What's the difference between a CNA II and an LPN in NC???

l150 · Apr 24, 2010

You can still see a difference ,even in LTC and rehab. A cna/medtech cannot due assessmants ,treatments,IVs,etc.

mcneillmama3, BSN, RN · Jun 9, 2011

I don't want to discourage anyone from continuing their education, but for the most part, CNA 2's are not recognized in the acute care setting. Most hospitals are only hiring RNs to do patient care since so many schools are running RN programs. You may be able to get a job in a nursing home, but you will probably be working as a CNA1. The difference between an LPN and a CNA2 is scope of practice. CNA2's cannot make judgement calls or delegate to other CNAs. CNA2s cannot administer meds or take telephone or verbal orders from a doctor. LPNs participate in the care planning activities of planning, implementation, and evaluation of clients. The RN directs the plan of care in the assessment, diagnosis, planning, implementation and evaluation functions. Always check with you board of nursing or division of facility services to know what your scope of practice is.

mcneillmama3, BSN, RN · Jun 9, 2011

CNA 2's can't pass meds unless they have taken the Medication Technician training program and passed the skills and written test given by the state. If you are going to pursue that much education, you should go ahead and take an ADN program.

caliotter3 · Jun 9, 2011

A CNA is held to the CNA scope of practice whereas an LPN is held to the LPN scope of practice. An LPN program would allow a student to test out at a CNA level at that point where the student has covered the CNA skills. Just as an RN program might allow a student to test out at the LPN level. A matter of convenience to the student, not an implication that a CNA is an LPN, or an LPN is an RN.

mcneillmama3, BSN, RN · Jun 9, 2011

The two year program I attended only offered the ADN course of study. They would not allow anyone to test out early at the LPN level. If you didn't finish the entire course of study you didn't get anything. It's up to the individual community college as to whether or not they have different exit options. They did after the 1st quarter sign us all up on the CNA I registry, but most of us had no intention of opting out after the 1st semester when we could finish the course and become RNs and make more money, find a better job.

mcneillmama3, BSN, RN · Jun 9, 2011

To smartnurse1982 I agree the same for Med Techs. They know how to give out medications, but they do not know and are taught things in a 48 hour course of study that makes it safe for them to make judgement calls. They aren't even taught how to administer epi if a pt has an allergic reaction. I observed a Med Tech mixing Lantus with regular insulin in the same syringe. When I questioned why she was doing that she couldn't tell me. She didn't know that Lantus isn't supposed to be mixed with anything. Then she said that the two medications were not "touching" each other in the same syringe. And Med techs are not supposed to be mixing any insulins at all. They are learning in 48 hours what took RNs 2-4 years to master.

**mya612, BSN, RN** · Oct 19, 2011

To those who believe that CNAs and Med Techs do not understand the rationale behind many of the therapeutic modalities received by patients - I'm truly disappointed. There arre many CNAs and Med Techs that understand much more than they're given credit for. To make the assumption that because a person isn't licensed means they don't understand the why of what they do is offensive. Sweeping generalities are never a good thing. Mcneillmama3, don't assume that the med techs you encounter don't understand pharmacology and pharmacokinetics. They may have only taken a course at the community college to get med tech certified, but you have no idea what other training or education they have. Furthermore, wouldn't it be more appropriate to educate the med tech that is incorrectly mixing meds about their scope as well as why certain meds cannot be mixed as opposed to belittling them? I'm just saying...

mcneillmama3, BSN, RN · Oct 19, 2011

I'm not assuming anything, I'm basing my belief on the lack of knowledge in pharmacology I have personally supervised while employed as a Nurse Consultant for Assisted Living Facilities in my area. For example, when the Med Techs believe that lantus can be mixed in a syringe with insulin, that is a dangerous situation because no Med Tech is supposed to be mixing insulins in an assisted living facility. One Med Tech was practicing giving subq injections on an orange and took the orange back to the dining room and put the orange back in to the fruit bowl that the residents help themselves from. That indicates a severe lack of knowledge regarding infection control. Another example of the lack of knowledge of drug side effects is when a Med Tech complains that a resident always "pulls a stunt" after she receives her hypoglycemic agents. The stunt she was referring to was the resident became shaky and sweaty after receiving her meds. The Med Tech was labeling hypoglycemia a "Stunt" and failed to follow up by checking the resident's blood sugar. I've also had Med Tech's tell me that OTC drugs aren't really drugs since they are not prescribed and thus were leaving the OTC meds the patients were taking out on their nightstands instead of waiting to observe the client to take them. I taught the Med Tech class and 48 hours is not enough training. It will never take the place of the training that professional nurses receive in a college credit program. Pharmacokinetics and pharmacodynamics is not even touched on in a Med Tech program, only basic drug math. The course rushes through classes of drugs and barely touches the surface regarding drug side effects. There is a lot more to administering drugs than handing patients pills in a cup. The differences between a CNA-II and an LPN in NC still hold true. CNA-IIs cannot supervise or delegate. CNA-IIs do administer medications. It is not within the legal scope of practice for them in NC. CNA-IIs are not taught planning, implementation or evaluation of the care plan. They can administer tube feedings only after the LPN or RN has verified placement of the tube. They can set up IV equipment, but they cannot adjust pump settings. They can d/c IVs. They cannot initiate O2 therapy, but can maintain it under the supervision of a nurse. They can do sterile dressing changes and set up a sterile field. Just be sure you are aware of your scope of practice in whatever state you work in. Many a nurse has gotten into licensure trouble because they exceeded their scope of practice. Ignorance is not a defense when you are up against the state board of nursing.

mcneillmama3, BSN, RN · Oct 20, 2011

Excuse me-correction-CNA-IIs do NOT administer meds. It doesnt' matter in the state's eye's how much training and education you have had. You may have taken an entire RN-ADN program, but if you don't pass the state boards, you are not an RN. It's your position on the registry for you state that says what you are allowed and able to do. This is what gets a lot of EMTs in trouble. I've supervised girls that were both EMT trained and CNA-1 trained. I had to remind them that when they were working as CNA's, they were not in the role of EMTs and thus could not do some of those skills they could do while riding on the ambulance. Know your scope of practice. When I worked in coronary care, there were a lot of cardiac drips that LPNs could not hang. I think this is still current that LPNs in NC cannot hang drips that have to be titrated to cardiac effect. Things can get complicated depending on what setting you work in and there are differences between states. I think the compact states probably are on the same page or we wouldn't be able to work in them without getting a new license in them.

**mya612, BSN, RN** · Oct 21, 2011

The tone of this thread seems a bit negative towards unlicensed assistive personnel. It makes a person wonder - how many of the posters have worked as CNAs or Med Techs/Aides prior to getting licensed?