People used to ask me why I "settled" and went to a vocational school to become an LPN, instead of going to a traditional college and becoming a "real nurse." I always had a list of potential answers running through my mind when that happened:
✔️ I do the exact same thing an RN does at my job with absolutely no variation.
✔️ I train both new grad RN's and BSN's, and have discovered that in my field, experience and competence are more valuable than the initials at the end of my name.
✔️ I work with babies, which is pretty damn cool (turns out I like them better than many adults).
✔️ I have an incredibly flexible schedule that allows me to continue my education.
✔️ The pay is much, much better than when I was the drive-thru girl at Taco Bell.
✔️ I took on 11 months of school and no debt to make sure nursing was what I wanted, rather than 2-3 years and a boatload of loans.
✔️ This Microbiology test isn't hard. My six-month old vent-dependent patient went into respiratory distress last night, and I guided them through it. That was tough. I eat micro exams for breakfast!
✔️ Vocational school helped me develop study/homework skills, so that when I entered traditional college, I got easy A's.
✔️ In Honors classes revolving around theory, I could speak about practical application in real life situations.
✔️ When scholarship time rolled around, I wasn't simply a student who wished to change the world. I was already actively changing the world.
So many students apply to awards because of who they want to be, whereas I could apply because of who I already am. When I had to write numerous essays, personal statements, and narratives about myself and my future dreams, I had so many compelling stories to tell about my job as an LPN. When asked about community service, volunteer work, or past experience performing good deeds for others, I got the opportunity to explain how such things weren't simply extracurriculars to me, but rather an integral part of my day to day life as an LPN.
Those people who used to ask me why I "settled" and went to a vocational school to become an LPN, instead of going to a traditional college and becoming a "real nurse?" These days, I don't need to tell them anything. Because I was awarded $124,500 dollars to complete my bachelor's degree, and $200,000 dollars for any graduate school I choose. Not because I was a traditional student (I came from one of those schools, a vocational school for people who weren't "good enough" for regular college). Not because I did well in high school (I dropped out at 15). Not because I was cookie cutter (I've got a dirty mouth, a sarcastic streak a mile wide, and I wear jeans and red converse to business casual events). Not because I had special advantages (as an older student, I had to fight for every opportunity, knock on many doors, and annoy professors into letting me take on special projects). I received all of this because of my work as an LPN and the way it made me stand out among other students when I transitioned back into traditional college.
So don't let anyone tell you this is a road for people who "settle" or don't have what it takes to hack it at a "real" college. You have no idea where an LPN license will lead you, or the impact you will have on the world because of it.
Directly from the New York State Office of the Professions as it relates to Registered Nurses versus Licensed Practical Nurses:
"Section 6902 of Article 139 of the Education Law distinguishes between the legal definitions of RNs and LPNs as follows:
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.
This definition authorizes Registered Professional Nurses to execute medical orders from select authorized health care providers. In addition, Registered Nurses may function independently in providing nursing care in such areas as:
Casefinding, including but not limited to:
â—¦Identification of epidemiological trends
â—¦Client abuse assessment
â—¦Early identification of emergent complications
•Health Teaching, including but not limited to:
â—¦Patient teaching re: signs and symptoms of medication side effects
â—¦Patient teaching regarding disease process (heart disease, cancer) and management in relation to life factors such as culture and ethnicity
â—¦Health care promotion, such as disease prevention, accident prevention, and teaching normal child growth and development
•Health Counseling, including but not limited to:
â—¦Mental health counseling
â—¦Addiction counseling
â—¦Health counseling related to management of chronic diseases such as Alzheimer's, Parkinson's, Bi-Polar and Diabetes
•Care Restorative of Life and Well Being, including but not limited to:
â—¦Rehabilitation services such as bowel/bladder training, ostomy/wound care
â—¦Triage and continuous assessment for early identification of signs and symptoms of post operative complications with timely intervention
â—¦Ongoing surveillance and nursing intervention to rescue chronically ill persons from development of negative effects and secondary results of treatment
•Care Supportive of Life and Well Being, including but not limited to:
â—¦Hospice and palliative care
â—¦Chronic pain management through non-pharmacological nursing measures such as ergo dynamic techniques, relaxation, imagery, therapeutic touch, and rational-emotive therapy (RET)
â—¦Public health care including elder care, well-baby care, school and industrial nursing.
Nursing diagnosis by an RN is cited in section 6901 of Article 139 of the Education Law as: the identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen. Such diagnostic privilege is distinct from a medical diagnosis. Nursing diagnosis has been additionally interpreted by the Department as including patient assessment, that is, the collection and interpretation of patient clinical data, the development of nursing care goals and the subsequent establishment of a nursing care plan.
Section 6902, cited above, does not include nursing diagnosis within the scope of practice of Licensed Practical Nurses. Thus, Licensed Practical Nurses in New York State do not have assessment privileges; they may not interpret patient clinical data or act independently on such data; they may not triage; they may not create, initiate, or alter nursing care goals or establish nursing care plans. Licensed Practical Nurses function by law in a dependent role at the direction of the RN or other select authorized health care providers. Under such direction, Licensed Practical Nurses may administer medications, provide nursing treatments, and gather patient measurements, signs, and symptoms that can be used by the RN in making decisions about the nursing care of specific patients. However, they may not function independent of direction.
The scopes of practice of RNs and LPNs are not interchangeable. Inappropriate use of LPNs may expose agencies to potential litigation, the delegating RN to a potential charge of unprofessional conduct for inappropriate delegation of professional responsibilities [see Regent Rules 29.1(b)(10)], and the LPN to a charge of acting outside the scope of nursing as a Licensed Practical Nurse [see Regents Rules 29.1(b)(9)]."
TL; DR: The scope of practices are different; RNs and LPNs are not interchangeable. LPNs who blur the lines of their roles may be subject to litigation. Period.
Let's remember that each state has their own scope of practice for LPNs and RNs. What may be true in one state will not be true in another. Here is my state, there are two things I cannot do. That is anything with IVs (can DC though) and Initial Admission Assessments. We do assessments after that admission one. In fact we, along with the RNS are always assessing. We also learn the critical thinking. In my state, after you work a certain number of hours, you can become certified in IV therapy and treatments.
From what I understand from the OP, in her LTC, there is no difference between what the LPNs and RNs do. That is due to the nature of the acuity of the need of the residents as well as what the LTC is certified to care for.
Can't we stop all this back and forth and bickering. As I said, much of it depends on each state's scope of practice for the two.
I am thankful that I work in a facility where all nurses come together to problem solve. We just had our monthly nurses meeting. It is always fantastic to see how we work together and brainstorm solutions for something. When we sit around that table, it doesn't matter if you have a RN or a LPN license.
Specializes in Vents, Telemetry, Home Care, Home infusion.
The only difference between the scope of practice of a LPN and RN is hanging blood in Florida. Lets not go into the whole LPNs don't know the why of doing each task either. Girl bye.
(19) Practice of practical nursing†means the performance of selected acts, including the administration of treatments and medications, in the care of the ill, injured, or infirm; the promotion of wellness, maintenance of health, and prevention of illness of others under the direction of a registered nurse, a licensed physician, a licensed osteopathic physician, a licensed podiatric physician, or a licensed dentist; and the teaching of general principles of health and wellness to the public and to students other than nursing students. A practical nurse is responsible and accountable for making decisions that are based upon the individual's educational preparation and experience in nursing.
(20) Practice of professional nursing†means the performance of those acts requiring substantial specialized knowledge, judgment, and nursing skill based upon applied principles of psychological, biological, physical, and social sciences which shall include, but not be limited to
a) The observation, assessment, nursing diagnosis, planning, intervention, and evaluation of care; health teaching and counseling of the ill, injured, or infirm; and the promotion of wellness, maintenance of health, and prevention of illness of others.
(b) The administration of medications and treatments as prescribed or authorized by a duly licensed practitioner authorized by the laws of this state to prescribe such medications and treatments.
A professional nurse is responsible and accountable for making decisions that are based upon the individual's educational preparation and experience in nursing.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I think that as someone else mentioned there are degrees of competency within each category such that an LPN may be an independent "self-starter" who is dedicated to increasing his/her knowledge base all the time and RNs who do just barely enough to get by. The idea that an LPN can only "collect data" and shouldn't assess or must keep their critical thinking inside the LPN box rather a self-defeating notion all the way around, and furthermore how would you know if someone's thoughts were out of bounds for their title?
I would want the CNA to tell me if something looked wonky while they were assisting the patient in their ADLs instead of "no I am the bath giver and I am not allowed to assess".
However, a good friend of mine here on the forum once said "so education doesn't matter?". I realized that was the dominant theme to much of the practical/vocational nurse vs registered nurse rancorous arguing and realized that although I as an LVN may go above and beyond there is no way to quantify that without getting a credential, degree or other type of certification.
There is a certain amount of political wrangling in scope of practice laws as well, which results sometimes in dilemmas relating to whether an LPN charge nurse in a nursing home or out in the field in home health is "under the direct supervision" of a registered nurse and is not allowed to assess. Clearly in both such instances the nurse is assessing as they should for patient safety sake.
The only bright spot to me in all of this is that there are ever growing numbers of RNs who were once LPNs and can speak through experience.
Did you even read the statute that you posted? I value LPN's I used to be one for a long time. AnRN can function in the role as an LPN but a LPN cannot function in the role of an RN...just as an RN can't function as a PA or M.D. There is no high horse here...it is the stipulations of the board of nursing, so if you are disgruntled then take it up with them.
I understand that.
However:
If that's the case,then why can't an Rn(without an lpn license) apply for a job titled as an "Lpn" position?
I thought a nurse needs an Lpn license to apply to get for an lpn position?
(19) Practice of practical nursing†means the performance of selected acts, including the administration of treatments and medications, in the care of the ill, injured, or infirm; the promotion of wellness, maintenance of health, and prevention of illness of others under the direction of a registered nurse, a licensed physician, a licensed osteopathic physician, a licensed podiatric physician, or a licensed dentist; and the teaching of general principles of health and wellness to the public and to students other than nursing students. A practical nurse is responsible and accountable for making decisions that are based upon the individual's educational preparation and experience in nursing.
(20) Practice of professional nursing†means the performance of those acts requiring substantial specialized knowledge, judgment, and nursing skill based upon applied principles of psychological, biological, physical, and social sciences which shall include, but not be limited to
a) The observation, assessment, nursing diagnosis, planning, intervention, and evaluation of care; health teaching and counseling of the ill, injured, or infirm; and the promotion of wellness, maintenance of health, and prevention of illness of others.
(b) The administration of medications and treatments as prescribed or authorized by a duly licensed practitioner authorized by the laws of this state to prescribe such medications and treatments.
A professional nurse is responsible and accountable for making decisions that are based upon the individual's educational preparation and experience in nursing.
That doesn't specifically say what a lpn can't do besides directly dealing with blood and delegate to RNs I'm going to contact the BON I rather get specific answers
I live in an area where the job market is not great for LPNs. I was accepted and ready to go to LPN school until I was advised by several people in healthcare that my job prospects were not going to be good after graduation. Just two hours away there is a hospital still churning out LPN grads twice a year, largely to staff the doctors offices and skilled nursing facilities in the town. LPNs have a great career outlook in that part of the state. I think it just depends where you live and how the job market.
Also, and I apologize if we already discussed this in the thread; in addition to adhering to state practice acts, you must follow the facility's policy for where you work. At my work, LPNs cannot pass meds. They take vital signs, do EKGs and do personal care like CNAs. Nothing wrong with that but just important to know how things can vary among facilities even in the same state.
I live in an area where the job market is not great for LPNs. I was accepted and ready to go to LPN school until I was advised by several people in healthcare that my job prospects were not going to be good after graduation. Just two hours away there is a hospital still churning out LPN grads twice a year, largely to staff the doctors offices and skilled nursing facilities in the town. LPNs have a great career outlook in that part of the state. I think it just depends where you live and how the job market.
Also, and I apologize if we already discussed this in the thread; in addition to adhering to state practice acts, you must follow the facility's policy for where you work. At my work, LPNs cannot pass meds. They take vital signs, do EKGs and do personal care like CNAs. Nothing wrong with that but just important to know how things can vary among facilities even in the same state.
True. In my state, LPNs can give certain IV meds. At one facility where I worked, by policy they could not. Eventually, this hospital quit hiring LPNs, but grandfathered the ones who were already there. By attrition, only a few remain, but they work on the oncology unity, a unit heavily invested in IV meds. The RNs have to give all the IV meds for these patients.
I really don't have anything to add except....lawdamercy! Where is the #NursesUnite movement when you need them?
Having been an LPN for a number of years, I know what is within my scope and what is not. Honestly, I think most of us LPNs do. Are we asked sometimes to go beyond that scope of practice by managers that are familiar with our work and think we can handle it? Absolutely.
I've been asked, and just about every LPN I've ever worked with has been asked at least once. I have never acted on it - or even considered it - but I do know LPNs that have done it with the manager's blessing - "blurring the lines", so to speak, so that others watching think it's perfectly acceptable. And let's face it, when you're asked, it's tempting; because you're thrilled someone recognizes your ability to do whatever it is, and because you'd like to please your manager. It can become so much a rote habit, maybe you forget you are really not supposed to do that thing you do.
I'm not excusing it, I'm just saying, particularly in my field, I see it happen more than occasionally. One can easily get caught up the idea of their own importance that they forget there is a limit to what they legally can do.
With that being said, I think the people with the most advantage in all this demand for higher education (other than me getting to learn the life histories of musical geniuses and the difference between iambic pentameter and free verse) are the hospital/medical facility corporations, who can demand degrees for bedside nursing without really paying a big difference in salary to a BSN-prepared RN and an AD-prepared RN; let's face it, the "scope of practice" between the two is the same. The managers/admins get to keep payroll within their constraints and get rewarded with big fat bonuses for allowing smart, capable, nurses to become overworked, understaffed, and bitter about spending all that time and money on school. If the nurses don't like it, well...the nursing shortage is over so let's just hire a bunch of young upstarts that don't know anything and will work for next to nothing because the loan coupon book just came in the mail, and let the more experienced nurses go find somewhere else to pay them what they "think they are worth". I'm putting that last part in quotation marks because although I think AD-prepared RNs should be paid considerably more than LPNs and that BSN-prepared RN's should be paid considerably more than AD prepared RNs, and so on, (that's just good old-fashioned common sense, in my opinion) this attitude is really how corporate administrators feel about what we do. Even the ones who have been nurses in another life. I have been told several places I've worked in a manager-type position: (when I've gone to my managers or administrators and asked if we can give deserving CNAs or nurses raises or bonuses for going above and beyond, and if we don't show appreciation for what they do, they may leave) "nurses now are a dime a dozen. If they don't think their paycheck is incentive enough, let them go." They have no real knowledge or appreciation for what seasoned, experienced nurses do for their facilities, because we are really good at putting the patient first and our feelings last, and we tend to keep our horns silent about it.
Hospitals and other medical entities want us to think they care about our education; in my opinion, what they really care about is appearances. Everyone knows the general public values higher education, especially in this country. If hospitals/medical facilities can brag through their TV, billboard, magazine, and radio spots that they have "more advanced degree nurses" than xxxxx competitor, it may cause Joe the plumber down the street to think, "Hm...I certainly want to go where the nurses KNOW what they're doing" without even blinking an eye. The general public doesn't have a clue as to what constitutes an adequate and safe nurse to patient ratio in an ICU, or a med-surg floor, or an acute-care facility. They have no clue they might be better off with an AD-prepared RN with 10 years under her belt and a slew of ACLS certifications than with a BSN-prepared RN coming straight out of school with nicely framed freshly-inked diploma on her wall she hung all of ten minutes ago (I'm not speaking of those RNs who used a bridge program to gain the BSN, I'm speaking of BSN RNs without an AD). All they know is, the more educated nurse is the better choice, because the hospital ad said so.
I'd absolutely love to see the ANA take on these corps and put out their own ads: and telling the average American: look, we want ALL our nurses to have the education they want. We want ALL our nurses to be the best they can in their particular scope of practice. We just don't want you to get the idea the corporate America cares, because if you look at what the hospital is charging you, and what they are paying your LPN, ADN, BSN, MSN, PhD nurses - who spend countless hours to learn how to take care of you, have to prove they know how to take care of you, consult other providers over how to take care of you, spend their sleepless nights worrying over how to take care of you - you will see the difference in what you are paying, and in what they are making, reflected not in improvements in medical equipment, not in research for better life-saving medications, not in scholarships to improve nursing education, not in incentives to retain experienced staff, not in the employment of more nursing and ancillary staff, but in corporate bonuses to the hospital managers not even medically trained; because THEY don't think YOUR life is worth having to give up a vacation home to properly staff, retain, and educate the people who are charged with keeping you alive and safe twenty three hours and 55 minutes out of every day you're in the hospital.
nynursey_
642 Posts
Directly from the New York State Office of the Professions as it relates to Registered Nurses versus Licensed Practical Nurses:
"Section 6902 of Article 139 of the Education Law distinguishes between the legal definitions of RNs and LPNs as follows:
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.
This definition authorizes Registered Professional Nurses to execute medical orders from select authorized health care providers. In addition, Registered Nurses may function independently in providing nursing care in such areas as:
Casefinding, including but not limited to:
â—¦Identification of epidemiological trends
â—¦Client abuse assessment
â—¦Early identification of emergent complications
•Health Teaching, including but not limited to:
â—¦Patient teaching re: signs and symptoms of medication side effects
â—¦Patient teaching regarding disease process (heart disease, cancer) and management in relation to life factors such as culture and ethnicity
â—¦Health care promotion, such as disease prevention, accident prevention, and teaching normal child growth and development
•Health Counseling, including but not limited to:
â—¦Mental health counseling
â—¦Addiction counseling
â—¦Health counseling related to management of chronic diseases such as Alzheimer's, Parkinson's, Bi-Polar and Diabetes
•Care Restorative of Life and Well Being, including but not limited to:
â—¦Rehabilitation services such as bowel/bladder training, ostomy/wound care
â—¦Triage and continuous assessment for early identification of signs and symptoms of post operative complications with timely intervention
â—¦Ongoing surveillance and nursing intervention to rescue chronically ill persons from development of negative effects and secondary results of treatment
•Care Supportive of Life and Well Being, including but not limited to:
â—¦Hospice and palliative care
â—¦Chronic pain management through non-pharmacological nursing measures such as ergo dynamic techniques, relaxation, imagery, therapeutic touch, and rational-emotive therapy (RET)
â—¦Public health care including elder care, well-baby care, school and industrial nursing.
Nursing diagnosis by an RN is cited in section 6901 of Article 139 of the Education Law as: the identification of and discrimination between physical and psychosocial signs and symptoms essential to effective execution and management of the nursing regimen. Such diagnostic privilege is distinct from a medical diagnosis. Nursing diagnosis has been additionally interpreted by the Department as including patient assessment, that is, the collection and interpretation of patient clinical data, the development of nursing care goals and the subsequent establishment of a nursing care plan.
Section 6902, cited above, does not include nursing diagnosis within the scope of practice of Licensed Practical Nurses. Thus, Licensed Practical Nurses in New York State do not have assessment privileges; they may not interpret patient clinical data or act independently on such data; they may not triage; they may not create, initiate, or alter nursing care goals or establish nursing care plans. Licensed Practical Nurses function by law in a dependent role at the direction of the RN or other select authorized health care providers. Under such direction, Licensed Practical Nurses may administer medications, provide nursing treatments, and gather patient measurements, signs, and symptoms that can be used by the RN in making decisions about the nursing care of specific patients. However, they may not function independent of direction.
The scopes of practice of RNs and LPNs are not interchangeable. Inappropriate use of LPNs may expose agencies to potential litigation, the delegating RN to a potential charge of unprofessional conduct for inappropriate delegation of professional responsibilities [see Regent Rules 29.1(b)(10)], and the LPN to a charge of acting outside the scope of nursing as a Licensed Practical Nurse [see Regents Rules 29.1(b)(9)]."
TL; DR: The scope of practices are different; RNs and LPNs are not interchangeable. LPNs who blur the lines of their roles may be subject to litigation. Period.