What's happening to the RN's being replaced by RPN's, if that's even true.

malenurse82 · Jan 29, 2011

In the facility where I work, it seems that RPN assignments are simply based on whether the patient has an IV or not, pity as there are many patients with IV's that are suitable for RPNs. The facility's own Policies and procedures limit the role of the RPN, in among other things, disallowing them to initiate IV therapies (meds, fluids, etc), but they can maintain said therapies. this particular thinking seems pretty backwards to me and is lacking in any sort of evidence based foundations.

I worked in a different place where the role of the RPN was just being introduced and RPN assignments were designated as assignments with predictable outcomes, not simply defined by a laundry list of skills and they would train them for IV therapies, even as OR nurses in the scheduled (planned) c-sections.

IMO nurses (whether RPN or RN) are professionals licensed by a governing body to practice nursing, period. The scope of practice is also defined by the governing bodies. It is the employers (hospital, provinces, etc) that define who can perform what set of skills. In my facility, only physicians can remove central lines, whereas, as a student in a different facility, I practiced this skill with my preceptor.

the idea behind a BScN is twofold. The first reason is to give nursing a stronger voice in the healthcare arena; sit at any multidisciplinary meeting and you will find a physician (undergraduate) a social worker (undergrad if not already with a masters), a psychologist (probably with a masters level education), surely nursing needed a little boost. The second one is to create nursing professionals that have the theoretical base and research skills to advance the profession of nursing at managerial, academic, theoretical or philosophical spheres. So, I am sure there are many people with the vocation to care and the skill to practice nursing (whether in an acute setting or complex continuing care setting, public health, whatever) but only a few that would be interested into furthering their practice into the higher academic spheres. Just as it happens in other fields; there are many architects, or engineers, or even physicians who practice their profession, but not all of them go and obtain PhDs and become researchers, academics, or consultants.

I think choosing RN over RPN is similar to the issue of choosing a university education over a college education. There is a misconception that college education is "easier" (read lower standards). This is not the case, my sister went to college and she would stay up until the wee hours of the night working on her highly advanced design projects. by the end of the 2 year diploma program, she had a large portfolio of high quality pieces that allowed her to get a good paying job and a rewarding career at the age of 22. In contrast, I saw many students drowning in the sea of people that attend undergraduate programs in Canadian universities; it is just the reality of the current state of affairs in education. Universities get money for enrolling herds of undergraduate students, but in reality the fruits of a university (the research) only happen at the graduate levels.

Choosing a college education over a university education is a decision made based on the reality of the circumstances of the person, and the reasons are unique everyone. If the person has an academic aspiration, they will thrive in the university environment, I say this because this was my experience as i went to university. Either way, if the person has the vocation and the right critical thinking skills, that person will make a great nurse irregardless of where they got their training.

Ignatius · Feb 22, 2011

RPN scope of practiced has increased and they are able to do everything an RN does (at least in ON) with the exception of a couple things. Otherwise virtually the same in Ontario. They're giving IV drugs here etc.. The real difference is the appeal they have to those in charge of the hospital budget. At about 1/2 the pay at the top end they're saving lots of money. So the trend is to quietly replace RNs with RPNs.

I even noticed a hospital in another province that previously did not employ RPN/LPN now has postings on their website.

Just when you think your hard work has paid off you realize you're just one decision away from EI and going back to school.

ruralgirl08 · Feb 26, 2011

I am going to go out on a limb here. I don't know if this is something for RNs to panic about, I live in Ontario, and our wages are frozen and I don't think the government will negotiate big "raises" for nurses in the future. Other professions may get theirs, and we may be at a standstill for awhile. I personally would be willing to take less pay to have a secure job and better work environment. The problem is alot of times we work short, under tremendous pressure, with little resources, and huge responsibility. It takes days to recuperate from our 12hr back to back work schedules. We deserve to be paid well for this, it is the most difficult/stressful job I have had. But if the stress & pressure were decreased, by: better resources, adequate staffing, and respecting nurses rights. I would think that the majority of the work force would be willing to take a pay cut. Also, RPNs should work in their scope of practice, and should be paid adequately for it. But maybe they should utilized RN advanced practice nurses to their potential, since all RNs require advanced education, the BScN in my eyes should be a stepping stone. I don't think the plan was to choke out the RN. I don't think they have fully created the practice model that they meant to. I think the money situation has really hindered everything. There may be a problem if they start pumping out RNs with no jobs to fill them, (like they have done with teacher education.

joanna73, BSN, RN · Feb 26, 2011

The reduction in RN positions in Ontario is the reason I moved to Alberta. I like it out here, and I don't see myself moving back anytime soon. I think Ontario is really shafting all their nurses right now (both RNs and RPNs) in terms of pay and workload. It is slightly better in Alberta, but I agree that the profession as a whole is suffering. I wonder when, and if things will improve. These policy makers clearly have no clue about the scope of nursing from any level.