Who to Contact for LPN changes??

[jewelzz72]

I am curious if anyone out there knows where a person would start in petitioning for changes regarding Long Term Care and regulations of the use of LPN's and RN's. The reasoning is that in my area (S.Dakota) there are mostly small facilities that use only one nurse per shift. Right now our regs include having an RN on duty at least 8 hours per shift. Because of this it is VERY hard to find any LPN positions, because of the reg the homes are often seeking RN's to cover the 8 hours on the weekends when the DON is gone, and therefore they have to hire them full time in most cases.

I've worked LTC for over 10 years. I've been charge nurse, worked alone with a couple CNA's, for all 10 of those years. I've done JP's, Trach's, G-Tube, PICC's. I've done CPR more than twice, the heimlich, and have had to make the judgement call of sending people to the ER many times. I've consoled many a family member, argued with plenty of dr's. All of this, no RN present nor needed. I'm not knocking the role of the RN, I know I couldn't do med-surg, etc. But in LTC the role is NO different, I have even had RN's call ME for advice. Experience overrides schooling many times.

Assisted Living Centers care for elderly simliar to those in the LTC facility, except those in LTC can't care for themselves. But their diagnoses are the same, their confusion is often the same, their meds are the same. I have worked AL so I am fully aware of the similarities. In AL facilities there is only the requirement of an RN to come in 20 hours per week, then the Unlicensed Personnel are in charge. Most don't have current CPR, and few know what to do in an emergency.

My goal is to change the regulations governing the LTC in regards to RN coverage. Many facilities are short because they are "holding out" for RN's, yet many LPN's have to take 2 part time jobs (no benefits!) because of this. Maybe change to having to have at least one full time RN on staff (floor nurse, not just MDS, etc), and allow the rest to be handled by the LPN, at each facilities choosing.

This would not only solve many problems for LPNs, it would help the nursing shortage as well. I know of many CNA's that can put things on hold for a year of school to get their LPN, but they don't because of the fact that it's so hard to find a LPN position (and not just 2-10p shift). They couldn't afford to do 2 years in school, as was my case. So this may add some help. It would also fill the positions that are just sitting there waiting to be filled, and help the residents of those facilties have the staff that they need (and deserve!)

It's a big plight, but any information would be appreciated. I do plan to go on in time with Excelsior to get my RN, because I would love to work as a director in one of our small facilities. I would love to be able to have a full staff for my residents!

[ohmeowzer RN, RN]

lvn's do not work under the license of the rn.

whoops you are right. but lpn's do have to report to the rn any changes in the pt status.

[SuesquatchRN, BSN, RN]

Many facilities are short because they are "holding out" for RN's, yet many LPN's have to take 2 part time jobs (no benefits!) because of this.

That's the facility trying to get the most for the least, not any fault with the regulations as they stand.

Blame cheap employers who don't care about their employees for that one.

[ERGirl83]

There is a similar situation brewing here for RN's, in terms of ADN vs BSN.

The same way diploma programs were phased out. Hospitals here are not wanting to hire ADN's and in some cases are virtually forcing them to get their BSN's. My SIL says it has something to do with Magnet status, but since I don't know much about magnet status, I can't vouch for that.

I think it's just a natural progression. Nursing (LPN or RN) used to consist mostly of "being a good listener," and "fluffing pillows," and it has become increasingly science-based. Nurses now have more responsibilities and can perform more procedures than ever before. Which can be both a good thing, and a bad thing.

A lot of it has to do with the increased legal scrutiny that hospitals and LTC are facing these days, and to many a laymen, credentials mean more than experience, regardless of whether or not that's actually true.

I think that LPN's are a valuable source of patient care, but I can remember a time when I was hearing how it was getting to be difficult for the RN's to find work because the hospital could pay the LPN less for the same job.

And, not to belittle the role, or dedication of any LPN, because I know many kind, caring, compassionate LPN's who are an incredible asset to their team, they should not be making the same amount of money as an RN or have the same amount of job availability. There's something to be said for the extra schooling, the extra cost of that schooling, and all that goes with it. If we go that direction, then what exactly is the incentive for anyone to pursue an RN? or an PA/NP/MD for that matter, if we continue on down the line.

Anyway, that got kind of long, and I'm sorry for your frustration as I really do see both sides to this.

[jewelzz72]

There is a similar situation brewing here for RN's, in terms of ADN vs BSN.

And, not to belittle the role, or dedication of any LPN, because I know many kind, caring, compassionate LPN's who are an incredible asset to their team, they should not be making the same amount of money as an RN or have the same amount of job availability. There's something to be said for the extra schooling, the extra cost of that schooling, and all that goes with it. If we go that direction, then what exactly is the incentive for anyone to pursue an RN? or an PA/NP/MD for that matter, if we continue on down the line.

Thanks for the insight. I realize there are alot of sides to this these days. Think of this though, in LTC the RN with the BSN does not make any more money than the RN with the ASN. 2 more years schooling, no better pay.

LPN vs ASN RN, One more year of schooling, LPN gets sometimes up to $8 hour LESS pay, and to do THE SAME JOB.

That's my focus here, I'm not saying the LPN should make the same as the RN, but in reality when we do exactly the same duties, are trusted to be left alone for 12 hours and oversee the workers and patients, then the pay shouldn't be such a stretch apart. I am keeping this topic to Long Term Care because as far as it is in many places LPN's cannot even think to work in the hospital setting, they won't get hired.

Maybe in larger areas there are more LPN positions available. I"m sure there are plenty of RN ones too. But in rural America, there aren't enough RN's for coverage in LTC (many RNs prefer anything BUT the LTC positions) and often more than enough LPN's without nursing jobs.

In rural LTC the team during a shift consists of 1 nurse, 3 CNA's. That 1 nurse at night is most often the LPN. She is trusted to work and lead the facility alone, no DON, no RN charge, and she makes every necessary call there is and does it well because of experience.

I do know I would never discuss this in person with a RN that has never worked for less than 2 years as LPN. They could never understand how much you learn and know from work, and that you know nothing less than they do in LTC if you've worked charge position at least that long (LTC) and truly care about your work and have the leadership skills, which many RN's AND LPN's sometimes lack.