Trying to understand difference between LPN and RN practice....

kbm318 · Apr 9, 2010

I'm in nursing school right now and this is what we just learned.

RN's can do:

admission assessment

IV medications

Blood products (transfusions)

care plans

client teaching

unstable clients

acute diseases

LPN's can do:

vital signs

uncomplicated skills

stable clients

chronic diseases

oral, IM, subq medications

sterile procedures

foley catheters

PO meds through PEG tubes

they CANT do IVs

so thats all I know of maybe this will help

NotFlo · Apr 9, 2010

I'm in nursing school right now and this is what we just learned.
RN's can do:
admission assessment
IV medications
Blood products (transfusions)
care plans
client teaching
unstable clients
acute diseases
LPN's can do:
vital signs
uncomplicated skills
stable clients
chronic diseases
oral, IM, subq medications
sterile procedures
foley catheters
PO meds through PEG tubes
they CANT do IVs
so thats all I know of maybe this will help

What state are you in? I can't think of any state where this list could possible all be true.

I'm in CT. LPNS most certainly CAN do IVs. I can't do IV pushes or blood products, but I can hang IV meds and fluids to any type of line, including central lines/PICCs etc. We can flush and maintain central lines as well. I work in a facility where we can't do IV pushes or hang blood products in the facility anyway (rehab) and the protocol is always to call the IV nurse for IV starts so no one in the facility, RN or LPN, ever starts IVs.

My unit manager is an LPN. All the unit managers in the buliding are LPNs. They do all the care plans for the entire facility.

I work subacute and we deal with acute illnesses and unstable patients on a daily basis. I also do patient teaching every.single.day I work. I think it's hard to interact with patients without doing any teaching.

I do admission assessments...the RN supervisor signs it without ever laying eyes on the patient (I'm not saying this is a good idea...I can't imagine signing off on something I didn't see/hear with my own eyes but it seems to be standard operating procedure around here).

We can certainly write verbal and telephone orders and take off any order. If LPNs couldn't do that I think the facility would grind to a halt...

In my facility when it comes to floor nurses there really isn't any difference between what the RNs do and what the LPNs do. If I have a fall or acute change in condition It'll be the house supervisor who will come and sign my incident report/assessment of the situation, not another floor nurse who happens to be an RN. If a floor RN has a fall or acute change she also needs to call the house supervisor.

Honestly although I'm interested in getting more actue care experience I would never work in a hospital because I can't imagine working under all those restraints and having to run and bug an RN for every IV push and even to take a verbal order. I like to work as independantly as possible under my license and I would hate to have to do that all the time. It seems like more of a hassle to the RNs than a help, anyway.

I can totally understand RNs making more money even if their job description is the same, like it is in my facility. They have more education. I would be lying though if sometimes the sheer HUGE amount more (like 12/hr more at my facilty) doesn't irk sometimes (really just irked at myself for not becoming an RN) but it is what it is.

Angel0411 · Apr 9, 2010

I agree with the first poster. It's really because the hospitals can pay what they want. At my school there is a one semester difference between an LPN and an RN if you go through their LPN program...not too much of a difference in terms of education.

Baloney Amputation, BSN, LPN, RN · Apr 9, 2010

In Iowa, LPNs don't can't do anything with IVs unless they've had a separate course for IV certification. Some states are silly like this...

allnurses Guide · Apr 9, 2010

I've been wondering about this lately...
Just from reading on here, I've become aware of some of the differences between LPNs and RNs. Some of the things I've read were pushing IV meds and a few other things I can't recall them. But it doesn't seem like there is a whole lot of difference between the pn and rn. Am I wrong? Please fill me in...
I am not a nurse. I've applied to an LPN program...hoping & praying I get in.
Here's my question to the nurses- If there aren't THAT many differences between the 2, why is there such a difference in pay?
And if I am wrong, please inform me....
Thanks so much everyone:)

That is a great question, lovesunsets-- and you've perceived this is a touchy subject, as are some others here that tend to get emotions boiling. The thing is that there is no one answer to or set of answers to that question when it comes to what tasks or procedures LPNs do vs RNs, and what the pay rates are relative to each other. If you browse the boards for a while, you will note that sometimes an LPN is actually paid more than an RN. Factors that influence this are region, experience level, and type of facility. For example an LVN or LPN often works as the Charge Nurse in an LTC facility and may make more than an entry level RN at a large acute care hospital.

The higher pay rates for RNs are reflective of the longer length of time training for that position. What does the RN have that makes the extra education worth the extra pay? It isn't task related, because honestly most procedures can be taught to LPNs. The education for an RN adds depth, scope and breadth to that basic task-oriented model, with the goal of being able to perform more complex assessments, detailed patient education, management tracks and delegating ability. Some RNs even divide that up and feel that the BSN should be the minimum requirement for an RN, and the reasoning is the same as the LPN vs RN argument.

It would probably be a good idea to narrow down your region and desired ultimate job responsibilities and take a focussed look at that. When I started LPNs worked everywhere, did everything except IVs. Then our hospital trained an IV team, composed of LPNs! Some places do not allow LPNs to perform assessments or patient education, but in my job I must do both.

The way I look at all of this anyway, is that- you don't stop learning when you get your diploma or your CE requirement. All of us are always learning, which is one of the cool things about nursing IMO. If your goal is to someday specialize or aspire to nursing management or education, you'll need to get your BSN, but the opportunities these days to bridge your LPN to a more advanced degree are becoming more numerous by the day. Best wishes!! :nurse:

**NickiLaughs, ADN, BSN, RN** · Apr 9, 2010

I was an LVN, and am now an RN. I believe most of the other posters gave excellent information. The more education you have, the more money you make (typically)

As they said, LVN scope will vary greatly state to state. The biggie between LVN and RN seems to be IV medication. The only thing I could do after becoming IV certified as an LVN, was hang IV fluid such as normal saline, or blood, and flush IV's. No medications!

I will probably get slammed, but I honestly, was completely disappointed in my RN program, because I thought I was going to learn all this new information, just leadership crap really. I will say that I really overstudied in my LVN program, I spent many extra hours with extra textbooks reviewing information because I was scared of making mistakes on the job later. I think it over-prepared me. My RN program, was a breeze. But the difference between my LVN and my RN? Well, you get a diploma with your LVN, and a Associate's Degree (at minimum) with your RN.

Now I'm going for my BSN. Why? Because I can make an extra 5% at my job, and more career opportunities. Any big differences between an RN and a BSN, not really. Except now I will have a Public Health Certificate.

I guess the difference is the more education, even if it seems repetitive sometimes, will bank you more bucks.

cherrybreeze, ADN, RN · Apr 9, 2010

It really must vary from state-to-state. The only thing LPN's can do with IV's here is hang fluids (as in changing a bag) and a very limited number of IV antibiotics. No blood and NO central lines (they can't even hang fluids on central line access). No assessments. RN's do the patient education and discharge teaching, etc.

Making matters worse, the care model where I work has changed. LPN's function as CNA's now, for the most part. It was that, or lay them off.

Even in areas that assign LPN's a specific patient assignment (our inpatient rehab does that, the rest of the floors do not), an RN does the head-to-toe assessment.

kcochrane · Apr 9, 2010

As others have pointed out, it depends on the state and the facility. LPNs and RNs do have different scopes of practice and you need to check your BON to see what they are.

For example, this is NYS:

The practice of the profession of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual or potential health problems through such services as casefinding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being, and executing medical regimens prescribed by a licensed physician, dentist or other licensed health care provider legally authorized under this title and in accordance with the commissioner's regulations. A nursing regimen shall be consistent with and shall not vary any existing medical regimen.
The practice of nursing as a licensed practical nurse is defined as performing tasks and responsibilities within the framework of casefinding, health teaching, health counseling, and provision of supportive and restorative care under the direction of a registered professional nurse or licensed physician, dentist or other licensed health care provider legally authorized under this title and in accordance with the commissioner's regulations.

LPNs are not allowed to assess, but can collect data. LPNs cannot teach unless a plan has been set up by a RN. In my facility LPNs have to have all their orders cosigned by a RN, cannot start a solution through a PICC or central line, but can monitor it, have to have thier discharges signed off by a RN, etc. LPNs can start IVs once they are certified.

I was a LPN and now am a RN. There is a difference and it has taken me awhile to adjust to that. :)

DaFreak71 · Apr 9, 2010

I live in Washington (right across the border from Oregon). I was 2.5 months shy of graduating as a RN and my better half got an amazing job offer at a hospital here...so we left the South.

Washington let me sit for the NCLEX-PN, passed it, no jobs. CNA's, with a bit more education, can pass meds so LPN's are essentially the "middle guy"--and the middle guy gets cut out lol. Just stretch those RN's a bit more and use CNA's and from a pure profit standpoint, it makes sense to kick LPN's to the curb.

I figured hey...no big deal. I'll just endorse over into Oregon and get a job as a LPN (they still use them). Oregon BON informed me I had to have graduated from a LPN program in order to have a Oregon license. I explained my situation and was told that I'm out of luck. She was super nice about it, even encouraged me to apply and appeal (with attorney) to see if a new precedent could be set lol.

I actually just have to laugh at my own situation because it's so pathetic. Educated as a RN, AM a LPN, would have been better off as CNA with regard to job prospects. It's so funny because I would actually have to go through a CNA program to take a CNA job. Being a LPN doesn't "trump" the CNA certificate.

Oh well...it is what it is. I told my husband "I'm doing in nursing in reverse". Maybe someday when I'm a NP, I'll go get my GED. :lol2:

Cheers!!

P_RN, ADN, RN · Apr 9, 2010

The National Council of State Boards of Nursing used to have the duties in a table form. I can't find it right now. I know I was astounded when a floater from Texas hung blood, cause LPNs in SC are not allowed that privilege.

88888888888888888888888888888888888888888888888888

http://bhpr.hrsa.gov/healthworkforce/reports/lpn/lpn6_C.htm

I should have made note that the table is waaaaay down at the bottom of that screen.

This is not what I was looking for but it is quite similar

Up2nogood RN, RN · Apr 9, 2010

:lol2:

I live in Washington (right across the border from Oregon). I was 2.5 months shy of graduating as a RN and my better half got an amazing job offer at a hospital here...so we left the South.
Washington let me sit for the NCLEX-PN, passed it, no jobs. CNA's, with a bit more education, can pass meds so LPN's are essentially the "middle guy"--and the middle guy gets cut out lol. Just stretch those RN's a bit more and use CNA's and from a pure profit standpoint, it makes sense to kick LPN's to the curb.
I figured hey...no big deal. I'll just endorse over into Oregon and get a job as a LPN (they still use them). Oregon BON informed me I had to have graduated from a LPN program in order to have a Oregon license. I explained my situation and was told that I'm out of luck. She was super nice about it, even encouraged me to apply and appeal (with attorney) to see if a new precedent could be set lol.
I actually just have to laugh at my own situation because it's so pathetic. Educated as a RN, AM a LPN, would have been better off as CNA with regard to job prospects. It's so funny because I would actually have to go through a CNA program to take a CNA job. Being a LPN doesn't "trump" the CNA certificate.
Oh well...it is what it is. I told my husband "I'm doing in nursing in reverse". Maybe someday when I'm a NP, I'll go get my GED.

Can any of your RN credits transfer? Try Clark in Vancouver, they have programs starting 3x year and they do LPN-RN bridge. There aren't really any LPN opportunities here in Oregon (Portland metro) except LTC. Hospitals aren't hiring them anymore except maybe their MD offices. There are Soooo many LPN and RN programs here that competition is real fierce and hospitals aren't hiring new grads like they were. Plenty of jobs for experienced nurses though. I do know that a home care agency for peds uses LPN's in WA, try PSA if you really are anxious to get your feet wet. Oh and try Salmon Creek in Vancouver, sometimes they have openings for LPN's in clinics. It's Legacy Health System so if you got in there you could always transfer within. Good luck, any ??'s and you can PM me.

kcochrane · Apr 9, 2010

I live in Washington (right across the border from Oregon). I was 2.5 months shy of graduating as a RN and my better half got an amazing job offer at a hospital here...so we left the South.
Washington let me sit for the NCLEX-PN, passed it, no jobs. CNA's, with a bit more education, can pass meds so LPN's are essentially the "middle guy"--and the middle guy gets cut out lol. Just stretch those RN's a bit more and use CNA's and from a pure profit standpoint, it makes sense to kick LPN's to the curb.
I figured hey...no big deal. I'll just endorse over into Oregon and get a job as a LPN (they still use them). Oregon BON informed me I had to have graduated from a LPN program in order to have a Oregon license. I explained my situation and was told that I'm out of luck. She was super nice about it, even encouraged me to apply and appeal (with attorney) to see if a new precedent could be set lol.
I actually just have to laugh at my own situation because it's so pathetic. Educated as a RN, AM a LPN, would have been better off as CNA with regard to job prospects. It's so funny because I would actually have to go through a CNA program to take a CNA job. Being a LPN doesn't "trump" the CNA certificate.
Oh well...it is what it is. I told my husband "I'm doing in nursing in reverse". Maybe someday when I'm a NP, I'll go get my GED.
Cheers!!

Since you did more the 50% of the RN program, you could finish with Excelsior.

Your problem is a new issue with many states now. Most states allowed you to sit for your LPN boards after a certain number of RN semesters - but no longer. Sorry you got caught in that. I think NYS (where I live) changed it in 2007.