Why can't I do everything a RN does as a LPN? We should be equal.

[SweetPoo]

Why do RN's make more when we practically do the SAME THING. I don't understand how RN's having the ability to start IV's and give a few medications IV push make them more valuable than an LPN. Those extra courses you take to become RN's, heck even BSN's don't add anything clinically. When I am on the floor, WE DO THE SAME THING, yet I take home 30% less than my RN/BSN colleagues. Does anyone else agree that us as LPNS should be able to make the same salary? I hope the Affordable Healthcare Act (AHR) addresses this issue with EQUAL PAY for EQUAL work. We are a lot cheaper to higher than RN's so hopefully the (AHC) will realize this and create more of a demand for efficient LPN's that are easier to train, and cheaper to higher, thus bringing RN wages on par with our wages. It just doesn't make sense for the hospital to pay a RN $25-30/hr to start, while I make $22/hr and have more than 18 years experience. Any thoughts?

[LadyFree28, BSN, LPN, RN]

Here you go, one study for starters:

Conclusions

Higher hospital LPN staffing levels are independently associated with slightly higher rates of mortality and sepsis in trauma patients admitted to Level I or Level II trauma centers.

Source: http://www.biomedcentral.com/1472-6963/12/247#abs

(For the record I am an LPN in the process of bridging to RN )

Love the EBP...thanks for linking this.

[MoJoRNBSN]

Sounds like someone is just butthurt and jealous. Maaaaaaybe on a medsurg floor LVNs and RNs aremt hugely different, but come to the ICU or the ER and I'm sorry but your little bubble will get burst.

[kaydensmom01]

Can you please link a study that compared LPNs vs RNs? They don't exist. So how can you make that claim? Second, you can claim NP and Physicians should get the same reimbursement for doing the same thing. Thank you, you made my point. You can't have it both ways. Using research on NPs on "mortality" is a bit extreme when a physician is always on hand just in case something happens out of their control, decreasing mortality. How does referring one to a physician, or having one look over them count? I'm sure LPNs have low mortality rates, we also have physicians we can call when things go out of control. Please find me a LPN study.

Here you go:

[h=1]The association between nurse staffing and hospital outcomes in injured patients, 2012. [/h]

A 1% increase in the ratio of licensed practical nurse (LPN) to total nursing time was associated with a 4% increase in the odds of mortality (adj OR 1.04; 95% CI: 1.02-1.06; p = 0.001) and a 6% increase in the odds of sepsis (adj OR 1.06: 1.03-1.10; p 

[h=4]Conclusions[/h] Higher hospital LPN staffing levels are independently associated with slightly higher rates of mortality and sepsis in trauma patients admitted to Level I or Level II trauma centers.

BMC Health Services Research | Full text | The association between nurse staffing and hospital outcomes in injured patients

There are plenty more if you would just research it...

[kaydensmom01]

I see that I'm not the only one that cited that great article, so here is another:

Nurse Staffing and Mortality for Medicare Patients with

Acute Myocardial Infarction

2005.

"n-hospital mortality.Results:

From highest to lowest quartile of RN staffing, in-hospital

mortality was 17.8%, 17.4%, 18.5%, and 20.1%, respectively (

P

0.001 for trend). However, from highest to lowest quartile of LPN

staffing, mortality was 20.1%, 18.7%, 17.9%, and 17.2%, respec-

tively

P

0.001). After adjustment for patient demographic and

clinical characteristics, treatment, and for hospital volume, technol-

ogy index, and teaching and urban status, patients treated in envi-

ronments with higher RN staffing were less likely to die in-hospital;

odds ratios (95% confidence intervals) of quartiles 4, 3, and 2 versus

quartile 1 were 0.91 (0.86 – 0.97), 0.94 (0.88 –1.00), and 0.96 (0.90 –

1.02), respectively. Conversely, after adjustment, patients treated in

environments with higher LPN staffing were more likely to die

in-hospital; odds ratios (95% confidence intervals) of quartiles 4, 3,

and 2 versus quartile 1 were 1.07 (1.00 –1.15), 1.02 (0.96 –1.09), and

1.00 (0.94 –1.07), respectively.

Conclusions:

Even after extensive adjustment, higher RN staffing

levels were associated with lower mortality.

https://massnurses.org/files/file/Legislation-and-Politics/Nurse_Staffing_and_Heart_Attack.pdf

RN care not just better in the hospital....

Licensed practical nurse scope of practice and quality of nursing home care, 2013.

"Care quality was better in states where the NPA clearly described LPN scope, but only when there was also greater RN availability".

Licensed practical nurse scope of practice ... [Nurs Res. 2013 Sep-Oct] - PubMed - NCBI

[RescueNinjaKy]

I guess I won't find support here, as a new user I was expecting more backing, I guess I was dead wrong.

This is an open forum for discussion, not a place to find cheerleaders. If people thought and believed what you said thus far as correct then they would've backed and supported you. Unless of course I end up being dead wrong about what the purpose of a forum is for.

[RescueNinjaKy]

I see what you are saying with the ICU, but at the same time the physician's orders will clearly state the parameters for titration. I can look up press it's and learn them pretty easily, I work on a Intermediate Care level floor with tele patients. It's not that difficult. Annoying when I have to get the RN to push the IV pressors because legally I can't. Makes no sense. Government should move out of the way and let the market decide what is best and affordable to the patient.

There's so many things wrong with this statement. Just because you can read a doctor's order doesn't mean you're doing the same thing as a rn. If it was as simple as that then anyone who could read could basically replace a nurse. This is where the critical thinking kicks in, rns are required to know the actions and parameters of the medication as well. If the doctor puts in an incorrect order the rn is responsible as well if she/he doesn't question the order. Rns don't blindly or simply read a doctor's order and carry it out, so to imply that you can do what a rn can just because you can read a doctor's order is ludicrous.

To say government has no place in nursing and to let the market decide is frankly irresponsible. How else are we going to have rules and regulations designated to protect patient safety. Where will the accountability be if government doesn't regulate nurses.

[LadyFree28, BSN, LPN, RN]

Here's one of my favorite skill mix EBP:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323141/

Nurse Staffing Levels: Impact of Organizational Characteristics and Registered Nurse Supply

Mary A Blegen, Thomas Vaughn, and Carol P Vojir

Author information ► Copyright and License information ►

This article has been cited by other articles in PMC.

Go to:

Abstract

Objective

To assess the impact of nurse supply in the geographic areas surrounding hospitals on staffing levels in hospital units, while taking into account other factors that influence nurse staffing.

Data Sources

Data regarding 279 patient care units, in 47 randomly selected community hospitals located in 11 clusters in the United States, were obtained directly from the hospitals from the U.S. Census report, National Council of State Boards of Nursing, and The Centers for Medicare and Medicaid Services.

Study Design

Cross-sectional analyses with linear mixed modeling to control for nesting of units in hospitals were conducted. For each patient care unit, the hours of care per patient day from registered nurses (RNs), LPNs, nursing assistants, and the skill-mix levels were calculated. These measures of staffing were then regressed on type of unit (intensive care, medical/surgical, telemetry/stepdown), unit size, hospital complexity, and RN supply.

Principal Findings

RN hours per patient day and RN skill mix were positively related to intensity of patient care, hospital complexity, and the supply of RNs in the geographic area surrounding the hospital. LPN hours, and licensed skill mix were predicted less reliably but appear to be used as substitutes for RNs.

[Sun0408, ASN, RN]

Did I really just read all of this I should have stopped at the wiki part !!

[nursel56]

I guess I won't find support here, as a new user I was expecting more backing, I guess I was dead wrong.

Maybe you'll have better luck elsewhere. If you are trying to solicit allnurses readers/menbers to form an outside advocacy group of some kind, you'll find that likely terms of service will hamper your ability to do so. Good luck to you!

[TiffyRN, BSN, PhD]

I guess I won't find support here, as a new user I was expecting more backing, I guess I was dead wrong.

If you would like support, I would suggest the following topics:

1. Reasonable staffing ratios for all care settings.

2. Tuition reimbursement for those furthering their degrees.

3. Protection for nurses from patient and/or family abuse.

4. Decent yearly raises for nursing staff.

Just some ideas.

Here's an example of a bad idea: Throw down the "Ain't no such evidence!" on a site frequented by nurses with some impressive research chops up to and including PhDs. Just saying.

Here, I have this not only bookmarked but saved on my toolbar for quick access:

Google Scholar

[ChrisGriffen]

You're being pretty arrogant, actually. There is no way you do what I do or know what I know despite your 18 years experience, just as an RN with 18 years experience can't claim equality with an M.D.

I just need to savor this sentence for a moment.

[JustBeachyNurse, LPN]

Maybe if this was posted in the LPN forum you would have found more that think like you, but not necessarily as per the evidence based research that has been posted thus far.