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?
I had only worked 2 cases with psa and both were good families so guess I was lucky there. I'm with the other major health system in Portland and was there as a CNA for 10 years and got my RN before the hiring freeze, whew. Both companies are good IMHO and some of our surgeons work at both systems.
The CPNE isn't too difficult, I passed it without having any hospital clinicals. It's more nerve wracking than anything!
I'm so glad that you're with a great company! It's nice to have that feeling of security in these troublesome times. Congrats to you for passing the CPNE! I know you must have been VERY relieved Glad your patients from PSA were good...I wish that yours was a more common experience!
I agree. If I had relied on my nursing program to provide me with ALL the education I needed to understand nursing, I would not be very smart. This is NOT because my program was academically faulty, it's because no program in any discipline can teach you everything. It's like education plus experience isn't enough...you have to desire more knowledge and that can only come from within. A thirst for knowledge...ya know?
Even if each of the states did not have differing rules on scope of practice, looking at the role of RN or LPN through a task based lens is myopic. I did not know this until quite recently, but was surprised to learn that LPN programs do not teach nursing diagnoses. I image that one of the bigger challenges for a LPN going through a RN program is not the physical tasks, but the learning of a "new language". It's just a different approach to learning.
It isn't enough to care. It isn't enough to be intelligent. It isn't enough to have good technical skills or enough to have excellent communication skills. It's the integration of all the above PLUS an open mind to learn more...always. This is true of every person in every profession. My clinical skills are not as good as the average LPN, despite going through all but 2.5 months of a RN program. And I've seen LPN's and even CNA's who's thirst for knowledge outshines many RN's I've encountered. It's the person that counts, not the title. In my opinion!
The LPN program I attended DID in fact teach nursing diagnoses. We were even taught how to do care plans. They taught us this with the thought that many of us would go on to RN school eventually. We didnt get REAL in depth on care plans like RN students do, but nursing diagnoses was something that was drilled into us. I think it all depends on the school and the state in which you are attending.
The LPN program I attended DID in fact teach nursing diagnoses. We were even taught how to do care plans. They taught us this with the thought that many of us would go on to RN school eventually. We didnt get REAL in depth on care plans like RN students do, but nursing diagnoses was something that was drilled into us. I think it all depends on the school and the state in which you are attending.
We also had nursing dx/care plans drilled into our heads in my LPN program, and were expected to write a full careplan each week in clinical for our patients.
I work in a Canadian hospital I am an RN and we have a mix of RNs and RPN's (registered practical nurses-equivelant to LPN in the states I thinkj). The RPN's pretty much do the same job for less pay but they don't have university degrees and paid less for school. They have their own pt assignment, but are partnered with an RN to relieve each other for breaks and help each other, give meds, assessments,etc. but don't do central lines, hang blood, push meds, and they are not supposed to have pt's who are critical. Having said that, some of the RPN's have been nursing longer than I have and thus have more experience. Just yesterday, an RPN was saying that she thought a GI bleed was too critical for her. Yes, he did get 8 units of blood in the unit and does have a central line but he is now stable and a DNR and her RN partner could flush the central lines for her. Although I love the floor I work on and virtually everyone I work with, there is a line be drawn between the RN's and the RPN's because the RPN's complain a lot about heavy assignments. One RPN complained because she knew when she was in next that she would have a heavy assignment: isolations, and an obese, isolated pt with dressings pretty much from head to toe. She says, that assignment is too heavy, an RN should have it. Another RPN said she didn't want to learn vac dressings because then she would have to do them. She just gets her RN partner to do them. Then I overheard her say to another RPN that "the RN's make more money so they should get the heavier assignments". I may have had an extra year of school but that pretty much means I can write a better paper, I did not get more clinical training-I think RN's probably get LESS training. There are many RPN's that I hang out with outside of work but I am tired of hearing about how they are always trying to get the RN's to take the heavy assignments. We were all hired for the same job. Period.
CathyLew, you are absolutely right- we should get paid more because we take on more responsibility. That's why docs get more-more schooling, more responsibility. Like duh!!!!
in our hospital, the LPN can not do an assessment on a patient. They can take down factual information. Height wt, vita signs, medications. But they can not assess a patient or create a nursing diagnosis or plan of care.
LPN's can pas medications, but can not give IV push meds, can not give the first dose of an antibiotic. They can not run a code. they can not take a verbal order from an MD. they can transcribe orders, but the order must be verified or checked by an RN before it can be carried out.
The LPN's can not hang anything on a central line or PICC line. They can not discontinue a central, picc or arterial line. they can not hang Blood.
I hear all the time at our hospital, the LPN's complaining that they do the brunt of the work, and get the least pay....but when the **** hits the fan, its the RN's ass that is hanging in most cases. the RN oversees the LPN in the professional hospital setting at hour hospital. Even when an LPN messes up, the RN's name also goes on the incident report.
I agree. If I had relied on my nursing program to provide me with ALL the education I needed to understand nursing, I would not be very smart. This is NOT because my program was academically faulty, it's because no program in any discipline can teach you everything. It's like education plus experience isn't enough...you have to desire more knowledge and that can only come from within. A thirst for knowledge...ya know?
Even if each of the states did not have differing rules on scope of practice, looking at the role of RN or LPN through a task based lens is myopic. I did not know this until quite recently, but was surprised to learn that LPN programs do not teach nursing diagnoses. I image that one of the bigger challenges for a LPN going through a RN program is not the physical tasks, but the learning of a "new language". It's just a different approach to learning.
It isn't enough to care. It isn't enough to be intelligent. It isn't enough to have good technical skills or enough to have excellent communication skills. It's the integration of all the above PLUS an open mind to learn more...always. This is true of every person in every profession. My clinical skills are not as good as the average LPN, despite going through all but 2.5 months of a RN program. And I've seen LPN's and even CNA's who's thirst for knowledge outshines many RN's I've encountered. It's the person that counts, not the title. In my opinion!
Interestingly enough, when I was working as an LPN in an LTC I was the only nurse, RN or otherwise, comfortable with IV's. I was flushing piccs and hanging IV ABT with 2 RN's watching me. Only because I had recent experience and they hadn't done it in quite some time.
I am an LVN in California/ I work in Acute care on a surgical floor. I work independently with my own group of 5 patients, but the Charge Nurse, who is an RN always, covers me for the IV stuff I cannot do. In California I can hang blood transfusions and blood products. I CANNOT do and Initial assessment, I cannot hang IV meds, I cannot do IV pushes. I AM allowed to flush a peripheral IV site with saline, but nothing else. I am IV therapy and Blood withdrawal certified, something we do in California. So I can withdrawal blood, start and maintain IV sites and hang maintenance bags of fluid and eletrolytes. I cannot hang medications such as antibiotics etc. Anything piggy back the RN does for me.
If I had it to do over, I might have gone straight to RN, however this is the route that worked best for me at the time. I was a CNA for 4 years and then graduated and passed my LVN boards. I am currently in a BSN bridge program working on my RN. I am told that a BSN does NOT make anymore pay than an ADN at my facility.
I AM allowed to note my own orders, co-sign boluses and syringe changes on PCA's. Also within our scope, hospital policy and procedure can dictate what the LVN can do as well. FOr instance according to my scope and since I am IV certififed, the state of california says I can hang potassium up to 40meq, but our hospital policy says I cannot administer potassium protocol.
All in all, I love being a nurse, but I am going for my RN. It will just be easier, and more pay. Right now as an LVN I am making 26.50. As an RN it will be a jump.
I also think things differ by state. I am in California (I am an LVN) and I can take a physicians order and I can note my own orders and do my own chart checks. I am also held accountable for my own actions. Yes, the RN covers my IV pushes and IV piggy backs. But I am given my own assignment of 5 patients. (I work in acute care) I cannot hang ANY antibiotics IV, no meds. Just maintenance IV's. I cannot do anything with central lines or PICC's other than change the PICC dressing. I CAN hange blood, but again I am in California and I am IV therapy and blood withdrawal certified. and I NEVER complain to the RN';s about doing the brunt of the work. We all work equally hard. I help out when needed, just as they help me. We work as a team. Truthfully, we do. Maybe it is because the Charge tends to cover me? I make a list of my piggy backs and pushes.
As for the S**T hitting the fan, when things go wrong in my hospital, it's the one person who is in charge of the patients care who gets it, and if that happens to be me, the LVN, the RN does not get in trouble. I can say this with confidence because I was recently written up for something, and the RN covering me did not get put on the incident report!
One was that I gave a pt with a blood sugar of 68, apple juice (her request) and she was fine. But per the MD he wanted her to have an amp of D50. When I told the charge RN (supposedly the RN covering me) that the pt was 68 she said "did you give juice" told her I was giving some now. Later in report I noticed the MD order for D50 under 80. Well by then the patient was fine. I tokld Charge RN that I should have given D50 (Which I cannot give because its IV push) and she said "Well too late now" But I got written up for violating the hospital's emergency hypoglycemic protocol.
Second write up was the day I came back to work after a 4 month medical leave of absence. I was ON orientation working directly under an RN. I acknowledged a medication wrong (Pharmacy had input it wrong) Initially I was told I only acknowledged the order, later in my write up I was told I had given it. According to the Union, I can't be written up for something while orienting under the RN. The RN never got talked to about this either.
That being said, I don[t want the RN to get talked to, It was my mistake. Not hers. So again, different facilities, different policies.
Being an LVN is not so bad ;-) But I am working on my RN :-)
in our hospital, the LPN can not do an assessment on a patient. They can take down factual information. Height wt, vita signs, medications. But they can not assess a patient or create a nursing diagnosis or plan of care.
LPN's can pas medications, but can not give IV push meds, can not give the first dose of an antibiotic. They can not run a code. they can not take a verbal order from an MD. they can transcribe orders, but the order must be verified or checked by an RN before it can be carried out.
The LPN's can not hang anything on a central line or PICC line. They can not discontinue a central, picc or arterial line. they can not hang Blood.
I hear all the time at our hospital, the LPN's complaining that they do the brunt of the work, and get the least pay....but when the **** hits the fan, its the RN's ass that is hanging in most cases. the RN oversees the LPN in the professional hospital setting at hour hospital. Even when an LPN messes up, the RN's name also goes on the incident report.
Discussing the fact that you have more education and therefore deserve more pay by using the phrases "Like duh" and "TRUE DAT!" completely undermines the point you're trying to make.
Specializes in Mother-Baby, Rehab, Hospice, Memory Care.
This discussion could go on forever about what an LPN/LVN can or cannot do compared to an RN. The reality is, the LPN/LVN scope of practice varies from state to state. Thus affecting how LPN/LVNs in those states are utilized. I am fortunate to live in a state (Texas) that has a fairly wide open scope of practice for LVNs. Much of our scope of practice is determined by the individual employer.
For instance I work at 2 hospitals. At hospital #1 the LVNs do their own assessments but the chart has to be signed by an RN at least every 24 hours and the RN must do the admission assessment, we do everything the same with IVs/PICCs/CVLs except IV push meds and spiking the bag of blood. At hospital #2 the only difference is the intial assessment and the RN signature that he/she reviewed the chart. LVNs give all the same IV meds including IVP and hang blood there. We do learn and practice nursing care plans in school.
In general LPNs/LVNs are considered bedside nurses caring for patients with predictable outcomes. The difference in pay comes from the education and the scope of practice. RNs are held accountable for a higher scope of practice.
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
Yeah, What state are you in? I am in California and I CAN do IV's, BUT I had to pay for and go to a class to become IV therapy and BLood withdrawal certified.
DaFreak71
601 Posts
I'm so glad that you're with a great company! It's nice to have that feeling of security in these troublesome times. Congrats to you for passing the CPNE! I know you must have been VERY relieved
Glad your patients from PSA were good...I wish that yours was a more common experience!