Working in MedSurg with ONLY RNs...

theRPN2b · Jul 24, 2018

I am an RPN and work on an acute medical floor in Hamilton (about 1.5 hours away from Toronto). And I take my own patient assignment (5 patients) and work alongside RNs NOT under an RN so RNs do not delegate their tasks to me. We do not have a PSW on out floor to help us with ADLs/bed baths etc (unless the floor is really heavy the manager might approve for a PSW from the float pool to work with us for a few shifts). As an RPN on my floor I can do anything an RN can do (push IV meds,administer blood products,vitals,etc.) and the only difference is that I can't be charge (which I have no interest in doing anyways, and like Fiona said above, the RNs make $15/hour more.

DowntheRiver · Jul 24, 2018

Here in Florida we see it all! I live in Central Florida and have worked in a facility with RNs, Medics, and CNAs. This is nice because the Medics can start IVs and draw blood which helps! I've also worked in a facility where we had just RNs and CNAs. Currently where I work we have RNs and Medical Assistants. Other units have RNs and Techs, and LPNs are sporadic throughout the hospital. Most LPNs were grandfathered in, or only work in Employee Health. I have several friends who work in northern Central Florida where they just do a RN + 1-2 LPNs with no tech.

Been there,done that, ASN, RN · Jul 24, 2018

This is the total care nursing model of care. I can see where it would be difficult for a new grad. As an oldie-moldie, I was always thrilled when I got my 4 peeps and was in total control, instead of eyeballing 9 patients and sprinkling meds around.

You will team up with your fellow nurses, and get the job done.

Be prepared for a change, the total care model... costs the most $$$ for the facility.

Good luck, let us know how it's going.

xoemmylouox, ASN, RN · Jul 24, 2018

Most shifts we work as total care for our patients because our techs are pulled to sit with patients. It's not bad when we only have 4-5 patients. More than that and it's a nightmare.

brandy1017, ASN, RN · Jul 24, 2018

I've worked where there were CNA's, although know of a hospital in the area that did primary nursing with no CNA's. Personally I think it is a terrible idea to run a hospital without CNA's to help lighten the load as one nurse can't be everywhere. That said, nurses still help out with CNA tasks such as cleaning and turning patients, but it is not their primary responsibility.

Fiona59 · Jul 24, 2018

That is a huge salary difference based on only TWO small differences. What is the difference in educational requirements in Canada between the two?

Practical Nurses are educated for two years at the College level with university transfer credit courses as part of the curriculum. Basically, it's the old, two year diploma RN course.

RNs are required to have a bachelor's degree as the entry point to practice.

The RNs who were hospital educated or have the diploma were grandfathered and are not required to get the degree. The last class of diploma RN's graduated in 2009.

angienicholson18 · Jul 24, 2018

Wow I couldn't imagine not having a CNA in North Carolina we work as a team and no one's beneath personal care for a Patient

angienicholson18 · Jul 24, 2018

I agree with you 100%

Horseshoe, BSN, RN · Jul 25, 2018

I am an RPN and work on an acute medical floor in Hamilton (about 1.5 hours away from Toronto). And I take my own patient assignment (5 patients) and work alongside RNs NOT under an RN so RNs do not delegate their tasks to me. We do not have a PSW on out floor to help us with ADLs/bed baths etc (unless the floor is really heavy the manager might approve for a PSW from the float pool to work with us for a few shifts). As an RPN on my floor I can do anything an RN can do (push IV meds,administer blood products,vitals,etc.) and the only difference is that I can't be charge (which I have no interest in doing anyways, and like Fiona said above, the RNs make $15/hour more.

I don't understand why anyone would be a PN in Canada if you are basically doing the exact same thing but being paid so much less.

Fiona59 · Jul 25, 2018

I don't understand why anyone would be a PN in Canada if you are basically doing the exact same thing but being paid so much less.

Getting admitted to a university programme has become increasingly hard. My local uni requires an 90% in the required Grade 12 subjects. They admit 120 pupils a year. They usually have over 1200 applicants for those seats.

The union that bargains for RNs is different from the union that bargains for LPNs.

Remember that Canadian healthcare is funded by the taxpayer. The trend is to reduce the number of RNs in acute care because, frankly, they are getting too expensive to employ. I'm an LPN at the top of my pay scale. I make $35/hour. An RN with the same time served is making $50/hour. Units such as mine don't need a high concentration of RNs. Basically two per shift and the other six nurses are LPNs. The RN union doesn't like it but they negotiated hard, got the money and have in some areas priced themselves out of jobs. ORs have one RN and one LPN in the theatre. Our NICU's are hiring LPNs. Our Cancer Clinics (think specialized hospitals) are increasing their LPN staff. Really the only units that remain solely RN are ICU and PICU.

So what you have are high school students who don't make it into uni for nursing becoming LPNs. Career changers without degrees become LPNs (my intake had two teachers and a marine biologist). Many plan to try and find a bridge to move on. Many don't because the cost is high, numbers are limited in the bridges. In my province if you make it through the bridge, your final placement can be anywhere in the province, not necessarily near where you live. I have a friend who had to do her final placement nine hours from where she owned her home, she hasn't found an RN line yet and is still working as an LPN. Remember just because there are jobs posted doesn't mean our employer is going to fill them.

Pepper The Cat, BSN, RN · Jul 25, 2018

I don't understand why anyone would be a PN in Canada if you are basically doing the exact same thing but being paid so much less.

Because the RNs will have additional responsibilities that the RPNs do.not. Like being in charge, being a resource for new staff, taking over care of a patient if they become unstable, etc.

I have had RPNs say they don't want to become RNs because of the increased responsibility.

dayandnight · Jul 25, 2018

Hi! i'm a new grad Canadian nurse working on a medsurg floor in a main hospital downtown Toronto. The entire floor is RN only, so we don't have any techs, RPNs (LVNs) or anything of the sort.. Which boggles my mind because I have to balance giving meds, cleaning up bowel movements, brief changes, and even feeding between 4-6 patients depending on whether I work a day or night shift. Day shifts I usually have 4 patients while on nights I take care of 6.. My friend who lives in the US (Texas) says most floors in the hospitals there have techs and LVNs who take care of the cleaning, feeding, taking vitals, etc. Are RN only units common in Canada or something? Is there a funding issue? Because the burnout is ridiculous....

It's very common in Canada across the country to have only RN or LPNS in the unit with no care aids but please do not say LPNs take care of the cleaning feeding and taking vital signs. If you are an RN it is very important to know the scope of the LPNs who are working with you. We have very similar scope of practice with some differences across the country.. they are not the equivalent of care aids.

In BC we have LPN-RN units with no cna with each nurse taking care of 4-5 patients every shift. In smaller units it's 50/50 and in bigger units there are more RNs than LPNs