US ADN vs Canadian LPN/RPN

[Daisy_08, BSN, RN]

This came up on another thread. First I am curious to know what the differences are in between the two types of RNs in the US. ADN and BScN i think?

Since the ADN is only two years as is our LPN/RPN program (that is based on the old diploma RN course) what are the differences?

In Canada for the last 15 or so years it is mandatory to have a BN or BScN (preferred) to be an RN. Those already working were encourage to return to school, but most were grandfathered in.

The RPN/LPN program is two years. Where theory, essay writing, ethics, patho, skills, professionalism and nursing care is all part of the curriculum.

Where I live as an RPN I cannot work in oncology and ICU unless they are short staffed, and I cannot give IV meds bellow the drip chamber. I have not run into anything else I cannot do, in my practice setting.

I have worked with a few US RNs who were only approved to work in Canada as LPN/RPNs.

So, does anyone out there know the difference in education and work?

[vintage_RN, BSN, RN]

I am a practical nursing student in Ontario, Canada and am also curious of the difference. From my knowledge, in terms of skill set there isn't anything RPNs can't do besides IV push (and this even depends on the facility). Here the difference is weather a pt has a predictable outcome...the more unstable a pt becomes the increased need to collaborate with the RN. curious to.hear the difference.

[roser13, ASN, RN]

Where I live as an RPN I cannot work in oncology and ICU unless they are short staffed, and I cannot give IV meds bellow the drip.

I don't understand this statement. In the US, your license either allows you to perform a task or function, or it doesn't. Practices vary by state. However, staffing shouldn't (in my opinion) have anything to do with a nurse's scope of practice.

To your specific question, BSN and ASN RN's function in a virtually identical role. There is no distinction between the two scopes of practice in a clinical setting. Both types of graduates take the same national licensing exam. There are a couple of areas (public health comes to mind) that request or require the BSN RN. Pay scales, for the most part, are identical. I have heard of facilities that pay the BSN $0.50 more per hour, but I believe that those are rare.

[Fiona59]

The hospital I work in has only ever permitted ER and ICU RNs to IV push. The logic being if the patient is that unstable they shouldn't be on the general wards. If a push is required on the floor prior to transfer, the ordering resident/MD pushes it.

In my province, PNs are in ICU, ER, NICU and Oncology. We mix and hang all our own IV meds. Blood and Travisol require two nurses to check and hang and for as long as I've worked it's always been done by an RN and an LPN, so there is always verification and signatures and yes, I've actually pierced the bags and hung it with the RN at my side, just as I would have been at his side if he had hung it.

In an ideal world an unstable is not the LPNs patient but I've never had a patient taken over by an RN when they deteriorated. The managers I've worked under all have the opinion that an experienced LPN is of more use than a new grad RN in such a situation.

The question really should be is why are the grandfathered diploma and hospital trained RNs permitted to continue working with this pay grade? The ones who graduated in the '70s and '80s and have only ever upgraded their education via hospital inservices are the most anti-LPN nurses in the building. By now they should have retired but the removal of mandatory retirement in Canada and the fact that the RN unions have negotiated well for their members are the cause. I know of five RNs who have reached the magic 85 combo for retirement with a full pension who continue to work (day rate of over $400/shift) and a couple even collect their CPP. We joke that the taxes they pay must be paying our wages.

What has been forgotten is why the BScN was created in Canada. It was to prepare RNs for management roles while the colleges and hospitals continued to educate nurses. The decision to create an all degree RN workforce is from what I hear from the RNs in my building one of the worst decisions ever. Too many of our new grads don't want to work the acute care floors, LTC's, rehabs, they want to go into management. Several of the RNs on my unit admit that if they had to apply today they would never get to become RNs (85% in two sciences, Grade 12 math, etc is the minimum). They doubt they would be accepted into the PN diploma with it's increased entrance requirements.

What does scare me is that Americans can become a PN in under ten months! How is that remotely possible? I understand that people present differently on the 'net but some of the posts display a poor command of the written language (and I'm not talking text speak) and a general lack of life knowledge that it's scary.

[Daisy_08, BSN, RN]

I don't understand this statement. In the US, your license either allows you to perform a task or function, or it doesn't. Practices vary by state. However, staffing shouldn't (in my opinion) have anything to do with a nurse's scope of practice.

Short staffing does not mean we practice out of our scope, it means we work within our scope in an area where we do not typically work (at least in my hosp - there are differences as Fiona points out)