Should BSNs be paid more?

sbic56, BSN, RN · Aug 6, 2005

This thread is an interesting one. Now we are looking at whether or not management can be taught. I wonder that myself, but I think the BSN or above would and should be considered above the ADN for management positions, if that is what it comes down to once the other aspects such as experience and managerial ability are taken into account. I'm an ADN in management, but I feel if a nurse with a higher degree and equal experience and management ability were to have applied when I did, then he/she would have been chosen and I would have understood why.

Dragonfair · Aug 6, 2005

Girls and Boys do you suppose that Flo is rolling in her grave. :specs: They way it has gone.

sbic56, BSN, RN · Aug 6, 2005

Spic, LPN's do assess...did you know we are taught head to toe assessments, system assessments...etc. Our scope of practice is very broad...also an LPN in particular situations does not have an RN to supervisor him or her. I am sorry Spic, but I was very offended by you stating an LPN does not assess...we do in many areas...yes when speaking of floor nursing we are under direct supervision of an RN, yes under your license as you under a provider...however we ASSESS and WE ARE TAUGHT HOW TO!!!

underwatergirl

Sorry if you were offended; I didn't mean to do that...but, I do understand why you were! LPN's are used as RN's all the time! I was an LPN for 14 years before going on to get the RN and often did just as much clinically as the RN's I worked with, but I also knew I was working out of my scope.

This excerpt is from the Maine BON, but I'm sure it is the same in all states:

Assessment

The Board determined that the performance of a nursing assessment is a proper function of the registered professional nurse and is NOT within the purview of a practical nurse license. The act of performing a nursing assessment can NOT be delegated by a registered nurse to a licensed practical nurse on the basis of the limitations within the curricula of practical nursing programs. Such curricula do not include the theoretical and clinical preparation necessary for the effective performance of nursing assessments. December 18, 1990

Facilities get around this piece by saying LPN's gather information, rather than assess. I know it seems like semantics, but that's the case.

I know it is frustrating, because you are assessing, just as I did, but as an LPN you always work under the direction of an RN who is ultimately responsible. Even if she /he isn't in the building, such is the case here in LTC facilities with less than a certain number of residents, there has to be one available to consult with.

That's why LPN's can't be exactly compared to RN's, as unlike BSN's and ADN's, their staff nurse job description is a little bit different where responsibility is concerned.

Again, I know the ire this brings. Been there!

mstigerlily · Aug 6, 2005

In one ER I worked in, they hired a new manager. She was an RN,MSN. She had NO clinical experience other than RN school, and we had to teach her drips, how to operate the pumps, etc. She was NOT respected, and left after less than 2 yrs b/c we DIDN'T respect her.

We have an APN at our unit now, I guess that is her title now. Not sure what she does but I do know she has a string of initials after her name: RN, BSN, MSN, NP, CNM, CNE - she uses all these on her lab coat, phone messages, etc. Yet her personality is wooden, her bedside manner poor, her skills questionable and I've yet to figure out what she does all day. Education does not make you a good nurse.

Melissa

ali_gator · Aug 6, 2005

Keep in mind that many BSNs are ADNs with additional education and consequently additional clinical time.I agree that the BSN doesn't necessarily better prepare you clinically, but it does provide a better foundation for management, leadership, nursing theory, research, political involvement, and non-traditional nursing roles. For years our nursing organizations have tried to raise the professional standards for nursing. It isn't just the nursing shortage that serves as a roadblock, but our overall attitudes. Meanwhile other healthcare professions continue to raise their standards (social workers, pharmacists, physical therapists, etc.). As a result, the professional role of the RN is minimized by other disciplines (semi-professionals, if you will).
Another problem: I'm not familiar with every states Nurse Practice Act, but it seems that here in NC that anyone can practice nursing without a license (outside of a hospital setting) except a graduate nurse! The Board of Nursing regulates nurses and doesn't prevent others from practicing our profession as does the Board of Medicine or the Board of Pharmacy. We are not protecting our own profession.
Sorry, I'll get off my soap box. Any comments?

I totally agree with you.

underwatergirl · Aug 6, 2005

Spic,

Perhaps when you went ot school that wasn't in your education...I know alot of LPN's say that...the older ones at least...

That excerpt is from 1990, alot of changes have taken place. Assessments are not out of our scope of practice unless...crictical, no RN present or supervising.

Perhaps if I have time I shall look up my nursing scope of practice. But I know it is left open most of the time to policy's and procedures deamed by a facility.

Also if it was out of the scope of practice...then jhaco would be fining alot of places, LOL

Annette

Dragonfair · Aug 6, 2005

I was a LPN for 18 years and had so much fun with my patients. money was not good. Get this My last wage before being a weekender was 6.66 and hour. now that was awhile ago,but Now all I get is Susan Did you Did you Did you. I have not went to bed yet and it is going on 30 hours cause my brain won't stop. Tylenol PM where are you. I worked 16 hours to help and what did I get. Not even a THANK YOU or KMA. It's ok I get like this once in awhile. Admin. is still safe but who knows HOW long. Oh where are those bargining units

sbic56, BSN, RN · Aug 6, 2005

Spic,
Perhaps when you went ot school that wasn't in your education...I know alot of LPN's say that...the older ones at least...
That excerpt is from 1990, alot of changes have taken place. Assessments are not out of our scope of practice unless...crictical, no RN present or supervising.
Perhaps if I have time I shall look up my nursing scope of practice. But I know it is left open most of the time to policy's and procedures deamed by a facility.
Also if it was out of the scope of practice...then jhaco would be fining alot of places, LOL
Annette

OK. Check it out when you get a minute. And, hey...I'm not that old! :lol2: Seriously, my LPN program taught assessment skills, too! I stick by my words even though I know you are assessing...not just "gathering information." I didn't say I agreed with the scopes, just stating what I know they are.

Dragonfair · Aug 6, 2005

I assessed IMC patients Monitors and did aterial lines as an LPN. I LOVE MY PATIENTS. They make it all worth it with soft touch and Thank You

underwatergirl · Aug 6, 2005

OK. Check it out when you get a minute. And, hey...I'm not that old! Seriously, my LPN program taught assessment skills, too! I stick by my words even though I know you are assessing...not just "gathering information." I didn't say I agreed with the scopes, just stating what I know they are.

Ok here is Iowa's nursing on LPN's and assessments...here is a link to the weNursing Process

Licensed Practical Nurse (LPN)

School Registered Nurse (SRN)

Assessment

Initial assessment outside scope of practice. Performs ongoing health assessment (collects, reports, and records ongoing subjective and objective data in an accurate and timely manner) as specified in the individualized health plan (IHP) and emergency plan (EP). Notifies the SRN of changes in status.

bsite I found this on.... http://www.iowa.gov/educate/ecese/cfcs/hpi/news/shs0305.html

So that states..no initial assessment...however ONGOING ASSESSMENT!!

Here is my current state...Washington....

"WAC 246-840-705 Functions of a licensed practical nurse. A licensed practical nurse is one who has met the requirements of the Washington state Nurse Practice Act, chapter 18.79 RCW. The licensed practical nurse recognizes and is able to meet the basic needs of the client, and gives nursing care under the direction and supervision of the registered nurse or licensed physician to clients in routine nursing situations. In more complex situations the licensed practical nurse functions as an assistant to the registered nurse and carries out selected aspects of the designated nursing regimen.

A routine nursing situation is one that is relatively free of scientific complexity. The clinical and behavioral state of the client is relatively stable and requires abilities based upon a comparatively fixed and limited body of knowledge.

In complex situations, the licensed practical nurse facilitates client care by meeting specific nursing requirements to assist the registered nurse in the performance of nursing care.

The functions of the licensed practical nurse makes practical nursing a distinct occupation within the profession of nursing. The licensed practical nurse has specific roles in nursing in direct relation to the length, scope and depth of his or her formal education and experience. In the basic program of practical nursing education, the emphasis is on direct client care. With additional preparation, through continuing education and practice, the licensed practical nurse prepares to assume progressively more complex nursing responsibilities."

So we can assess, delegate, perform nursing tasks, in routine care basis...report things as needed to the RN

Here is a link to that page... http://www1.leg.wa.gov/documents/wsr/1997/13/97-13-100.htm you have to scroll a ways down...

So in conclusion, as you can see a LPN can and does assess legally with appropriate levels of patients cares/needs. Anything that is too complex or critical should be reported to an RN...that is how most LPN's get in trouble they fail to recoginze or double check there ability to care for patients...I am a freak about that, if I dont' fully understand it I am asking my RN's and my Providers for clarification before I provide care. I hope that clears up the misconception of many states regarding the LPN and role. We all have roles in healthcare from CNA's to RN's with MSN or doctrates...we all have a a place and to make it one degree, one job, would hurt what we are able to do with healthcare. As an RN to be, I ask all RN's out there to please recognize your LPN's capabilities, know their scope of practice, don't hinder them from performing what they are qualified to perform.

Thanks,

Annette

jennifersrexie · Aug 6, 2005

You are comparing apples and oranges when you compare an RN to LVN. LVNs DO NOT do the same things that RNs do and they do not have the same
responsibilities. A large majority of places do not even hire LVNs anymore. We are comparing RN-BSN to RN-ADN, not RN to LVN. I am not bashing LVNs here either, I was one for several years.

I apologize for the misunderstanding-- I was being completely and extremely sarcastic, to prove a point. I am FULLY aware of the difference between an RN and an LPN. (I also know there are no monkeys passing meds.) :)

My point was to highlight how as nurses LPN, ADN, and BSN may perform the same chores/tasks during a certain patient's care (and yes they still do in some places) However, they are performing at 3 different levels. Yes, in some places an LPN can perform nearly the same tasks as an ADN. Should those two nurses recieve equal pay? I used this as an example to explain my position re: the ADN/BSN argument.

By the way, the NCLEX-RN, does NOT prove that anyone is good nurse. There's proof of that in any clinical setting.

sbic56, BSN, RN · Aug 6, 2005

So in conclusion, as you can see a LPN can and does assess legally with appropriate levels of patients cares/needs. Anything that is too complex or critical should be reported to an RN...that is how most LPN's get in trouble they fail to recoginze or double check there ability to care for patients...I am a freak about that, if I dont' fully understand it I am asking my RN's and my Providers for clarification before I provide care. I hope that clears up the misconception of many states regarding the LPN and role. We all have roles in healthcare from CNA's to RN's with MSN or doctrates...we all have a a place and to make it one degree, one job, would hurt what we are able to do with healthcare. As an RN to be, I ask all RN's out there to please recognize your LPN's capabilities, know their scope of practice, don't hinder them from performing what they are qualified to perform.
Thanks,
Annette

I had sent you a PM as I didn't want to derail this thread further.....but, after checking out your post I am going to agree that it is up to interpretation. I see what you posted as indicating that LPN's "gather data" according to their scope and work under the RN licensure, just as it is here, but I can see where you see it differently.