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Who is wanted more, RN's or LPN's?

Dezy Dezy (Member)

I have heard some time ago that LPN's were needed less. That places were taking nursing students in the jobs of LPN's and RN's were the ones that are were more in demand.

More recently, a friend of mine who's fiance is a nurse told me that LPN's are being taught much more then before ( I don't know if these things are technically allowed) and are preferred than RN's because of the difference in pay. He said RN's were too expensive and the way things are going now, LPN's will just receive on the job training and RN's will find it more difficult to find work.

What is more correct?

You need to qualify your post. Don't you live in Canada? The job market and hiring practices differ widely across Canada and then again in the US.

Everything taught in PN School is "allowed" within their scope of practice.

Some feel that RNs in the province of Alberta have priced themselves out of the market. UNA bargained well for their members but not so well for the taxpayers.

With the ever dwindling healthcare dollar it makes sense to utilize staff to their full scope of practice. Back when the degree became available, it was determined that these few RNs would work in management. We've all seen how that worked out in Canada. The death of hospital based education, the death of the two year diploma RN. Now it's a degree for every RN and two years at college for LPNs. So yes, it makes sense to reduce the number of RNs on the floor whenever possible.

I've worked surgical units where there have only been two RNs on the floor out of nine nurses. As long as an RN is on the floor to take charge it works. No patient care was compromised. Other units are a 50/50 split.

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education.

I think your friend is making a valid point. All-RN staffs are very expensive, and with declining reimbursement, I am sure that many organizations are going to have to re-think their nursing staff mix to decrease cost. However, LPNs have a much more limited scope of practice and must be supervised by qualified RN staff. I am already seeing a revival of "Team Nursing" that has been popular decades before.... RN teamleader working with LPNs & CNAs to provide care to a group of patients.

The type and amount of nursing staff needed is dictated by the patient care that has to be provided. RNs always have to be leading this effort in most settings... the only exception is physician offices, where the physician supervises everyone. From a purely financial aspect, it just doesn't make sense to pay RN wages for the performance of tasks that can be performed by lesser-paid staff under the supervision of an RN.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Since the person who originally posted this discussion lives and works in Canada, this thread has been moved to the Canadian Nurses forum for more local responses.

Topaz7

Specializes in Psychiatric- Detox and ECT.

If you are talking Canada then I don't know, in the U.S. specifically Michigan, I'd say BSN's are wanted more than LPN's and RN's, at least in the hospitals. As a LPN there are only 3 things I cannot do that a RN can- IV's (with the exception that I can remove them, and draw up meds for IV just can't administer), Care Plans (except in LTC because the LPN's pretty much run nursing homes), and 'delegating', instead it is called 'assigning' same thing just a gray area. We are taught how to do care plans but in most places we can only "contribute" to them, again unless it's LTC that's a different story. In my opinion LPN's will never be phased out, because honestly I don't think RN's would want to do the job in nursing homes. 35-60 patient load is a lot when as a RN you could have 8 or less.

I was going to post this in the Canada thread but I wanted a view on all over place. One area may be different from the next but this way I get kind of a wordly view. Does this mean going into bachelor or nursing science is a waste of money? I wanted this so I could do everything and anything in the field of nursing an now it seems like I won't be valued much at all, especially when they ate giving what are supposed to be, special tasks to anyone. ( my friend fiancé is an LPN and does Iv s and much much more). Like... What's the point of doing all this if it doesnt get us anywhere

I think this varies by the attitude of the employer.

Silverdragon102, BSN

Specializes in Medical and general practice now LTC.

It will vary from local to local but if looking at working overseas or in the US and a visa is required then LPN will not meet requirements

loriangel14, RN

Specializes in Acute Care, Rehab, Palliative.

When speaking of the scope of practice for LPNs it greatly depends on where you are.PNs in Canada go to college for 2 years and have a much wider scope than LPNs in the US.Where I work there are far more RPNs than RNs.

Let's see in Acute Care I can't be Charge (never would want that job btw!), pierce a blood or travisol bag, work in NICU or L&D (never had the desire to go there), oh and I can't hang chemo meds.

Now, it takes two nurses of any description to hand blood or travisol, after that the LPN is still fully and legally responsible for their patient.

No desire to be in a NICU or a delivery unit (small children just are not my forte)

Chemo meds? Most nurses will never hang them in my hospital. We had to do a huge AHS study manual the other year. In that year since we've had one patient who required them and he stayed for three days and was assigned to the same nurses over the course of his stay. The LPNs also had a manual on oral chemo drugs which we'd all been handing out for as long as I can remember.

So I'm seriously beginning to wonder why the heavy need for RNs on some units. Outpatients and day surgery units are hiring more LPNs as their older staff are retiring and positions are re-evaluated.

I wish I knew what AHS was upto but I'm not psychic.

Generally the RN is moving more into a leadership, less hands on role, the pt navigator for instance. RNs still are the only ones in high speciality areas (ICU's, L&D, ER, SICKKIDS, onc.) however this is slowly changing especially in the last few years. Where I work RPNs can start IVs, but cant do IV meds, that's a facility thing, as it is within the RPN scope of practice. It depends where you want to work.

I am an RPN, getting my RN. I'm young, I enjoy school (as much as I hate it right now - currently procrastinating with AN), no kids, can afford school, make good while I'm in school so for me it was an easy option.

Edited by Daisy_08

loriangel14, RN

Specializes in Acute Care, Rehab, Palliative.

It varies so much from place to place.We have RPNs in L&D and ER.RPNs can do IV meds and flush and access PICC lines.

Yup, AHS has LPNs in ER and I've heard down in Calgary they are in ICUs as well. Personal choice again. Never wanted to work there. I can see the appeal of ER though, the patients do leave eventually and the frequent flyers only stay a couple of hours instead of months!

I've noticed a few people posting in relation to what they can and cannot do as an RPN in Canada.

It's really facility specific. I work for a large multi-site hospital system as an RPN and I can draw-up and hang IV medications. I can start IV's and I can administer blood. These courses were offered to me post-grad through my employer, but once we attend the employer's in-service, we're able to perform the procedures.

I have a second job with a smaller facility, and RPN's aren't allow to do anything in relation to IV's. If the pump is beeping, we can't even back-prime the line, we have to call the RN. We also have to get our Coumadin's double-signed by RN's, as well as Insulins, where as at first job, there's is no double signing for any meds. I get paid the same rate of pay at both jobs ($26.xx + 14% in lieu). But as you can see, very different as far as allowing us to work to our full scope.

Hello, I am a RPN, and yes it does depend on the facility for IV meds. We can hang premixed IV meds. I took the Advanced IV therapy course at Centennial College. My question is are RPNs allowed to; 1. Flush a IV with saline.

2. Flush a PICC line after administering an antibiotic, which is going to be in the community setting. Our roles are increasing and I do have the knowledge skill and judgment however I want to practice with in my scope.

loriangel14, RN

Specializes in Acute Care, Rehab, Palliative.

I am an RPN and I can hang IV meds premixed or not and I can flush with NS.I can mix my own IV meds.I ddn't take a special course.My employer allows RPNs to access and flush PICC lines if we take the inservice on doing so.

I would like to know if we are allowed to flush picc lines as a RPN in the community setting. I will be adm. antibiotics through the picc and therefore shouldnt we be flushing before and after?I did take a Advanced IV Therapy course but it was more focused on starting a IV, Venipuncture and drawing blood. where do you work ?? I can also hang premixed IV meds are you allowed to prepare IV meds ?

Thank You so much!!!!!! I have been rewiewing like crazy all weekend... I am starting a new in the community position and have received shifts for this patient with a PICC. So I guess I would have to contact the agency to see if they have inservices.. Also when mixing IV meds do you still use the dose desired/ dose availble X amount formula and then inject into the 50ml bag NS? Once again Thank you soo much. The agency required the IV therapy Certificate before they hired me for this patient so I just wanted to make sure that I am with in my scope.

loriangel14, RN

Specializes in Acute Care, Rehab, Palliative.

If your employer is assigning you to a patient that needs IV meds via a PICC you need to be sure you have the training you need. I wouldn't attempt anything that I haven't been trained to do and I felt confident doing,especially in the community when there is no one to ask.

I do mix my own meds.Not everything goes into a 50ml bag. It depends on the med.We have a reference book and I check everything when I mix it.

Thank You so much!!!!!! I have been rewiewing like crazy all weekend... I am starting a new in the community position and have received shifts for this patient with a PICC. So I guess I would have to contact the agency to see if they have inservices.. Also when mixing IV meds do you still use the dose desired/ dose availble X amount formula and then inject into the 50ml bag NS? Once again Thank you soo much. The agency required the IV therapy Certificate before they hired me for this patient so I just wanted to make sure that I am with in my scope.

PICC lines and IV meds are within the RPN scope of practice, provided your employer allows so in their policy. However, if you have never done these skills and are not comfortable you need to ensure you have the training before doing so on your own. For example I recently had a suprapubic catheter that required changing. This was something I have never done before. I phoned my education lead so see if this was within my RPN scope of practice. She stated that if I have the knowledge skill and judgment and have an experienced nurse with me the first time then it is with on my scope of practice. So I read the how to perform the procedure in a text book, and stayed past my shift so the oncoming nurse could watch me.

It sounds like you need to review more about the IV medications. I would read in your med-surg book. Also ensure you have enough training.

Good luck

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