Some thoughts on the whole LVN vs. RN thing ...

[Sheri257]

I've always read about tension between RN's and LVN's on this board but I never experienced it until now. I'm an RN in a new job where there are a lot of LVN's and due to various circumstances, I was put to work quickly (although not with LVN's yet) and didn't get around to orientation until now.

Anyway, for part of the orientation, LVN's and RN's were put together so, naturally when people were introducing themselves, people were constantly asking if you were an RN or LVN. So ... I didn't think much about it when I asked one of the LVN's if one of the speakers was a supervisor or an RN or LVN.

Then, later on, when we were informed about a meeting, I asked if I needed to attend since my understanding was that it was for LVN's only, not RN's. I had a lot of work to do and thought I would use the time for that instead.

This LVN snapped at me and said: "You need to get over this class thing because we're all nurses here." I was stunned ... all I wanted to know was if I had to attend this meeting or not (and, as it turns out, it was an LVN only meeting).

During orientation we were going over medication administration procedures and I had a few questions, but another LVN informed me that I didn't need to learn it because "the LVN's do most of the work and RN's don't do anything but paperwork around here." Of course it was absurd to suggest that I don't need to learn the facility's medication protocols.

It seems the problem is that the RN's do make a lot more money than the LVN's at this facility ... and I certainly overheard a lot of griping about that. But it's not like we set the pay rates.

Anyway ... this whole thing got me wondering about all those threads I've read where LVN's complain about RN's insulting them. I'm sure these LVN's feel that way about me but I'm certain that I did nothing of the kind.

I thought maybe it was just me but other RN's also mentioned that they got similar comments from the LVN's. I'm starting to wonder if they're going to resent us no matter what we say or do.

I just think the whole thing is kinda sad ... I have utmost respect for LVN's. We haven't even had a chance to work with each other ... yet, it seems, the war has already begun.

:typing

[BerryHappy]

Wow, it's great to hear that angle. I am a LPN in school and I sometimes get that impression too! RN's don't want to bother with LPN's, and the LPN's feel as the RN's are bossy and snobs. Don't forget about the LPN vs. CNA discourse too! Jeez, kinda like a caste system!

Here are the matchups:

BSN vs. ASN

RN vs. LPN

LPN vs. CNA

Really ridiculous isn't it? Can't we all just get along????

[Aggie RN, ADN]

I have the upmost respect for LVN's. I've worked with some that are just hands down better nurses than I probably ever will be.

Having said that, I think the divison of the licensure between RNs and LVNs is a cancer to the profession.

It would be nice if someday in the future we only had RNs coming from four year pograms. Then we would have one less thing to complain about and divide the profession.

And for full disclosure, I myself graduated from an ADN program, but I do plan on continuing my education.

[TazziRN, RN]

Yes, the job descriptions are different, but it's a shame that there is such emphasis placed on the differences in the licenses otherwise, because each is important. We are a team.

[RNsRWe, ASN, RN]

You know, it's interesting to me to read this thread, as the OP's experience has been alot like mine! NONE of the RNs I work with slam the LPNs but it seems to be open season for the LPNs to dig in at the RNs. Of course that's a broad statement, but honestly it's accurate.

We don't have many LPNs on our unit at all, but the ones we do have seem to make a point of commenting on how much money the new RNs make (new grads make a pile of money more than the experienced LPNs) and the "class system" comment. Even though WE don't do that. Probably because one comment like that would get our heads handed to us, LOL!

Anyway, I don't say much on it because I *DO* make a pile of money more than any of them, and am comfortable in my role. I don't have anything to prove, but maybe some of them DO feel like they have to prove (or keep proving?). I don't know.

We have these nifty red and white buttons we wear, stating RN or LPN, and that opened it up again. The RNs didn't really care (other than to think the buttons were unnecessary). The LPNs fumed that it should just say "nurse", that it was demeaning. And no one BUT the LPNs made any issue at all. Personally, I don't see why it's demeaning: it's ACCURATE; it tells the pt who is taking care of them. It's not like it says "real nurse" and "sorta nurse"!!

I think we've got some awesome LPNs and some awful ones. Just like the RNs. Shame the title gets in the way so much.

[TheCommuter, BSN, RN]

I'm an LVN, and I feel absolutely no jealousy or resentment toward my coworkers who have their RN licenses. In fact, I am pleased that they have earned the title, and hope to earn the same license in the near future. Since I have full awareness that they earn more money than me for doing a very similar job, it makes me want to attain more education so that I can be on that same pay scale.

[RNsRWe, ASN, RN]

TC: I'd be happy to work with you :)

[PickyRN]

Ok, let me start by saying that I started in this field as a non-licensed nurses' aide. Then I became a CNA. Then I became an LPN. Then I became an RN. BSN looms. So I have experience at every level of nursing (except for senior management).

1. As a CNA, I saw nurses who made comments like, "oh, you're just an aide." Like a CNA is worth less as a human being than a nurse. I also knew nurses who valued my opinion and showed a real spirit of teamwork. I loved working with those nurses.

2. As a LPN, I saw RN's that were snooty towards me because I was "just an LPN", and others that were indifferent ("we're all nurses"). But I ALSO saw CNA's and medication aides who seemed to resent my license. They were rude and disrespectful, not because of who I was or what I was asking them to do, but because I was in charge of them. There was one woman who had been a medication aide at this nursing home for years. I started working there, and she felt like she didn't have to listen to me because I was new (or whatever).

3. As an RN, I have worked with LPN's who didn't have any problem, and LPN's who were very "bristly" about the whole thing. Especially if you refer to LPN's in any way as "not as good as" or "less than" an RN.

When I make comments like that, I am usually referring to staffing numbers (on our floor, an RN can have 3-5 patients by themselves, an LPN and RN team can have 6-7) or policies and procedures (there are certain things that LPN's are not allowed to do that RN's are). Do I think LPN's are not as smart as RN's? no. Do I think they are not as gifted, committed, kind, knowledgable, etc? No. But I think we need to recognize that there is a reason for the distinction. RN's have more education, are responsible not only for themselves but for their entire team, and they are "in charge" of LPN's by virtue of the way the system is set up (LPN's by definition legally must be "supervised" by an RN).

On the one hand, RN's should not be cocky and oppressive with their position. On the other hand, LPN's should not act bitter and all "victim-y" (is that a word?), taking offense at every imagined slight. As another poster already said, "Can't we all just get along?"

[TheCommuter, BSN, RN]

On the other hand, LPN's should not act bitter and all "victim-y" (is that a word?), taking offense at every imagined slight.

Victimized? Now, that's a word!

[coleandgavinmom]

How about EVERYONE try this one for a change...... Instead of assuming someone is compentent or not based on the letters after their name... CNA, CMA, LPN, LVN, ASN, BSN, MSN, NP etc... how about instead we decide if they are competent or not based on their performance. Having a nursing license of ANY type doesn't make you competent. All it means is you've passed a test, it says nothing for how well you put that knowledge to use in a real world setting. I've seen people from every category make HUGE mistakes, I've seen them all goof up. I've seen them all act unprofessional. I've seen them all be a disgrace to their chosen profession. I"ve also seen them all be highly skilled, knowledgeable, compassionate, professional and incredibly resourceful to their coworkers, both with licenses "above" and "below" theirs.

I've been an LPN for 6 years, I'm in nursing school to get my RN. I'm sick and tired of being asked if I'm a "nurse" or an "LPN". I'm sick and tired of people assuming I automatically know less than my RN counterparts.

. However my duties include taking orders, hanging IV meds/drips, IV push meds, placing NG tubes foleys, CBI's, PIVs, managing PICC and central lines,blood draws,full head to toe assessments, monitoring patients with chest tubes, changing and maintaining VAC dressings, stage IV wound care,bedside peritineal dialysis, managing patients who are weaning from ventilators etc... you name it! I take care of patitents who have multisystem failures and require long term ACUTE care. I am ACLS certified, and have been for 5 years. I am telemetry certified. I have been a preceptor to new hires, RN and LPN alike. I am an excellent NURSE, not because I know everything, far from it. But I continually strive for excellence. I stop and ask why, when I don't know why. I use nurses around me as resources, and I serve as a resource to them. I know my limits, and get help when I'm not sure or just plain don't know. I don't allow others to do for me, I ask them to help me understand, in turn I assist them whenever possible. Most nurses I work with don't even know I'm an LPN till they find out by accident at some point long after they've met me. I'm not trying to brag I'm just pointing out titles don't mean ANYTHING. I work with plently of LPN's who don't know lateral from medial sides, let alone interpreting blood gas values to determine if a pt is respiratory or metabolic acidosis etc... however I"ve worked with plenty of RN's who don't the difference either. When are we going to stop with the superiority complex. LPNS- many of us are just as guilty. Many of us criticize the CNA's for being "just an aide" etc.... I face discrimination all the time. BUT by being a hard worker, a determined worker,a competent worker, and a nurse who always tries to learn more, learn why, understand the rationales etc... I've earned the respect of a LOT of nurses. Nurses who typically don't like LPN's will at least give me the credit I have coming. If you want to be treated differently, don't just demand respect EARN IT. Don't act like a LPN, or a RN. Act like a NURSE. A medical professional who has an obligation to provide their patents with the best care possible. You might not be able to change someones mind. Many people are just ignorant and their is nothing we can do about that! WHATEVER YOUR TITLE, whether your a long term care, home health, hospital, ICU, MD's office etc... step back and ask yourself why am I so bent on being critical of this person "below" me on this license ladder. Ask yourself what has this individual done to show me they are incapable of practicing safely and competently within their scope of practice? If you don't know the answer, it may be that their just isn't one and it's time you try to make the place you work the best it can be for the patients. It starts by supporting each other in your various roles and recognizing the value of each!

[sonnyluv]

No one is better than anyone else. And competence is comptence BUT there is a reason why RN's got to school for a year or more than LVN. If you feel inferior (which LVN's are not) then gert your RN. If an RN feels inferior to a Doc then get your MD. Otherwise, take good care of your patients, have strong boundaries, act professional and deal with it.

[ss07]

Excellently expressed. Thank you.