but I think that's not unusual in any work environment. There are hard working people at every level from janitor to CEO and there are those that just try to get by with doing the minimum work. No one likes to be called out. 

I hope things work out for you.

[msmerrie, RN]

Thank you. You are correct.  It wasn't just an RN vs LPN/LVN pay issue that led me to quit.  There was so much more to this story that I didn't share.  I might have come across as a nurse who feels entitled just by virtue of their education and license alone, in truth, I am much more pragmatic, than emotional when it comes to work (pay=good, drama=no good, LOL). No one was more surprised than me when I finally came to the realization that it was the total lack of respect and support that bothered me more than anything. Hopefully I can put this behind me soon, so it won't spoil my next job. Thanks again for your insight. 

[DavidFR, BSN, MSN, RN]

Yes, we had the same situation in the UK when we had the Enrolled Nurse, a second level nurse who had ony trained for two years as opposed to the stantard RGN (RN) who had trained for three (or in the case of degree nurses, for four).

You were graded according to the job that you did, so for example an E grade Enrolled nurse could actually be getting paid more than the D grade Registered Nurse. This two tier system caused nothng but aggro and Enrolled Nurse training was eventually phased out, existing Enrolled Nurses being encouraged to convert to being Registered Nurses. In any case, their job opportunities soon dried up.

Here in France there is only one level of nurse the IDE (Infirmier Diplômé d'Etat) trained for 3 and a half years. We are supported by Aide Soignants who train for one year but they do NOT have the status of "nurse" - they are assistants. I find this system much better. the RN/EN wars in the UK were interminable. Some experienced Enrolled nurses were excellent and it was a shame they were blocked in their career progression. Some had chips on their shoulders and deiberately made life hell for the new RN. One level of trained nurse is far better IMO.

[JBMmom, MSN, NP]

1 hour ago, DavidFR said:

Some experienced Enrolled nurses were excellent and it was a shame they were blocked in their career progression.

We had the same sort of situation here. About 10 years ago, the hospitals in my area started phasing out the LPNs from acute care. When I was a nursing student I did two semesters of clinical on a floor in our hospital that had two excellent LPNs. Getting assigned to one of them in particular was the jackpot for any students. She was a fantastic nurse and she loved to teach. However, the LPNs were unable to hang blood and unable to administer IVP medications, so the RNs on the unit ended up with some additional workload. The hospital decided that the LPNs were no longer appropriate for their care model and they were reassigned or laid off. Some left, some went back to get their RN, the nurse I spoke of decided that she would take a job as a tech in same day surgery. She still gets paid what she made as a LPN, but she is now a tech. How that decision was cost effective for the hospital I'll never know. I wish they had just grandfathered in the LPNs to continue in that role and not hired more. But that's life. She was disappointed at first but she said now she loves it. She gets paid well for the job she has to do, she retained her vacation time and years of service. But it's unfortunate that a really good nurse was no longer considered worth the investment because of her license level. 

[msmerrie, RN]

Thank you David(FR) for your insight! I love that you work out of the US and can offer a different perspective into nursing practice in Europe. It looks like France has a good system.  A few years ago I was dating a man from Ireland and we talked about me moving there eventually.  When I researched there nurse licensing process, I found it to be somewhat similar to the US when it came to education, background checks, language proficiency, ect. But what really impressed me the most was the licensing board (or your workplace, not sure) assigned you a preceptor for 6 months and you wouldn't be fully qualified (licensed) until you were signed off. That is unheard of here and it's a shame.  In the US, each facility has it's own new hire training, and you might get a preceptor for a few weeks, if your lucky.  Most of the time they just throw you out there once you learn the computer (and where the nearest bathroom is on your floor, LOL).   In the job I just left, I recently proposed a six month new hire preceptor program and was basically ignored by leadership. I hated the fact that we were setting new young nurses (LVN or RN's) up for failure because we didn't support them in the beginning. It was disappointing, to say the least. 

[Suzanne lemmon]

I’m sick of people picking on lpns

[Jedrnurse, BSN, RN]

3 hours ago, Suzanne lemmon said:

I’m sick of people picking on lpns

Did you think that the OP was picking on the nurses because they were LPNs or because the OP didn't think that they were good nurses?

Editor-wannabe note to OP: It's not RN's or LPN's it's RNs and LPNs because you're talking about plurals, not possessives.

Note complete/micro-rant over. ?

[guest1143647]

Some homecare agencies pay the same for Rns and Lpns because the agencies claim we do the same work, even though the government reimburses the agencies more for Rns than Lpns.

This is with private duty nurse agencies.

[Guest67138]

No, I’m not picking on LPNs…

If you are comparing actual job performance and quality of care, then a nurse is a nurse. Period. 
 

If you are comparing what one nurse (like an RN) can do versus what another nurse can do (like an LPN), then I’d have to argue that a RN is (or should be) more qualified, capable, etc than that LPN. It doesn’t matter what setting you put those two nurses in, that RN should be paid more than the LPN. I have experience in ER/Trauma, Clinic, Pediatrics, Family Practice, Geriatrics, and Home Health. I am a RN and have worked with a LPN in every setting. And in each setting, there are just too many nursing duties that fall out of the LPN’s scope of practice (e.g. administration of certain medications, blood products, certain procedures, initial assessments, patient education/instruction). Even in home health, it is out of the LPN’s scope of practice to perform an initial assessment, therefore they are unable to perform OASIS visits (start of care, resumption of care, recertifications, discharges). Even in a clinic setting, an LPN can’t do what RN’s can do (such as IV administration of certain meds or initial assessment, medical teaching, and education to a patient and family). 
 

Now, with all that being said, a nurse’s experience needs to be taken into account. For example, when I was a baby nurse in the ER, there were a couple of the LPNs that could run circles around me, taught me so much, and were some of the greatest nurses I have ever known. And a few of them had been nurses for 20 to 30-something years. Those nurses probably made more than me, and justifiably so. They had been around much longer and had far more experience. But when you look at those nurses compared to me as a Spring chicken, I technically outranked them. I just didn’t think that way. I respected them for their experience and knowledge, not looked down on them because I went longer in nursing school. And after a few years, when I was able to run a code or handle a trauma on my own, making me even more experienced and knowledgeable, I STILL respected those veteran nurses. If those nurses hadn’t retired shortly after, I probably would’ve passed them with my pay increases for experience as well as my certifications eventually. Ultimately, none of that really mattered (to me anyway).
 

What irks me more than anything is these sorry nurses that don’t do their jobs, making nurses look bad in general, as well as just ticking me off, because I’m one of those that actually care about the patient and family. I’m currently dealing with this myself as well as management acting like the numbers matter more than the quality of care. But then that’s a whole other rant about the same tiresome story of same ole crap but different day. ?

[msmerrie, RN]

Thank you CamaroGirl13 for your response!  This is what I wanted to convey with my original post.

Bottom line: LPN's and RN's have a different scope of practice, different educational requirements, and a different NCLEX to pass in order to practice. 

My former employers chose to ignore these facts just so they can fulfill the contract. My former "leadership" team (management) also chose to ignore these facts just so they could continue to hire their friends and family members no matter how little nursing experience they had. This also meant no one was properly trained or held accountable for their poor work performance. (Honestly, the more I write, the angrier I get, even after 3 months.)

In short, as RN's, instead of "playing nicety nice", we need to spend more of our efforts advocating for our profession and less time worrying about the "butt hurt" feelings of our co-workers.

If we don't, no one will. We should all know that by now, right?

Thanks 

[NotFlo]

I am in a role that either an RN or LPN can do. Primary care clinic. I am the only nurse in the clinic. My company has over a dozen primary care clinics in my state and some have one LPN and some have an RN. We do the same exact job. I cover for some of the RNs when they are on vacation and vice versa. 

The RNs performing the same duties that I do make substantially more. 

Being human, sometimes I feel a tiny jab of resentment about the disparity however I understand the RNs are RNs, have more education and have earned the additional pay. It does seem appropriate to me that RNs should make more.