Why can't RN take LPN positions?

[jjjoy]

RN and LPN role differentiation is so confusing! In some areas the LPN does almost everything an RN does but in that case why can't an RN take an LPN position if he/she is willing to take the lower pay? Or at least, why can't an RN also take the NCLEX-PN in addition to the NCLEX-RN?

I wanted to work at an inpatient hospice but the only RN positions were as charge nurse, the only RN in the building. As a newbie, I wasn't comfortable with shouldering that much responsibility. But they couldn't hire me into any other nursing position there because those were for LPNs.

Also, if I find team leading with a LPN too difficult to manage along with my own responsibilities, as an RN I don't have the choice of being team-led by another RN.

On the one hand, I can see where LPNs would want to protect their role, but on the other hand, many LPNs insist that they have just as much responsibility as RNs and almost all the same skills. If I'm willing to accept the same pay as an LPN, why can't I work in that role? It's not like a doctor wanting to work as a nurse. They are very different roles. The doctor won't know all that nurses do in a shift.

I do know there are reasons... I guess I'm just looking for sympathy over feeling overwhelmed by RN responsibilities and wishing there were more steps to assuming more responsibility as opposed to pushed to the deep end so quickly.

[Katnip, RN]

It probably depends on facility policy and has nothing to do with licensure.

The facility likely has strict salary policies and RNs are paid higher than LPNs. If you're an RN, you're an RN and therefor have to be paid on a higher scale.

[WolfpackRed]

Does that mean that a charge nurse (also an RN) would be charged in a case of bad discharge teaching because an RN working under them didn't do THEIR job? If there's an RN-case manager on the floor reviewing a chart and sees a missed med, notifies the nurse but the busy nurse doesn't do it, is the RN-case manager held liable for the missed med?

As an RN or LPN, if you saw that an IV push hadn't been given, then it's your responsibility to make sure that it is given. If it's not in your scope (LPN), then you make sure that the appropriate parties are notified. And they don't tell just any hospital employee with an RN. What if the hospital nurse recruiter who also has an RN license but hasn't practiced in 10 years is on the floor showing prospective employees the unit? The LPN can't find any unit RN to give the IV med push so she asks the nurse recruiter to give it. Can the nurse recruiter refuse?

I hope I don't come across as just being ornery. This discussion has made me curious about the legalities of working below one's license.

The only problem I see is that staff RN don't work under a charge RN's license, the way that LPN's and UAP's work under the RN license. If a staff RN makes a mistake, its their license that is in jeopardy.

Concrete examples b/w LPN and RN are difficult to give, but I think you could understand the difference b/w UAP and RN. IF you had and RN license and worked as a CNA, you could be held as responsible as the pt's RN if something happened to that pt while under you care. This is because YOU as a "licensed nurse", even though this is not the role you are in at the time, are caring for the pt and would reasonably have had the knowledge, evidenced by your license, to recognize the situation and respond accordingly. You would not be able to make a legal defense that your were the CNA, and CNA's wouldn't reasonably have the same knowledge to recognize the situation to act.

Don't know if this better illustrates the situation or not.

[SharonH, RN]

jjjoy, all this talk about whether or not an RN can work as an LPN and whether or not a doc can be a PA etc. is really covering up the real issue which is that you are not sufficiently confident in your role as a new nurse to perform independently or in a leadership position. Fair enough. However, working in a role in which less is required of you (theoretically) will not help you develop those skills or that confidence. You need to work with someone where you can be mentored or have the chance to learn your craft until you are more comfortable. Don't worry, it takes time. But the fact is that you are an RN, you can't be an LPN or a CNA because that is not what you are. Your scope of practice is defined by your licensure.

[Tiwi]

The reason an RN can't take the LPN exam and work as an LPN is because once you have that RN license you cannot hold the other license legally. I

It is a similar situation in Australia. When I became an RN I had to hand my EN (enrolled nurse - sounds very similar to LPN) registration in. It was one of the saddest things I ever had to do, losing a qualification I had worked for. And it meant for at least a week and a half until my registration as an RN was accepted, I was in limbo. I couldn't work as either. Basically the reason here is that in our act an EN works under "the indirect supervision of an RN". You can have your own patients and in some States give medication etc, but an RN has to be around. That doesn't mean an EN isn't accountable or responsible for their own actions within their scope of practice legally as of course they DO have their own patients. They admit them, assess them, care for them and discharge them.

I'm happy now I do have my RN registration, but I will never be able to work in an EN position again in Australia.

[ginger58, ASN, RN]

Because you aren't licensed as an LVN. A doctor can't take a job as an RN.

[antmaggiern]

I think before you consider a specialty area you should have some experience in Med Surge. Then you wouldn't feel intimidated by being a charge nurse or the only RN on staff when starting such a job. To answer your question I believe its a matter of being over qualified. You would want to do what you are licensed to do as an RN. Its not easy taking a job in which your training and skills would not be used. Its not a matter of being willing to take the lower pay but a matter of legal responsibilities. The employer who advertises the position of LPN cannot hire an RN if their are qualified LPN's available for that job. WE are a litigeous society and for every job filled by the wrong person the right person for that job is willing to sue for.

[txspadequeenRN, BSN, RN]

This is not true of every state. In Texas you can hold a LVN license and a RN license at the same time.

The reason an RN can't take the LPN exam and work as an LPN is because once you have that RN license you cannot hold the other license legally

[TrudyRN]

Please give an example.

If I'm on a plane and someone stops breathing, if I don't perform rescue breathing/cpr (and no one else can or does), am I liable for neglect because I do have the training? Good question. If I do, then fine. If a CNA with an RN sees that a patient has stopped breathing, they need to tell the nurse. If the nurse can't be found and no one is running to help, perhaps the person with the RN should then jump in until help arrives. I don't know the legal ramifications.

What if I were just visiting an inpatient and saw the roommate wasn't breathing and couldn't find any staff to take care of it? Would it be neglect if I didn't perform rescue breathing/cpr because of my RN licensure?

I'm not a lawyer but I do believe that, depending on your state, you are not required to take action. Example: It is not required of anyone to try to rescue a drowning child. It is legal to stand there and watch the child die. Why? Ethically, this is horrible and morally the non-responder will likely have nightmares for years. Legally, though, the law cannot compel you to risk your own life and limb to help someone else. You might have a young child who needs you, a disabled spouse, you might have health limitations of your own. So the law does not compel you to risk your own life or well-being or jeopardize your ability to care for your own loved ones in order to help someone else.

That said, I reiterate that you need to verify with an attorney who knows your own state's laws whether or not your state requires you to act in an emergency off duty. On duty, we are required to care for our patients. I have often wondered why I am expected to care for visitors and coworkers who develop an emergency in my facility, as these people are not my patients, legally speaking.

This all gets into Good Samaritan laws. Be familiar with those in your own state.

[Thats Mr Murse to U]

RN and LPN role differentiation is so confusing! In some areas the LPN does almost everything an RN does but in that case why can't an RN take an LPN position if he/she is willing to take the lower pay? Or at least, why can't an RN also take the NCLEX-PN in addition to the NCLEX-RN?

I wanted to work at an inpatient hospice but the only RN positions were as charge nurse, the only RN in the building. As a newbie, I wasn't comfortable with shouldering that much responsibility. But they couldn't hire me into any other nursing position there because those were for LPNs.

Also, if I find team leading with a LPN too difficult to manage along with my own responsibilities, as an RN I don't have the choice of being team-led by another RN.

On the one hand, I can see where LPNs would want to protect their role, but on the other hand, many LPNs insist that they have just as much responsibility as RNs and almost all the same skills. If I'm willing to accept the same pay as an LPN, why can't I work in that role? It's not like a doctor wanting to work as a nurse. They are very different roles. The doctor won't know all that nurses do in a shift.

I do know there are reasons... I guess I'm just looking for sympathy over feeling overwhelmed by RN responsibilities and wishing there were more steps to assuming more responsibility as opposed to pushed to the deep end so quickly.

Ok, lets back up to the gist of the question - and please forgive me if I come off strong in this....

1st if you feel you cannot handle a job PLEASE do not lessen your (and our) degree by accepting a lesser paying position b/c if there is anything we have learned in this country is employers will use and abuse their employees to the best of their abilities.

2nd There are differences between LPN and RN licenses - no disrespect, just different roles that would be VERY difficult for one to separate.

3rd JuMP IN! Dare yourself, I bet you will be better in that role than you think. Just believe in yourself

Hope you took this how I intended it.

-Az.