The title "NURSE"

MQ Edna · Oct 31, 2005

An LPN/LVN is just as much a nurse as an RN, hence Licensed Vocational NURSE. You betcha LVN's call themselves nurses! CNA's cannot.

Hello all,
I had a debate with my brother, who is a 4th year med. student about the title nurse.
My wife, who has her BSN and is Registered Nurse in the State of Georgia, obviously has earned the title "nurse". I'm not going to get into the details of the debate, but my question is. Can LPN's or CNA's call themselves "NURSES"? I am under the assumption that they cannot. Please correct me if I am wrong. I understand the clinical differences between an LPN and an RN, and in no way am I discrediting an LPN, that is not my debate! Thank you!
Omega!

LoriAlabamaRN · Oct 31, 2005

An LPN is most definately a nurse. Just look at the title- Licensed Practical NURSE. Your wife has earned the right to call herself an RN BSN, but an LPN or an ADN is no less of a nurse. CNAs are certified nurse assistants (and legally are not considered to be nurses, no more than a legal assistant can be called a lawyer...) although I have INCREDIBLE CNAs and could not do my job without them. I put myself through nursing school working as a CNA, and I mean them absolutely no disrespect.

I hope this helps!

Lori

omega17632 · Oct 31, 2005

ok, now lets take the everyday practical use out of it...what about legally?

I understand the titel LPN/LVN, but can they LEGALLY call themselves that?

lady_jezebel · Oct 31, 2005

ok, now lets take the everyday practical use out of it...what about legally?
I understand the titel LPN/LVN, but can they LEGALLY call themselves that?

"Nurse" is not a protected title. "Registered Nurse" and "Licensed Practical (or Vocational) Nurse" are legally protected, and require licensure from the state in which the nurse practices.

mtorado27 · Oct 31, 2005

ok, now lets take the everyday practical use out of it...what about legally?
I understand the titel LPN/LVN, but can they LEGALLY call themselves that?

YES of course they can call themselves nurses. Why wouldn't they be able to? That's what they are.

caroladybelle, BSN, RN · Oct 31, 2005

Actually (per what I was taught in Florida in 1993 - very specifically), in some states, LPNs/LVNs are not classed as "Nurses" per the BON. The term practical (or presumable vocational) must be included in all descriptions of them.

Recently, buried among the vast number of LPN vs CNA vs RN threads on this BB, several posters did reference Nursing Practice Acts, that clearly described that the Title of "Nurse" as including RNs, but not LPNs.

I say this, not because I dislike LPNs nor do I wish to minimize their accomplishments. But I do know that in some areas, they are not considered "Nurses", in the legallydefined sense.

As to what concern it is of a medical student, I do not know. Some of them still think of us as handmaidens that are under their control, cannot figure out what our scope of practice is, and rarely bother to employ anything higher than an MA because they are too cheap to employ "any" nurse.

WindwardOahuRN, RN · Oct 31, 2005

Actually (per what I was taught in Florida in 1993 - very specifically), in some states, LPNs/LVNs are not classed as "Nurses" per the BON. The term practical (or presumable vocational) must be included in all descriptions of them.
Recently, buried among the vast number of LPN vs CNA vs RN threads on this BB, several posters did reference Nursing Practice Acts, that clearly described that the Title of "Nurse" as including RNs, but not LPNs.
I say this, not because I dislike LPNs nor do I wish to minimize their accomplishments. But I do know that in some areas, they are not considered "Nurses", in the legallydefined sense.
As to what concern it is of a medical student, I do not know. Some of them still think of us as handmaidens that are under their control, cannot figure out what our scope of practice is, and rarely bother to employ anything higher than an MA because they are too cheap to employ "any" nurse.

As far as I know, there is no uniform "Nurse Practice Act." Did those references specifically exclude LPN/LVN's, or just fail to mention them?

Definitions of "scope of practice" are different as applied to RN's or LPN/LVN's.

Registered Nurses and Licensed Practical Nurses aka Licensed Vocational Nurses are all, indeed, NURSES. Their scope of practice varies, sometimes according to the facility in which they are employed.

LPN/LVN's are nurses. They are licensed as such. If BON's are disputing such a title, they should then abolish the title of "nurse" as applied to LPN/LVN's and dream up something else.

But I do agree with your assessment of many physicians' opinions of us, be it of RN's of LPN's.

Thunderwolf, MSN, RN · Oct 31, 2005

oh my goodness, what a can of worms.

each state bon in conjunction with its state legislature defines "legally" what a nurse is and what the "scope of practice" is for "each level" of nursing.

currently, there are three tiers/levels of nursing practice, which are determined by each state for it's own population. the needs of each state may differ, which may determine some of the differences seen in each level of practice.

first level

--------------

licensed practical or vocational nursing

licensure: lpn or lvn depending upon which completed

practice is under supervision of the rn

not an independent license

second level

------------------

registered nursing

licensure: rn, regardless if from an adn, diploma, or bsn program

independent license, not required to be under direct supervision

can also obtain additional certification in a specific area of nursing

third level

------------

advanced practice nursing

licensure: nurse practitioner, clinical nurse specialist, nurse anesthetist, or nurse midwife depending upon focus of study (masters degree in area of study)

independent, yet (as defined by that state) may be under the supervision or in collaboration with a physician that the nurse works with...the nurse is part of that physician's team of practitioners...does much of the same work...makes rounds, writes orders, writes prescriptions (in some states), assesses, treats, and bills for service. it is illegal for lpns/lvns/rns to hold themselves out as advanced practice nurses if they do not hold this additional nursing licensure.

all are nurses, just levels of training and scopes of practice are different...

which again are determined by each state with its own state legislature.

the "license" is the state's legal recognition that that provider of care is a nurse.

in most, if not all states, it is a "protected" title. protected means that no one else can hold them self out as a "nurse". it would be illegal. the similarity here to the medical field is that a person can not hold them self out as a "doctor (of medicine)" without it...just as illegal.

medical assistants, patient care assistants, medical techs, medication techs/assistants, orderlies, nursing aides, nursing assistants, or nursing techs are not nurses for this very reason. most hold "certificates" or may be "certified" after some "technical school" training, but they "do not hold a license of nursing". some of the above may not have even that, but are given a title after a short period of training in their health care facility...consider it like ojt. they are not nurses, and it would be illegal if they should ever refer to themselves as such. in saying this, there is absolutely no disrespect in any way to this level of health care provider. they provide a valued level of service. however, the topic is "practice and legalities". again, each state and bon will define their role and the level of service. they work under the direct supervision of "licensed" personnel.

this is my understanding.

i hope this helps.

thunderwolf

__________________

Tweety, BSN, RN · Oct 31, 2005

Below are definitions from the Florida Nurse Practice Act.

I find it hard to believe that if a professional license says the word "Nurse" in it like "Licenesed Practice Nurse" that in Florida such a person can't legally say they are a nurse.

"Registered nurse" means any person licensed in this state to practice professional nursing.

"Licensed practical nurse" means any person licensed in this state to practice practical nursing.

"Advanced registered nurse practitioner" means any person licensed in this state to practice professional nursing and certified in advanced or specialized nursing practice.

"Certified nursing assistant" means a person who meets the qualifications specified in this part and who is certified by the board as a certified nursing assistant.

DusktilDawn · Oct 31, 2005

The actual title "nurse" is a legal title protected under law:

Title Protection for Registered Nurses -- Examples from State Nurse Practice Acts

http://www.nursingworld.org/gova/titlepro.htm

I wish I could have found a similar documentation as easily in regards to LPNs/LVNs, however if you search your state in regards to the State Nurse Practice Act for example:

From Arizona Only a person who holds a valid and current license to practice as a licensed practical nurse in this state or in a party state as defined in section 32-1668 may use the title "nurse", "licensed practical nurse", "practical nurse" or the abbreviation "L.P.N."

Only a person who holds a valid and current license to practice professional nursing in this state or in a party state pursuant to section 32-1668 may use the title "nurse", "registered nurse", "graduate nurse" or "professional nurse" or the abbreviation "R.N.".

You may come across wording like this. Alot of states have this type of wording in regards to the title "nurse."

From Florida

No person shall practice or advertise as, or assume the title of, registered nurse, licensed practical nurse, or advanced registered nurse practitioner or use the abbreviation "R.N.," "L.P.N.," or "A.R.N.P." or take any other action that would lead the public to believe that person was certified as such or is performing nursing services pursuant to the exception set forth in s. 464.022(8), unless that person is licensed or certified to practice as such.

Each state BON in conjunction with its State Legislature defines "legally" what a NURSE is and what the "scope of practice" is for "each level" of Nursing.
Currently, there are THREE tiers/levels of nursing practice, which are determined by EACH state for it's own population. The needs of EACH state may differ, which may determine some of the differences seen in each level of practice.
First level
--------------
Licensed Practical or Vocational Nursing
Licensure: LPN or LVN depending upon which completed
Practice is under supervision of the RN
Not an Independent License
Second Level
------------------
Registered Nursing
Licensure: RN, regardless if from an ADN, Diploma, or BSN program
Independent License, not required to be under Direct Supervision
Can also obtain additional certification in a specific area of nursing
Third Level
------------
Advanced Practice Nursing
Licensure: Nurse Practitioner, Clinical Nurse Specialist, Nurse Anesthetist, or Nurse Midwife depending upon focus of study (Masters Degree in area of study)
Independent, yet (as defined by that state) may be under the supervision or in collaboration with a physician that the nurse works with...the nurse is PART of that physician's team of practitioners...does much of the same work...makes rounds, writes orders, writes prescriptions (in some states), assesses, treats, and bills for service. It is illegal for LPNs/LVNs/RNs to hold themselves out as Advanced Practice Nurses if they do NOT hold this additional Nursing Licensure.
All are NURSES, just levels of training and scopes of practice are different...
which again are determined by each state with its own state legislature.
The "License" is the state's legal recognition that that provider of care is a NURSE.
In most, if not all states, it is a "Protected" title. Protected means that no one else can hold them self out as a "Nurse". It would be illegal. The similarity here to the Medical field is that a person can not hold them self out as a "Doctor (of Medicine)" without it...just as illegal.
Medical Assistants, Patient Care Assistants, Medical Techs, Medication Techs/Assistants, Orderlies, Nursing Aides, Nursing Assistants, or Nursing Techs are NOT nurses for this very reason. Most hold "Certificates" or may be "Certified" after some "technical school" training, but they "do not hold a License of Nursing". Some of the above may not have even that, but are given a title after a short period of training in their health care facility...consider it like OJT. They are NOT nurses, and it would be illegal if they should ever refer to themselves as such. In saying this, there is absolutely no disrespect in any way to this level of health care provider. They provide a valued level of service. However, the topic is "practice and legalities". Again, each state and BON will define their role and the level of service. They work under the direct supervision of "Licensed" personnel.
This is my understanding.
I hope this helps.
Thunderwolf

I think this explains it very well.

HONEYBEAR · Oct 31, 2005

oh my goodness, what a can of worms.
each state bon in conjunction with its state legislature defines "legally" what a nurse is and what the "scope of practice" is for "each level" of nursing.
currently, there are three tiers/levels of nursing practice, which are determined by each state for it's own population. the needs of each state may differ, which may determine some of the differences seen in each level of practice.
first level
--------------
licensed practical or vocational nursing
licensure: lpn or lvn depending upon which completed
practice is under supervision of the rn
not an independent license
second level
------------------
registered nursing
licensure: rn, regardless if from an adn, diploma, or bsn program
independent license, not required to be under direct supervision
can also obtain additional certification in a specific area of nursing
third level
------------
advanced practice nursing
licensure: nurse practitioner, clinical nurse specialist, nurse anesthetist, or nurse midwife depending upon focus of study (masters degree in area of study)
independent, yet (as defined by that state) may be under the supervision or in collaboration with a physician that the nurse works with...the nurse is part of that physician's team of practitioners...does much of the same work...makes rounds, writes orders, writes prescriptions (in some states), assesses, treats, and bills for service. it is illegal for lpns/lvns/rns to hold themselves out as advanced practice nurses if they do not hold this additional nursing licensure.
all are nurses, just levels of training and scopes of practice are different...
which again are determined by each state with its own state legislature.
the "license" is the state's legal recognition that that provider of care is a nurse.
in most, if not all states, it is a "protected" title. protected means that no one else can hold them self out as a "nurse". it would be illegal. the similarity here to the medical field is that a person can not hold them self out as a "doctor (of medicine)" without it...just as illegal.
medical assistants, patient care assistants, medical techs, medication techs/assistants, orderlies, nursing aides, nursing assistants, or nursing techs are not nurses for this very reason. most hold "certificates" or may be "certified" after some "technical school" training, but they "do not hold a license of nursing". some of the above may not have even that, but are given a title after a short period of training in their health care facility...consider it like ojt. they are not nurses, and it would be illegal if they should ever refer to themselves as such. in saying this, there is absolutely no disrespect in any way to this level of health care provider. they provide a valued level of service. however, the topic is "practice and legalities". again, each state and bon will define their role and the level of service. they work under the direct supervision of "licensed" personnel.
this is my understanding.
i hope this helps.
thunderwolf
__________________

amen!!!!! thank you....i can see this thread already upsetting many people.