Wow! Just wow. NB needs to get with the times.

Fiona59 · Sep 14, 2013

I've never considered myself a "substitute" anything.

The NB College of LPNs needs to get a move on.

Having said that, it's vaguely familiar to some of the CARNA and UNA propaganda that appears during contract negotiations.

lilaclover6984 · Sep 14, 2013

I've never considered myself a "substitute" anything.
The NB College of LPNs needs to get a move on.
Having said that, it's vaguely familiar to some of the CARNA and UNA propaganda that appears during contract negotiations.

Yeah they really need to get a move on. It's awful the way they devalue the LPN profession there. They basically treat LPNs like health care aides. LPNs working in hospital don't even get their own assignment. They are working "under" an RN at all times and can only do personal care, vitals and some simple dressing. No meds. Nothing. The LPN program is 2 years and they are still expected to write the same national exam as the rest of the country but as soon as they graduate they aren't allowed to do anything. And I mean nothing. The LPNs aren't even allowed to call themselves the "nurse", RNs in NB have some kind of ownership over the title. When a pt. has a concern or even so much as needs a Tylenol the LPNs say " let me get your nurse". Isn't that awful?

I just feel LPNs in the rest of the country should be letting our colleagues in NB know how we are treated in the rest of the country and how far they are being held back. We need to get this profession more on the same page nation wife.

petethecanuck · Sep 14, 2013

I'm sorry but there isn't a substitute for an RN. I have more training then an LPN. I have greater responsibility and care for more complex and acute patients then an LPN. Sorry, but that is a fact.

Now, that being said. LPN's are most definitely nurses and their utilization (not being able to admin meds) in NB is wrong.

LPN's are an important part of the health care team and advertisements promoting divisions amongst nurses (as CARNA and the UNA have done in the past) is counter productive and hurtful to our profession as nurses. In my perfect world, LPN's would be members of said organizations but the powers at be will never allow that to happen.

Fiona59 · Sep 14, 2013

Pete, here's a question for you. Do you feel better qualified as an RN than those who were trained in the hospital system or graduated up until 2009 as diploma RNs? These RNs had less than three years formal education and received on the job training to upgrade their skill set as the scope of practice expanded.

Now, the PN programme in AB is the old diploma course for RNs.

I'm not claiming we are the equal of RNs just asking a totally relevant question.

Oh, and the complex, acute patient. Total bunk. I've cared for patients newly discharged from the ICU and advocated to get those turning sour admitted to the ICU. I don't get to pick and choose my patients. I get them assigned by a Charge Nurse who knows the abilities of the RNs and LPNs working that shift. I don't magically get to turn my patient over to an RN because they are bottoming out. I have to continue with care until they are transferred or my shift ends.

I wish I worked in this Ivory Tower Acute Care Unit where I can hand over a patient that isn't doing well, that I would only be assigned "stable" patients. It just doesn't happen.

I know many LPNs aren't happy with AUPE for their union, but those same LPNs would never join UNA.

mLPN79 · Sep 14, 2013

Pete, here's a question for you. Do you feel better qualified as an RN than those who were trained in the hospital system or graduated up until 2009 as diploma RNs? These RNs had less than three years formal education and received on the job training to upgrade their skill set as the scope of practice expanded.
Now, the PN programme in AB is the old diploma course for RNs.
I'm not claiming we are the equal of RNs just asking a totally relevant question.
Oh, and the complex, acute patient. Total bunk. I've cared for patients newly discharged from the ICU and advocated to get those turning sour admitted to the ICU. I don't get to pick and choose my patients. I get them assigned by a Charge Nurse who knows the abilities of the RNs and LPNs working that shift. I don't magically get to turn my patient over to an RN because they are bottoming out. I have to continue with care until they are transferred or my shift ends.
I wish I worked in this Ivory Tower Acute Care Unit where I can hand over a patient that isn't doing well, that I would only be assigned "stable" patients. It just doesn't happen.
I know many LPNs aren't happy with AUPE for their union, but those same LPNs would never join UNA.

Well said, Fiona.....

vintage_RN, BSN, RN · Sep 14, 2013

ONA in Ontario circulates the same sort of ads regarding RNs. Unfortunately RPNs will probably never be included in these organizations.

mLPN79 · Sep 14, 2013

To add to what Fiona said, LPNs where I work are given bigger patient loads with a mix of stable and unstable patients. Whereas there are times when the RNs only have 3-4 patients who don't have any complex issues. Tell me, how is it right to give an LPN an assignment more complex than most of the RNs are and then sit there and demoralize us?? We may not have all the theory based knowledge but for that we make up in skill. The bullying needs to stop somewhere.

aywl · Sep 14, 2013

To add to what Fiona said LPNs where I work are given bigger patient loads with a mix of stable and unstable patients. Whereas there are times when the RNs only have 3-4 patients who don't have any complex issues. Tell me, how is it right to give an LPN an assignment more complex than most of the RNs are and then sit there and demoralize us?? We may not have all the theory based knowledge but for that we make up in skill. The bullying needs to stop somewhere.[/quote']
Same in my unit, and the typical labour intensive needing PTs (go to bathroom q2hrs with assistance, confused pt, overweight pt who need assist to get up..) are always assigned to Lpn

dansamy · Sep 14, 2013

I don't know about Canada's scope of practice, but in the US the RN is responsible for the LPN & her assessments. When my facility did have LPNs, usually 2 RNs and one LPN would split 16 patients. Sometimes, the 2 RNs would each take 8 & the LPN would do all meds & treatments. Sometimes, the 2 RNs would each take 5, the LPN got 6 & the RNs were each responsible for consigning 3 of the LPNs assessments.

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BellionRN · Sep 14, 2013

I'm an RN in NB. I graduated in May 2011. Recently, we've been going through some difficult times with the cuts to RN, LPN and support staff positions (ward clerks, ward aids, laundry, food service, etc.). Healthcare has been tumultuous since I joined the ranks, with the future of RNs very uncertain.

In NB, LPNs have a very limited scope of practice, especially in hospital (please keep in mind my post is geared toward LPNs in hospital as I have never worked in a LTC facility). This is just the way it is. For some reason, the health authorities here decide to train LPNs to a certain degree, and then not allow them to practice within their scope. In the ICU I worked in, there were no LPNs unless we were extremely short RNs. Presently I work in Emergency, and we have maximum 2 LPNs on days, one on evenings and nights. I worked on a med-surg unit fresh out of school and that's the most I worked with LPNs. LPNs in NB can certify in blood draws, med admin, and I think IV initiation as well. The problem is, health authorities do not let them practice these skills in hospitals, certified or not. I think the farthest they've come is having LPNs do med admin, but on family medicine units only. I do not know if LPNs take assignments on family medicine units. Even though LPNs learn many skills, they (for some odd reason) are not allowed to practice within this scope. Please keep in mind that there seems to be a similar situation with paramedics. NB trains ACP (Advanced Care Paramedics) but does not employ them (ACPs have a larger scope than RNs). As far as I know, our PCPs (Primary Care Paramedics) also have skills they learn but are unable to practice... as an ICU nurse I've had to help with patient transfers simply because the patient has an unaccessed central line. They cannot travel with D5W infusing. They have limited medications on board they are covered to administer. Ridiculous? Yes, and the medics feel this way as well. NB I feel is behind the times in many ways.

I'm not from New Brunswick, and I find things a little ridiculous at times... but it's important to realize we have no control over this. I know that practicing as an LPN in NB seems a tad prehistoric compared to other parts of Canada and the States, and it must feel like an ego blow. I work with LPNs who are sharp, smart, driven, and amazing at what they do... and yet they are so limited. You can see their frustration. However, this feud between RNs and LPNs is tiresome and unnecessary... & it looks to me that RNs often come out as the bad guy. This could just be my experience, but in hospital and on this board, I find there is a constant issue of LPN vs RN. I learned we are a team. LPNs are just as important within the hospital setting as RNs. But both are necessary. (Why can't we all just get along!!?)

The OP attached an image geared toward the changes made in our healthcare system here in New Brunswick. I've received this poster along with a message explaining these changes in my work email (the message was not included by the OP). It is not in response to LPN position increases specifically. From my understanding, the province isn't ONLY increasing LPN positions. They are aiming for a "good mix of staff in all areas", which means some units will have increases in LPN positions, some will have decreases. Just like some will have increases in PSW positions (Personal Support Worker, 1 yr program here in NB), and some will have decreases in PSW positions. Many units are having a decrease in RN positions because they want to introduce more LPN positions (med courses are now mandatory for LPNs I've heard for the year 2015, which I'm sure means more cuts to RNs in the future, which scares me, but I digress...).

There IS no replacement for a Registered Nurse. It's true. Just like there is no replacement for a Licensed Practice Nurse. Why is this image so insulting? If the LPN union (CUPE in NB) made a similar poster encouraging LPN positions, I would smile and say, "Well that's neat. It's about time NB stands up for their LPNs."

Fiona, I love that you've given me some insight into what scope LPNs have in other parts of the country. The whole AN community has. Unfortunately, here in NB, things just don't work that way. I don't think Pete is saying LPNs can't do what you described... just that they don't, here in NB, even though they are perfectly capable.

During my shift at work, I am responsible for my patients. Whoever they come into contact with that day and whatever care this person performs (PSWs, LPNs, etc.), the ultimate responsibility is on me. Maybe this isn't the case in other provinces. If I don't check the vitals taken by an LPN or PSW, and there is an issue that doesn't get addressed, it's my fault. Even though I feel like I should have been told about the problem (if I took abnormal vitals on another nurse's patient, I would let them know), the patient is in my care, under my name and license, and therefore my responsibility. I am perfectly capable and willing to do my own vitals and often do (I started in an ICU where we are responsible for the total care of the patient), but if they are done by someone else... any issues arising are still ultimately my fault. I hate double-checking my coworkers' work, and I often don't because I 100% trust the LPNs I work with (we don't have PSWs on the units I work/have worked on), but if something gets missed, it's my bum on the line. This is NOT to say LPNs or PSWs are more apt to miss something than me... not at all. I am just as likely to miss something as the next person, the initials after my name don't make me any smarter or more astute than my coworkers. But it is what it is. It's just the way of Nursing in NB.

To be honest, I'd much rather LPNs work as they do in other parts of Canada. I think the sense of community and teamwork would be much stronger, there would be less resentment on both parts and there would be greater harmony in the workplace. Our LPNs are just as capable of doing what their counterparts do... so why aren't they?

ceridwyn · Sep 14, 2013

It's a funny old world, EN role (LPN) has been put on the the skilled shortage list in Australia as the scope of practise is large and EN's are employed everywhere, the only 'skill' they cannot do is hang blood and IV push and be left on their own in a medical facility without an RN on call, EN jobs are climbing.

RN jobs decreasing. Enrolled Nurses get paid about 7-8 dollars less an hour and their scope of practise is Australa wide as we have national registration not state by state....all education for ENs now is with a 18 month diploma.

There has not really ever been a RN versus EN problem in Australia as you can see scope of practise is pretty much the same and to become an RN is easy to covert just another 2 years at a university.....but now with RN obviously positions being made into EN positions there is are rumblings....Union aware, say thy are keeping 'an eye' on skill mix mmmm not tightly for sure.

So I have hi jacked a thread again, just could not resist showing another side to these LPN restrictions from across the planet.

The moral of the story........as an EN the place to be is Australia for job satisfaction and jobs.