Why are LPNs not allowed to do more?

[GaMBA]

I've read several threads on here about what LPNs can and can't do. I've even read some threads where LPNs used to be able to do some stuff but are no longer allowed by law to do those things. I guess I'm not understanding something here. Why would an LPN no longer be allowed to do something they were able to do for years and years? If there is a so-called nursing shortage, why is the scope of an LPN's job becoming more narrow, and why are some hospitals doing away with them altogether? It all seems pretty backward to me. Does it have anything to do with the education an LPN receives? Are LPNs not trained/qualified to do the things they aren't allowed to do, or is it that it's becoming a liability issue? I've also seen a few posters say they consider themselves glorified CNAs and that's why the hospitals are getting rid of them. What is going on? I'm working on prereqs for an LPN program and I just want to understand what I'm getting myself into.

Thanks!

[pagandeva2000, LPN]

To be honest, I have not seen too many limits in job opportunities in NY's metropolitan area for LPNs. In terms of limited scope of practice, the BON says no IV push except normal saline and heparin, cannot hang blood products unless having taken a class and must countersign with an RN and no central lines. That doesn't sound too limiting to me, but now, the individual facility may limit how much one can do. There is not much difference between us in my clinic, except I cannot triage. The floors, well, we primarily administer medications, including IV piggybacks, can be certified to initiate a peripheral line, can catherize, give meds through g-tubes. However, because we are primarily medication administrators, we do not often have enough time to do dressings and such, but it can and has been done. Our sister hospital allows LPNs to do primary care, but with more stable patients.

I do believe that these things are done to secure the reason to retain more RNs, but I have seen these phases even before I became a nurse. When it gets too short, suddenly, the LPN can rise to the occasion. If not, then, oh, well, go back to your corner. To be honest, I am doing all that I am interested in doing, and that is fine with me...I can step up to the occasion when it is necessary.

[pagandeva2000, LPN]

I'm courteously asking that we refrain from engaging the member OncologyRN23.

This person spends plenty of time in the forums where the LPNs tend to post, such as the Geriatric/LTC forum and the LPN Corner. The vast majority of his posts include snide comments directed at LPNs, although he is free to express his opinions. I personally feel he is trying to stir the pot, so don't fall for the game. Stay strong and ignore the unfriendly debaters.

Okay, I'll behave...:wink2:

[BinkieRN, BSN, RN]

I received my LVN schooling in California, which is a state where virtually every RN program is impacted with 2 to 3 year waiting lists. On the other hand, I could enter an LVN program immediately with no waiting.

I see no waste of time or money with an LPN program.

I see no waste of time or money with an LPN program either, I said I see it with a two year course of study in a college, getting an associates and coming out an LPN rather than an RN.

I have never thought of LPN's as measly or as anything less than a nurse because they are nurses in every sense except the pay, but that's not my fault.

I agree with the BS in the humanities, etc but we're talking nurses here.

[BinkieRN, BSN, RN]

I disagree, Binkie. The public doesn't really know the difference. I think we are being replaced with cheaper, unlicensed personnel for a lot of what nurses, period, used to do.

I disagree Suequatch, the public definately does know the difference. We have patients complain all the time when their primary is an LPN. It makes me angry because every LPN I work with is totally capable, can push narcs, start IV's, run blood (just not spike it) and they carry a full assignment just like the RN's. I think it's wrong but it is the way it is. My employer keeps the LPN's they have and all have been there 10+ years but they haven't been hiring LPN's for years.

[OncologyRN23, BSN, RN]

I'm courteously asking that we refrain from engaging the member OncologyRN23.

This person spends plenty of time in the forums where the LPNs tend to post, such as the Geriatric/LTC forum and the LPN Corner. The vast majority of his posts include snide comments directed at LPNs, although he is free to express his opinions. I personally feel he is trying to stir the pot, so don't fall for the game. Stay strong and ignore the unfriendly debaters.

How funny it is for me to be talked about in this way! I've simply voiced my OPINION just like everyone else as.

And as for my other postings I invite ANYONE to look at them, you don't have to agree with what I'm saying but I have made valid points.

Furthermore I have always assumed that this website was for the purpose of meaningful debates, and I don't need a "staff" member to tell me otherwise.

Now to continue with this thread.....I do find it odd and confusing that some states will allow nurses to do some things while others don't...it makes for a confusing situation for us all. I live in NC and the LPN's here have a broad scope of practice to work with.

[TheCommuter, BSN, RN]

Furthermore I have always assumed that this website was for the purpose of meaningful debates, and I don't need a "staff" member to tell me otherwise.

I absolutely do not recall telling you anything in particular. I am also assured that no other moderator has told you anything. However, we've been receiving complaints about you.

Here is a quote from the website's TOS (terms of service):

We promote the idea of lively debate. This means you are free to disagree with anyone on any type of subject matter as long as your criticism is constructive and polite.

[SuesquatchRN, BSN, RN]

I disagree Suequatch, the public definately does know the difference. We have patients complain all the time when their primary is an LPN. It makes me angry because every LPN I work with is totally capable, can push narcs, start IV's, run blood (just not spike it) and they carry a full assignment just like the RN's. I think it's wrong but it is the way it is. My employer keeps the LPN's they have and all have been there 10+ years but they haven't been hiring LPN's for years.

Huh. Maybe it depends on where you are. Seriously, it isn't an issue here, but we are rural, and have way more LPN's than RN's even in hospitals.

[pagandeva2000, LPN]

I disagree Suequatch, the public definately does know the difference. We have patients complain all the time when their primary is an LPN. It makes me angry because every LPN I work with is totally capable, can push narcs, start IV's, run blood (just not spike it) and they carry a full assignment just like the RN's. I think it's wrong but it is the way it is. My employer keeps the LPN's they have and all have been there 10+ years but they haven't been hiring LPN's for years.

My experience tells me that it depends on where you work, or maybe I should say the population that is being served. I work for a city hospital with a great deal of foreigners who are not aware of the divisions of nurses; in fact, they believe that everyone wearing scrubs, from CNAs and up are nurses. I introduce myself to patients as 'nurse' because I am, but if anyone does ask for specifics, I have no issues with explaining the difference between LPNs and RNs.

One of the things I believe should happen, is just as the public advertises or promotes RNs, the same should be done for LPNs. It should be told that we also take a nursing program, sit for NCLEX nursing boards and are licensed to do the things within that scope of practice. In addition, LPNs should continue to be update themselves on current trends, act and look professionally in order to demonstrate that we are not dummies. I take it as both simultaneously, a compliment as well as an insult (depending on who it is coming from) that I "carry myself like an RN that I can fool people". I staunchly believe that anyone that holds a nursing license should be intelligent-it should be the norm, not the exception.

Thank you so much, for acknowledging that we can positively contribute to patient outcomes and team players...it means a great deal to me!

[ohmeowzer RN, RN]

My, what an interesting turn this thread has taken. I appreciate everyone's contributions, however I don't feel that anyone has answered any of my actual questions. Why is the LPN's sope of practice becoming more narrow in some parts of the country? Why are they being allowed to do less, and why are hospitals no longer using them in some places? Who is doing the work that LPNs used to do if they are no longer being used in hospital settings?

TIA!

i think many people answered in different ways..but i'll try to answer the best i can

i think the LPN's scope isn't being narrowed , it just depends on what state you work in and the policy in faciltiy or hospital you work at.

in the hospitals the RN's do the work of the LPN and alot of times the CNA , we donot hire LPN's at the hospital where i work, but my parttime job they do hire LPN's and CNA's which i am grateful for..

i hope this helps

[labvampire]

I am an LPN in an ER. I do 95% of what an RN does. The only thing I don't do is push IV meds. The RN is paid more because she is ultimately the one everything falls back on. Charting, patient care, medications, supervision, etc. Yes, my RN's respect me and treat me with the upmost dignity. I do the same to them. We may do alot of the same things but she is the one that will get her head chewed off. I need that RN around to ask questions or to show me something I am not familiar with. I plan to bridge over soon to RN, but in the mean time I see where our job defintions are divided and respect them for their knowledge. I believe they are taught more in depth about things that we brush over in school. Do your best, don't think of titles and take advantage of what they have to tell you.

[GaMBA]

As a member of "the public" (*smile*) I honestly had no clue there were different kinds/levels of nurses until I started researching the profession earlier this year. Had absolutely no idea nor did I care as long as my loved one or myself received the medical care we needed.

[jjjoy, LPN]

It's my understanding that the LPN training and role began with a shortage of nurses some decades back. The LPN was specifically designed to have a smaller scope of practice than the RN... so that the requirements for licensure could be lower (eg fewer pre-reqs) and finished quicker.

However, no matter one's training, a motivated person can learn and do just about anything. Either due to personnel shortages or money-saving strategies, LPNs were asked to take on more and more responsibilities, beyond those originally considered, such that some LPNs were practically functioning in the same role as the RN, but for less pay.

Instead of being upset at facilities/states for unnecessarily restricting LPN scopes of practice, one could instead be upset that facilities have been taking advantage of LPNs by asking then to take on job roles beyond their qualifications - not beyond their abilities, that's not the point here.

Anyone can be great at anything without a formal education or this or that licensure or certificate... whether as an engineer, a surgeon, a teacher, a childcare worker, a chef, etc. The question of job roles and formal educational and licensure requirements is separate from the fact that anyone who is smart and motivated is capable of fulfilling a particular role.

What minimal formal educational and licensing requirements do we want for someone responsible for various nursing responsibilities?

If you don't minimally need to complete a two year nursing program (RN) to be a nurse, do you really need a that whole year program (LPN) either? What's the bare minimum formal education needed to be qualified as a nurse? What about a six month course of study? What about going back to all on-the-job training for nursing positions without any specific formal education requirments? You'd learn what you need to know to do your specific job.

Just questions. I don't have any easy answers!!