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They've Gotten Rid of All Their LPNs...

Posted

Specializes in Hospice, Adult Med/Surg.

I am an RN. The largest hospital system in my area just recently decided to get rid of all of their LPNs at all of their facilities--no exceptions, they were all just let go within the past two months, reasoning being that "there is no longer any place for them in the workplace". Besides the fact that I don't agree with this statement or the firing of so many skillful, experienced nurses who added so much to the patient care, I don't understand something else about this: it hasn't resulted in any new RN positions. Even this system's largest hospital only has less than ten open RN positions listed on their website. To my way of thinking, each patient needs a nurse. Since LPNs were allowed to take patients with the RN overseeing them, an RN and an LPN would together have a team of 11-13 patients on a typical inpatient Med/Surg unit. If all of the LPNs are suddenly gone and no new RNs are hired, who picks up the slack? That same RN can't just take all 11-13 patients by herself, and according to this hospital system's staffing policy, that would never happen, as non-critical care nurses are only allowed 5-7 patients apiece, max. Any thoughts? I just feel terrible for the LPNs who were let go. I have known LPNs in my career who were much better nurses than a lot of RNs that I have worked with.

PAERRN20

Specializes in ER. Has 3 years experience.

The same thing has happened where I work. Except they realized they really do need the LVN/LPNs to care for patients and hired them back. You might be surprised- they might hire them back. For their sake I hope they do!

DogWmn

Specializes in LTC Family Practice.

Interesting that there is another thread about LPN's being disrespected right now. I am an LPN and I'm PROUD to be an LPN. Many hospitals have gotten rid of LPN's, I'm not sure I understand their reasoning behind it. I'd love to hear from someone who is in management who thinks it's more cost effective to have all RN's.

I must say when I read PAERRN20 post I did a little chuckle behind the hand.

I'd love to see LPN's and RN's unite and value each type of nurse for the skills they bring to the table.

I recently got my license re-instated by taking online CE's, all the CE's I took were for RN/LPN's, I was taking the same CE's required for both.

There will always be a place for LPN's, maybe not in a hospital setting so much which I think is sad, since we are both supposed to be there for the patient.

When I graduated eons ago, all the hospitals I worked in were ALLNURSES - in other words LPN's and RN's no aids or techs, and I'll say the quality of care the patient got was quite good.

iluvdetroit

Specializes in Hospice, Adult Med/Surg.

Because, with no disrespect intended towards CNAs (I was one myself once upon a time), when you have all nurse staffing, the patient is always going to be strictly in the care of someone who was trained in A&P, nursing practice, physical assessments, and general nursing knowledge. The care would have to be better. The bottom line however...well, that's a different story, and we all know just how important that bottom line is...:o

Midwest4me

Specializes in A myriad of specialties.

because, with no disrespect intended towards cnas (i was one myself once upon a time), when you have all nurse staffing, the patient is always going to be strictly in the care of someone who was trained in a&p, nursing practice, physical assessments, and general nursing knowledge. the care would have to be better. the bottom line however...well, that's a different story, and we all know just how important that bottom line is...:o

you echoed my sentiments which i elaboratd on in the thread about disrespect for lpns. so glad to hear(read) another supportive view of how care would be better if it was provided solely by nurses. i'm not trying to bash cnas or cmas--i, too, once was a cna--but the wealth of knowledge that all of us nurses bring to the bedside should account for something and be recognized!!!!!

Edited by Midwest4me
misspelling

ohmeowzer RN, RN

Specializes in ob/gyn med /surg.

yes they fired all the LPN's where i work and hired new grad RN's .. pretty sad feel like it's a great loss for the hospital ...oh and they just let the CNA's go , they gave us less patients... they have had no trouble staffing all RN's because of all the new grads looking for jobs.. my manager said she had 25 applications for RN's alone...

OldnurseRN

Specializes in ED, Med-Surg, Psych, Oncology, Hospice. Has 30 years experience.

I understand the reasoning with all nurse cares but is it really possible to meet all the needs and to go beyond? There is no CNA on my 12-hour shift. The problem is that our population is elderly and alot of them are swing beds from larger hospitals here for skilled care. when discharged they go home or to a nursing home. When you are passing meds, doing assessments, covering ED, charting etc. and these people want the commode the every hour or two, position changes, or just on their call lights it would be nice to have unlicensed help. I have no problem with any of these tasks but everyone doesn't get 100% plus from me. I can't magically make time appear in order to get these done. I actually left nursing for 7 years for these very reasons and here we are back at that same place. It's a shame.

NewTexasRN

Specializes in Ortho and Tele med/surg.

You have to look at the big picture. It was a purely business decision. They are thinking that if they get rid of all the LPN's, think about how much money they can save? I mean they still have the same amount of nurses and nursing assistants doing the same job.

iluvdetroit

Specializes in Hospice, Adult Med/Surg.

You have to look at the big picture. It was a purely business decision. They are thinking that if they get rid of all the LPN's, think about how much money they can save? I mean they still have the same amount of nurses and nursing assistants doing the same job.

And that goes back to my original question: Since each patient has to be assigned to a nurse, why isn't there suddenly a huge need for RNs to replace the LPNs who got laid off? A CNA can't take a patient assignment, at least not in terms of passing meds, physician communication, IV starts, etc. so if an acute care nursing unit had, for example, this staffing before letting the LPNs go: 48 beds=four RN/LPN teams of 12 patients each=4 LPNs and 4 RNs, then shouldn't their staffing after letting the LPNs go still require eight nurses, only now it would be eight RNs? You can't leave a patient only covered by a CNA, and you can't safely (or probably legally) give an RN twelve patients, so who is making up the disparity in the patient assignments with the LPNs gone? The way that our RN/LPN teams always worked was that the RN was ultimately responsible for all twelve patients, but the LPN passed meds, did most treatments, and gave bedside care to at least half of them. So now is it set up that the RN has to do meds, treatment, assessments, and all nursing care for all twelve patients with the exception of unlicensed care such as taking patients to the bathroom, feeding them, etc? If so, that isn't even right. Who would want to be an RN under those working conditions? And how safe is it for the patients to have their nurse spread that thin?

nerdtonurse?, BSN, RN

Specializes in ICU, Telemetry.

I'm a LPN, working on the RN because I've seen the handwriting on the wall; I'm just hoping the powers that be don't kick us out before I finish in May.

Have I learned ONE THING in school that I didn't already know? Nope. I was looking forward to more Patho, more of the "this will keep your patient alive" kind of information. Not getting it. Getting lots of questions on how to handle different cultures. That's important, no doubt, but CHF and COPD and ESRD will kill you via the same mechanisms whether you're a Buddist or a Brahman or a Baptist. And it's not the teacher's fault, it's whoever's coming up with the curriculum. Man, I'd love to have a "sister, can we talk about the real world" discussion with THEM.

They said that next semester we may have "3 or 4 patients." Half the time when we were in Med-Surg, we had to double up on patients because we didn't have enough "student level" patients. So how are we going to get 3 or 4 when last semester we often couldn't manage 1 a piece? And besides...3 or 4? Give me a break. Try 9. When you're also having to take a turn being secretary and telemetry tech and your CNAs are too busy smoking to do the job (most of ours are great, but there's one who I can never find, and all I have to do is smell her to know what she's been doing when she does show back up -- but she's the boss's snitch, so no point complaining).

They spend so much time focusing on "leadership" in this and most of the schools around here that they seem to have forgotten that the first word in "nurse leader" is NURSE. Thank GOD I was an LPN first, because otherwise I'd be a scarily unprepared RN.

To iluvdetroit:

Same thing here just outside of Flint. (HMMM...wonder if it is the same health system?) They fired all the LPNs and there were no more RNs added. They did however, hire several CNAs. Of course, we never had a LPN or a CNA.

I'd give anything for an extra pair of hands to help turn and lift. Trying to find another nurse who can leave their patients to help you clean up a patient who has soiled their bed and dressings can be nearly impossible some days. Get a couple patients with c-diff and you are in big trouble.

I hear the nurses on the floor are having a very difficult time absorbing all the LPNs tasks into the RNs usual busy day. But hey, they just passed out a big do and don't list... so buck up...put a big smile on your face and work, work, work OR ELSE. (Oh, and forget about lunch or going to the bathroom... just put a smile on your face and deliver "an excellent patient experience".

Nurses all over are going to have to unite and start showing the public what the "business" end of healthcare is doing to their health care. I think all the veeps need to post their income including all those bonuses that they get as they try to screw the public out of good health care.

iluvdetroit

Specializes in Hospice, Adult Med/Surg.

To iluvdetroit:

Same thing here just outside of Flint. (HMMM...wonder if it is the same health system?) They fired all the LPNs and there were no more RNs added. They did however, hire several CNAs. Of course, we never had a LPN or a CNA.

I'd give anything for an extra pair of hands to help turn and lift. Trying to find another nurse who can leave their patients to help you clean up a patient who has soiled their bed and dressings can be nearly impossible some days. Get a couple patients with c-diff and you are in big trouble.

I hear the nurses on the floor are having a very difficult time absorbing all the LPNs tasks into the RNs usual busy day. But hey, they just passed out a big do and don't list... so buck up...put a big smile on your face and work, work, work OR ELSE. (Oh, and forget about lunch or going to the bathroom... just put a smile on your face and deliver "an excellent patient experience".

Nurses all over are going to have to unite and start showing the public what the "business" end of healthcare is doing to their health care. I think all the veeps need to post their income including all those bonuses that they get as they try to screw the public out of good health care.

Amen!! But no, it's not the same health system, as the system I am talking about only has a few small facilities in Michigan, with all of their big facilities in Ohio. Do you know what else they are doing? Phasing out the unit secretaries! Holy cow! What would we do without unit secretaries? So now it's getting to the point where RNs (and the same number of RNs as before, apparently) are going to be doing ALL of the nursing care AND all of their admission paperwork, processing orders, etc.? What is seriously up with this???? I had an interview with this particular healthcare system this past week and I am anxiously awaiting a call, one way or the other. Sadly, at this point, I don't know if I want the job anymore or not, even though we could really use the money. I am not looking forward to doing the work that three or four people used to do...and we were really busy then, so what must it be like now? Ughh...:eek:

Amen!! But no, it's not the same health system, as the system I am talking about only has a few small facilities in Michigan, with all of their big facilities in Ohio. Do you know what else they are doing? Phasing out the unit secretaries! Holy cow! What would we do without unit secretaries? So now it's getting to the point where RNs (and the same number of RNs as before, apparently) are going to be doing ALL of the nursing care AND all of their admission paperwork, processing orders, etc.? What is seriously up with this???? I had an interview with this particular healthcare system this past week and I am anxiously awaiting a call, one way or the other. Sadly, at this point, I don't know if I want the job anymore or not, even though we could really use the money. I am not looking forward to doing the work that three or four people used to do...and we were really busy then, so what must it be like now? Ughh...:eek:

Does anyone ask the "geniuses", who come up with these nit wit ideas, what THEY ARE GIVING UP FOR THE SAKE 0F THE ALMIGHTY BUDGET?? Why is patient care taking the cuts and not the dead weight who contribute NOTHING TO PATIENT CARE?? I see a grand oppurtunity for a Letter to the Editor signed by all of the nuirsing staff. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

linzz

Specializes in Geriatrics, Med-Surg..

I love your posts, lindarn. They are like a breath of fresh air. You are so right that money is the bottom line. My father is a Chartered Accountant and I can tell you for certain that money is the absolute main concern.

I wonder if the next step will be to reduce the RN's to the absolute minimum that they can get away with. With the remaining nurses that are left there, they will be run ragged and patient care will suffer and the inevitable outcome of poor care will soon be obvious.

Edited by linzz

iluvdetroit

Specializes in Hospice, Adult Med/Surg.

I love your posts, lindarn. They are like a breath of fresh air. You are so right that money is the bottom line. My father is a Chartered Accountant and I can tell you for certain that money is the absolute main concern.

I wonder if the next step will be to reduce the RN's to the absolute minimum that they can get away with. With the remaining nurses that are left there, they will be run ragged and patient care will suffer and the inevitable outcome of poor care will soon be obvious.

One outcome of which will be RNs getting sued because we are taking on too much responsibility which sets us up for making preventable mistakes because we are stretched too thin. This could be the beginning of a really ugly period in the nursing profession.

yes they fired all the LPN's where i work and hired new grad RN's .. pretty sad feel like it's a great loss for the hospital ...oh and they just let the CNA's go , they gave us less patients... they have had no trouble staffing all RN's because of all the new grads looking for jobs.. my manager said she had 25 applications for RN's alone...

Don't know whether to think this is a good outcome for new grad RNs or a poor outcome for LPNs and CNAs who were let go, not to mention the patients who are the recipients of the consequences.

iluvdetroit

Specializes in Hospice, Adult Med/Surg.

Don't know whether to think this is a good outcome for new grad RNs or a poor outcome for LPNs and CNAs who were let go, not to mention the patients who are the recipients of the consequences.

Exactly. As a new grad many years ago, I remember learning a ton from the long term LPNs on my unit. They were beyond competent and really helped me, as a brand new nurse with no experience, to get my bearings. I can't imagine having to start out without nurses like that on the unit.

When it comes to not having a job, whether just let go, fired, or not able to find a job, I don't know if it makes a difference if one is a CNA, LPN, or RN. Unemployed is unemployed. There are some fantastic stories about what transpired at a facility that laid off workers that I used to work at. One of the better stories was the nurse manager chasing about five newly hired, and newly quit, CNAs into the parking lot when they left at assignment time in the morning. For some strange reason they had no desire to take care of 20 or more residents. The nurse manager threatened to report their certificates to the state and they kept on walking to their cars. You can only make people work in environments that are unsafe to the extent they are willing to take the abuse. After that, they will refuse and then, like in this case, you have the haggard RNs trying to pass breakfast trays at the same time they are doing their AM med pass.