Why LPN??

Q. · Mar 27, 2001

Lynn-

You weren't the only one confused with "the boss". I am not familiar with LPNs that appear so highly functional as her. The few LPNs that I have worked with could only do post-partum, not labor patients, could not start IVs and certaintly did NOT work in the critical care areas, especially our NICU. In fact, the LPNs charting needs to be co-signed by the RN responsible for her. In our state, LPNs work directly under the supervision of an RN. RNs, as you know, can obviously do the skillsets like injections, etc, but only RNs can do full out assessments, evaluations, education. But it is "the boss's" statement, like I said, that prompted me to ask this question. If she does the exact same thing as an RN, but gets paid less, what is the point?? But, like I said, I admire LPNs and find them valuable, but I think many RNs would argue that they do alot more than simply "get paid more."

Jay-Jay, RN · Mar 28, 2001

As Tracey said, in Canada the term is RNA or, more recently, RPN. We also have HCA's (Health Care Aides) and PSW's (Personal Support Workers), but only RN's and RNA's are licensed and have to write provincial exams.

In homecare, RN's do admissions and handle all IV's and central lines. About the only other thing they can do that the RNA's can't is IM injections. Some RNA's can do IM's but for them it's an "added skill," requiring a special certificate. RNA's also need special certification to do sterile dressings and PO meds.

RNA's are also not supposed to look after patients who are unstable, in the words of the Guidelines to Practise their patients must have "a predictable outcome." This leaves a lot of room for interpretation, and means they can handle just about anything in the way of wound care, palliation, diabetic patients, etc. (What we wouldn't give for a few more RNA's right now!!) I have a lot of respect for our RNA's and feel that they get a bit of a rough deal. Many of their calls are only coded for 30 minutes, which means they have to work a lot harder during the day to cover their caseload, and may see as many a 14 or 15 patients. Add to that the fact we don't get travel time, only mileage, AND they get paid less to start with.

College guidelines also permit RNA's to supervise IV's that are strictly for hydration (again, this is an added skill). When i was in hospital for surgery in October, an RNA was looking after my IV, and the RN only came in when she needed to hang an antibiotic.

What determined my choice? I guess I wanted more money, so I went for my RN. As I was an older student, and had to support myself, it was a tough call, and I seriously considered going for my RNA instead. If I'd had a family to support, I probably would have needed to go that route. It just would have been too time-consuming otherwise.

I did not want to do the BSn, because I already had a bachelor's degree in biology and another in education! Now, that is going to be the required entry point to nursing, starting with this year's students.

Dplear · Mar 28, 2001

SuzieQ,

you said it all in the statement "i ahyve only been a nurse for 3 years". I assume that is in rural wisconsin only. I have worked as a travel nurse all over the country going on almost 15 years as a BSN, and I find that NOWHERE are they laying offf nurses, esp LVN's. n In Texas they are allowed to do whatever the hospital or doctor that they work for certifies them as capable of doing. I work pediatrics and have LVN's that start IV's give pushes and even hang blood. They HAVE a license to work and have taken nursing boards also. as far as I am concerned they are full nurses. I have given report to LVN's and taken report from LVN's and I have never had to co-sign their charting or assessmnets. Like I said I have doine this for over 15 years now and I would tyake an experienced LVN ANYDAY over a new grad RN or even one that has a few years experince for that matter. there is something to be said for about on the job training. And by the way LVN's can run codes as long as they are acls certified.

NurseMark · Mar 28, 2001

Originally posted by Susy K:
Well, aside from the two insecure individuals, I read some great responses that helps me to understand and think about things. For some of you, this argument is "old", well maybe for some of you who have been in the profession that long, but I have only been a nurse for 3 years, so sorry if I am behind your times. Apparently Iris and "realnurse also" seem to think that LPNs are just abdundant everywhere because they are abdundant in thier small corner of the world. Well if that were true, then I guess I wouldn't have to post this question and I could simply ask the LPNs that I work with....oh, wait, that's right...WE LAID ALL THE LPNS OFF!!! But according to realnurse and Iris, that just can't be so. Hmmmmm...how peculiar.

On to some intelligence here; I liked the question that was posed of "why go for your BSN or MSN, why not be an MD," it made me think about my own choices and why I chose them. It also makes me understand LPNs more. I've only worked with one or two in my 3 years, luckily for me they weren't Iris or Realnurse. It's nice to understand the full scheme of healthcare delivery. Thanks for the intelligent feedback - apparently a few seem to be threatened with challenges.

Susy,

You are indeed being condescending to the individuals who posted their quotes. Iris was responding to CLO's comment, which was rude, unprofessional, and hurtful, not yours. Secondly, Realnursealso was a little rash, but in her area, LPN's might serve a function and jobs may not be scarce. Also, it may be just your hospital laying off LPN's. Let me give you an example: Out here in Arizona, St. Joseph's Hospital laid off all their LPN's but almost every other hospital uses them and continues to hire them. These nurses do not lack intelligence and neither do you. I have been an LPN for 4 years and learned that I made a mistake. The LPN level suffers much disrespect from RN's who have the disease known as RN-itis, which means lazy, holier-than-thou, my dookie - doesn't- stink attitude that a select few RN's possess. If I would have known that LPN's were considered so invaluable by co-workers and employers, I never would have become an RN. I am actively working on my RN through Regent's College because I want the pay and the conditional respect of my peers. i stayed an LPN for financial reasons, as I amke $34,000 a year as an LPN, and I almost left the profession because I was so disgusted at the way women work together. You may think me a pig, but I never worked in such a back-stabbing, lying, vengeful,power hungry profession. If you nurses stuck together, and viewed every member of the profession as whole as valuable, you would really be considered professionals. It is more than just schooling. Do you want to know why nursing is so lacking of respect and why you are not considered professionals? First of all, it is women dominated, and like it or not, women are still second class citizens. Secondly, look at what nursing started out as. You are nothing but a physician's lackey - you can't breathe without an order from your "master" - the doctor (Hyperbolically speaking). The nurse was created to assist the physician with his or her duties - like wiping butts, emptying urinals, giving baths, giving pills, etc. Thirdly, the public views nurses as "maids" that are supposedly paid very well. So why am I staying in the profession? easy, big money when you work for an agency (Registry) full time. And, because a very little part of me still enjoys helping people. As for the rest of me, well, many of the so-called professionals have ruined what should be a truly great profession for me. I can't wait to here the responses to this post.

NurseMark · Mar 28, 2001

Originally posted by Susy K:
Lynn-
You weren't the only one confused with "the boss". I am not familiar with LPNs that appear so highly functional as her. The few LPNs that I have worked with could only do post-partum, not labor patients, could not start IVs and certaintly did NOT work in the critical care areas, especially our NICU. In fact, the LPNs charting needs to be co-signed by the RN responsible for her. In our state, LPNs work directly under the supervision of an RN. RNs, as you know, can obviously do the skillsets like injections, etc, but only RNs can do full out assessments, evaluations, education. But it is "the boss's" statement, like I said, that prompted me to ask this question. If she does the exact same thing as an RN, but gets paid less, what is the point?? But, like I said, I admire LPNs and find them valuable, but I think many RNs would argue that they do alot more than simply "get paid more."

Again, RN's and LPN's do very much the same job except for a few subtlties. For example, I passed all the meds and gave all the shots on the floor while the RN had to do those oh-so-difficult assessments at the desk (sitting on her fanny no less). She really deserved $10 more an hour for that "skill". Oh, and I should mention that LPN's are taught how to assess a patient in school, but we need that high and mighty RN to cosign our assessments, because that nine months more of education makes them so much more qualified. In most states, an LPN can do more than just wipe a butt and take vital signs.

Q. · Mar 28, 2001

NurseMark-

If you read Iris's post, she was responding directly to me. She stated "why should any of US (us, as if we are somehow different) enlighten you?'

Secondly, no I do not work in rural Wisconsin. I work at a Level 3 Medical Center in Milwaukee. Thirdly, if would all read the post "No More LPNs" that may also give you some insight as to other LPNs that are experiencing job problems. Even in my post, some LPNs wrote that they can only work in geropsych. In Milwaukee, and in other areas, certain areas of nursing (ie public health, school nursing, coordinator positions, infertility nurse specialists, nurse educators, to name a few) all require a RN, BSN. This is what prompted my question. I find it hostile that you refer to RNs as "high and mighty" - most of us don't feel that way at all, and I am not one of them. Why would I feel high and mighty when I'm underpaid, overworked, and work in a profession that so easily can start bashing and comparing each other experiences?

Unless we have practiced as an LPN, or practiced WITH them (which I haven't - in Milwaukee) we don't know thier scope of practice. We have 9 nursing schools in the Metro Milwaukee area, and they closed down all 3 of the diploma programs in the last 5 years. My alma mater itself used to be a diploma program until they changed it 8 years ago to a BSN program.

The point is, unless we are RNs and have gotten our degree, we don't know what it is that "rounds us out" or adds to our education. As much as LPNs feel put down, RNs feel just as put down. A lot us went to school, worked pretty damn hard, paid a hell of a college tuition, and yes, had just as much clinicals as anyone else, yet we are viewed as somehow "less skilled" or just simply "paid more." I really don't think that is the case at all. We can't make blanket statements about things like this.

If the nursing profession decides to make a BSN a requirement, I don't think it is to say that LPNs are useless or not "real nurses." I think it will make the profession more attractive to young people and will only add more education. I never think there is anything wrong with making requirements more stiff.

nona · Mar 28, 2001

I was an LPN for a few years before becoming an RN. I was the only LPN working in a PACU, when I decided to go back to school and get the RN. My job has not changed one bit, I just have the official signature. The hospital I work at sends LPNs to several inservices to expand their role, and they do the same work as the RNs. Their are certain meds they can't do IV, and to be honest even as an RN I have never had to use those meds. It's a disservice to the LPNs because they are doing the RN work without the pay. Plus the LPN course was superior to the RN course. I learned to be a nurse as an LPN, I learned to do paperwork as an RN.

Q. · Mar 28, 2001

Originally posted by nona:
It's a disservice to the LPNs because they are doing the RN work without the pay.

/B]

Hi Nona,

that is why I asked my question in the first place. But thank you for your reply.

davisll · Mar 28, 2001

Originally posted by Susy K:
Well, aside from the two insecure individuals, I read some great responses that helps me to understand and think about things. For some of you, this argument is "old", well maybe for some of you who have been in the profession that long, but I have only been a nurse for 3 years, so sorry if I am behind your times. Apparently Iris and "realnurse also" seem to think that LPNs are just abdundant everywhere because they are abdundant in thier small corner of the world. Well if that were true, then I guess I wouldn't have to post this question and I could simply ask the LPNs that I work with....oh, wait, that's right...WE LAID ALL THE LPNS OFF!!! But according to realnurse and Iris, that just can't be so. Hmmmmm...how peculiar.

On to some intelligence here; I liked the question that was posed of "why go for your BSN or MSN, why not be an MD," it made me think about my own choices and why I chose them. It also makes me understand LPNs more. I've only worked with one or two in my 3 years, luckily for me they weren't Iris or Realnurse. It's nice to understand the full scheme of healthcare delivery. Thanks for the intelligent feedback - apparently a few seem to be threatened with challenges.

First of all Suzy Q you haven't even been a nurse long enough to even have an opinion.

Q. · Mar 28, 2001

Originally posted by davisll:
First of all Suzy Q you haven't even been a nurse long enough to even have an opinion.

Ouch, Davis. And I'm the one who puts nurses down? Talk about eating our young.....

Secondly, that post was directed at two INDIVIDUALS who flew off the handle for my mere MENTIONING LPNs. The post, anywhere, does not put down LPNs as a whole or even in part. So, thanks for re-posting it as you just proved my point for me.

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From my previous post:

-QUOTE_

But, like I said, I admire LPNs and find them valuable,

[This message has been edited by Susy K (edited March 28, 2001).]

davisll · Mar 28, 2001

Originally posted by Susy K:
Lynn-
You weren't the only one confused with "the boss". I am not familiar with LPNs that appear so highly functional as her. The few LPNs that I have worked with could only do post-partum, not labor patients, could not start IVs and certaintly did NOT work in the critical care areas, especially our NICU. In fact, the LPNs charting needs to be co-signed by the RN responsible for her. In our state, LPNs work directly under the supervision of an RN. RNs, as you know, can obviously do the skillsets like injections, etc, but only RNs can do full out assessments, evaluations, education. But it is "the boss's" statement, like I said, that prompted me to ask this question. If she does the exact same thing as an RN, but gets paid less, what is the point?? But, like I said, I admire LPNs and find them valuable, but I think many RNs would argue that they do alot more than simply "get paid more."

You have a real bad attitude, we are all working to help people, that's why most of us got into nursing whether we are a CNA, LPN, or RN. I really hate this debate, and you really have no business being in the healthcare field with an attitude like that, we all have to work as a team.

Q. · Mar 28, 2001

Could you please outline for me what attitude it is you think I have? If you are referring to the above post, those are are true statements in my area. Those same statements are true in New York. Sorry if that offends you but that is the scope of practice for LPNs in Wisconsin and New York. How is stating facts having a bad attitude? I asked why anyone would tolerate lower pay (ie being an LPN) if you are performing the "exact same job as the RN?" Can you please explain to me why that question you find so offensive?

Here is another post:

Why are so many people being defensive about Suzy K's questions? I don't see that she was rude or condescending in any way.

To all those LPNs who say they are the exactly the same as RNs only with a different title:

Why do you allow yourselves to be exploited by doing the exact same job for less pay?

In NY there are different scopes of practice for LPNs as opposed to RNs. RNs have a broader scope than LPNs. Most experienced LPNs have learned to do most of the tasks that an RN does-but it would be ILLEGAL to do some of them and could lead to loss of licensure, so WHY would anyone do it?

Also, where I live in NY, most of the hospitals do not hire LPNs; in this area the only work for LPNs is in long term care or MDs offices.

AND I AM NOT PUTTING ANYONE DOWN. These are truly just honest statements & questions

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[This message has been edited by Susy K (edited March 28, 2001).]