Stressed ER LPN

Esme12, ASN, BSN, RN · May 12, 2012

I am sorry your feel frustrated. LPNs used to have a much larger role that they do now.....which is sad as I have always felt they were a huge asset. Your practice is not just limited by policy but it is limited by state law and nurse practice acts. These laws were enacted and accepted by evidence based practice...which task is best/safest carried by which license and level of schooling that is required for this task. Nurses are trying to remove associate degree nurses from the scope of RN practice so one would see that the LPN entry level education would be phased out as well.

This argument has gone on since I was a baby nurse and it hasn't happened yet. There are bad PhD prepared nurses as well as bad LPN nurses. You can't fix stupid. But I am also believe that nurses should be paid by education and license. I am sure the LPN that starts great IV's can because they are a paramedic. while a valued member of your team you are limited by your license and what you are legally allowed to do.

Before you lobby on the benefits of LPNs remember it is the RN's who are lobbying to limit their practice. It isn't prudent to hire anyone if they legally can't do the job. Go to your state's nurse practice act and see where you limitations are in your practice. it's a legal thing not just hospital policy and Acute care facilities are regulated differently than LTC facilities.

When I graduated nursing school I learned everything from the LPN I worked with I owe her great thanks.

Good Luck In school

RCBR · May 12, 2012

I hear you libran1984. You have my sympathy. I am an SN, graduating with a BSN in few months. I work as a tech at an acute care unit. We have 24 RNs and 2 LPNs on our floor. I have worked with them all and I will tell you: if I were admitted to my unit as a patient, I would INSIST on the LPNs being assigned to my care. They have a wealth of experience and knowledge; they are caring, humble, competent and the safest and hardest working nurses I have ever seen. On the other hand, I see these newly minted RNs showing off their BSN titles on their badges who are absolutely useless on a hospital floor. They don't know how to turn a patient, have no clue how to safely transfer them and think that cleaning patients is beneath them. All I have to do is look at my university colleagues. I see how they work during clinicals and I AM SCARED TO DEATH TO THINK THAT IN A FEW MONTHS THEY WILL HAVE A BSN AND BE TAKING CARE OF PATIENTS. It is really unfortunate that these people get rewarded with much higher pay to the detriment of people like you. But the reality that the USA is a very degree/education conscious country. At the end of the day, is the RN and BSN designation that counts. You can vent and get exasperated about it and hope it will change but it will not. It will only get worse. Look at all the nursing schools opening left and right in the country, most of them offering BSNs. With only an LPN degree, you are going to be way behind. The future, it appears, will be a BSN to get an RN license. For LPNs, the best is to accept this reality and get on with that LPN-RN bridge program and then an RN-BSN program. Getting that ADN or BSN is not that difficult, but requires discipline and sacrifice. Good luck to you libran1984.

Autymn · May 12, 2012

RCBR - wow, I so appreciate your commentary to the op. Very helpful for all of us.

I have my suspicions that there are a myriad of outstanding LPN's out there - both experience-wise and bedside-manner who choose not to go on with studying for the RN partially because they want to continue being able to do the level of patient care they do as an LPN. While they know there are more specialty and other avenues open to RN's, some do NOT want to deal with the hassle/extraordinary risk of being responsible for other employees - ESPECIALLY in light of the very thing you explained in your post.

Whether it be young grad's attitudes, or an older new grad; the fact is a good many know exactly how to safely undertake turning a patient and/or other tasks such as that. They don't want to be bothered or take shortcuts or push that off on the CNA's etc instead of helping when they easily could. If you are the senior RN responsible for either LPN's, CNA's or even orienting other RN's - your license is on the line for those 'under' you. Everyone who once decided they wanted to become an RN, did not once decide they wanted to be responsible for other employees whom they know do not perform. Teamwork aside -- there are those who are proficient, who have plenty of potential to become RN's, but the run-over-each-other-on-the-way-to-the-err..not 'top' but rather just daily competency, seems littered by those who will not 'help' anyone any more than they are made to. :sniff:

Same mentality in other professions - yes. But we are talking about our nursing profession.

So, deciding to become an RN can be a difficult decision. In fact - just posts here and anecdotal information from within my family and friends who are in the profession would highly suggest that the additional 'management' responsibilities as well as the further or additional administrative/documentation that an RN has to handle may make some miserable.

I like and respect so many nurses, but feel slightly sad about the difference between what the occupation used to stand for, the differences between what school is like and the actual daily shift one faces after getting out into the 'real' world. Glad there at least at this point, are still many GREAT LPN's who are out there excelling as part of our healthcare workforce.

HazelLPN, LPN · May 18, 2012

I am a retired LPN and worked most of my career in critical care nursing. I had a broad scope of practice and there was little for my RN charge nurse to do for me except check blood with me before I gave it. What was in my scope was MY license, not the RNs. The RNs license was on the line when she/he had to cover what was outside of my scope. It is simply mistaken that the RN must follow the LPN around checking for mistakes or risk loosing her nursing credentials. The RN is responsible for covering what is outside of the LPN scope of practice and for knowing what that LPN scope of practice is. Depending on the state or facility, this could be next to nothing (like it was in my case) or it could place a huge burden on the RN if LPN scope is restricted.

I would advise all young people interested in nursing to get their BSN immediately out of high school because it will give them the most options, but remind them it will not make them a better nurse than the 30 year veteran LPN or diploma educated RN they work alongside.

Many LPNs who work in acute care have many years experience. It is unfortunate when they are forced aside and hospitals use poorly designed and biased research that they call "scientific" to get rid of the LPNs. I would love to see a study on veteran LPN mistakes vs inexperienced BSN mistakes. You will NEVER see this study, because LPNs don't do research. They take care of patients. MSN and PhD students do the research and it is against the professional interest of any RN to suggest that LPNs are anything but mindless automatons incapable of any critical thinking and constantly putting the RNs license in jeopardy. Then there would be danger that RNs could lose their positions and be replaced by cheaper LPNs so the CEO could make even more money. I've read some pretty pathetic "research" done by graduate students against LPNs, the worst of which sited an "undocumented case" of a veteran LPN killing an unstable neonate because she didn't check critical lab values. I'm sorry, but to site an "undocumeted case" is nothing more than chasing phantoms.

I think that LPNs who work in acute care should be grandfathered and respected for their years of service and dedication. I think their practice should be expanded to minimize the burded on RNs, and they should be phased out by attrition. Hire no more, but allow the ones to remain and finish their careers with dignity. LPNs and diploma RNs may not have a degree, but a degree is NOT the same thing as an education. Ideality and reality are two different things.

Mrs H.

tothepointeLVN, LVN · May 18, 2012

$14 are you serious?

I keep on getting calls to staff up at one of the hospitals in this area though my agency. Now I'm not safe (in my opinion) to take shifts there because the last time I was in the hospital was as a student nurse. This is the facility that was talked about a while back on AN for the RN's having a candlelight vigil to get rid of LVN's. So now they just spend more for them by getting them from an agency since they promised they wouldn't hire more. A lot of the attitude comes down to job security. At least what I do no they don't want RN's for the position. Too expensive when the LVN can do the job.

I wonder if all this hubbub would exist if the title were Nurse Level 1 or Nurse Level 2 or 6/8RN and FullRN

Fiona59 · May 19, 2012

Having had suffered through several bouts of Kidney Stones, let me tell you that when my pain increases my breathing becomes irregular and rapid. I'd want somebody to notice.

But back to the topic under question. Are you in a union facility? Have you approached your stewards to see if they know anything?

I agree with the title thing. I think the "registered" and "licensed practical" designations need to go. Go by a numbering system. On my unit, I can't be Charge. That's it. And a wage difference of $10/hr.