Because a large influential health care system came up with a study which showed better patient outcomes were associated with level of nurse education and everyone drank the kool-aid.... .
I've met LPNs who can run circles around BSNs. I have my DNP, but its only because I've written more papers. Academia requirements to be a nurse are different than real life needs. Don't confuse a degree with knowledge, compassion or common sense
It’s my understanding then an LPN knows how to do a particular skill but doesn’t know why she does it that way and when you do not have the background mistakes are made and most mistakes in nursing are signed in blood. I’ve worked with plenty of LPNs that I thought were good nurses most of what they Knew they learned on the job. An LPN nearly made a fatal mistake on my son in an emergency room setting one time Wayback when. My son was prescribed a shot of Thorazine for constant diarrhea and the LPN (at that time you drew up your own meds) drew up a syringe of 3.5 mL rather than .35 ml of course I questioned it and she got very nervous and I asked her to call the pharmacy to confirm but the scary part for me was that she didn’t question giving 3.5 mL to a eight month old baby no matter what the drug. Sorry I feel if they wanna be an RN go back to school. As an RN I do not want to be responsible for the mistakes that an LPN working under me that particular day may make.
I keep hearing about how it is difficult for an LVN to get a job because they are only hiring RNs. I live in Southern California and began working as an LVN before I even graduated LVN school. I have worked as a Camp Nurse, in Drug Rehabilitation, in Outpatient Surgery, in Long Term Care and now in a School setting. I have been an LVN for 12 years and have never had a down time where I couldn't find a job. I have settled in the School Nurse setting because it is pretty low stress, and the retirement pension is what I am looking for now. I am off on the weekends and evenings and the Summer, if I choose. I have lots of time off to travel or just do home projects and still make a pretty nice income. When I want more income I do Flu Shot Clinics during the season and did a lot of Covid Clinics over the past 2 years. There is a lot of work out there if you are willing to look for it and keep your skills on cue.
Eric, in this case it is not about the glib answer of money.
There are different skill levels and cognitive levels that are involved. the driving factor is that little thing called STATE NURSE ACT. Then there is Joint Commission (or whatever accrediting bodies are involved). There is a push on to increase the education levels of bedside RN's.
Research done in the early 2000's indicated regardless of setting and regardless of the acuity of the paints all patients did better when the unit was staffed with all RN's or with a very high percentage of RN's. I can't give you the citation or date of publications unfortunately.
Before you call me a LPN basher ... I stared as a hospital orderly before and while I was getting my RN - and frankly looked at one RN particularly and said if the dumb ( person ) can be an RN so can I. So I went to a diploma program (followed by BSN completing, and MSN FNP programs) - I am that chronologically experienced! I have worked in hospital, addiction centers, and corrections facilities with many brilliant and talented LPN's I liked them and they did a great job .... in fact in a family with 1 NP, 3 RN's hospital business office people we count 2 LPNS in the mix. I have no trouble with LPN's
Laws and official skill sets and policies drive the who, what, where, when, and why of health care operations.
LPN's do not have the same training, scope of practice or level of responsibility that RN's do. That would be the reason.
I would like to offer another perspective… first we must stop with the whose better LPN vs RN. The reality is that OUR profession is a calling and there are good and bad nurses…period. If we as a profession want to improve patient care (because that’s the real issue with a shortage) then we will need to rethink and create a new staffing model that utilizes the expertise that we as NURSES can offer. If you live in a state in which LPNs can work in the hospital and you have excellent candidates then I urge the NURSE leaders of the hospital to create a safe staffing model that utilizes both skill sets, in accordance with the state laws.
Another thought….there are plenty of rural areas that could benefit from a NURSE run clinic in which both APNs, RNs and LPNs could work side-by-side to provide care to the most vulnerable populations. I am sure there is grant money out there that would support this idea. Remember the hospital systems that we know today is based on the same principles that Florence Nightingale used to create the first hospital in the 19th century.
Final thought…the inter-professional “bickering” does not serve us well and only holds the profession from moving forward, which in the end, is a grave disservice to our patients.
We have had an RN shortage since the late 1990s/early 2000s. I have worked with a lot of good LPNs and LVNs. However, your statement is grossly incorrect based on Board of Nursing scope of practice, nursing practice acts, and formal education. Research studies show that nursing care improves greatly if you have more BSN RNs to ADN RNs. Reducing the education levels of the front line nurse to LPN/LVN would set up a hospital for so much risk for bad outcomes and law suits they would lose funding from insurance companies and Medicare. The Joint Commission would close the hospitals for Immediate Jeopardy to life and limb of patients.
I would recommend the LPNs that are out of work find an ADN program, complete it and sit for the RN NCLEX and bring what they have newly learned and LPN experience and get back into the game.
The state I am from the ADN RN literally only goes 1 more semester of schooling that an LPN. You can’t tell me that they learn that much more in 1 semester. As to you all that are saying RN’s know so much more than LPN’s seriously need to educate yourselves. I’d much rather have an LPN with years of experience than to have a new RN as my nurse any day. Learning hands on no matter what letters appears after your name will truly make you the better nurse. Trust me I’ve seen good and bad nurses as an RN and an LPN.
The major differences between nurses educated The major differences between an RN and an LPN are based upon their level of responsibility and how they are taught to think. The LPN is not encouraged to develop significant investigative and critical thinking skills. Instead,when their astute powers of observation identify a potential problem,they are not charged with finding the solution, just finding the RN and reporting it. Also, while LPNs administer meds well, they don't have the same knowledge level about the meds they're giving, as the RN does.
G. Gwozdz APRN, MSN, MBA
Former LPN instructor
I am an RN that works in a very busy ER level one trauma center. The majority of our nurses are now LVN/LPNs. When I have four very busy patients and they’re usually all vented yes this does happen, I’m supposed to sign off for an LVN and I have decided in my practice not to do so for many reasons. One of them happens to be legalities. I went out and spent my own money and created drip cards for these LVN‘s who are now being told to do their own drips (not in their scope) and get an RN to confirm. Well while I am monitoring my four vented patients and holding them in a very busy trauma center you want me to stop what I’m doing to go and take a look at what somebody else is doing? That’s not going to happen. I ended up leaving my position because the stress was so intense and for the last year I’ve been traveling again. Yes we may be both nurses but our scope of practice is very different. Some nurses left for the money I will agree. Some of us left after three years of absolute intense Covid thrust… My desire to be honest with you is to look at retiring. This is not the same nursing I started 21 years ago. Good luck to everyone.
LPNs can’t assess, which is honestly necessary in patient care, given all the meds that are being prescribed. I don’t know any hospitals hiring LPNs (ie. They can’t hang IV meds). Why hire an LPN that can’t be used for the requirements of a job. That’s a waste of money because they’ll need to call in a RN. LPNs just don’t have the training, experience and education that RNs have. It’s not just LPNs, many hospitals are requiring RNs to get their BSN. They are using research and evidence based practice to determine best patient outcomes. The data has proven less error with more education.
Hospitals do not see it that way. Each state has its own rules when it comes to what the LPN/LVN can do. One state may allow it but another one might not. Health systems seek higher-educated nurses who can provide a wider scope of duties, especially the ones that are considered "magnet hospitals." It is ashamed really because I have worked with some excellent LPN/LVN. These are the nurses that the hospital needs to send back to school to become RNs.
As more and more hospitals pursue Magnet status, the LPN does not fall within the practice model required for Magnet designation. The ANCC offers an alternative to Magnet which is Pathway to Excellence Framework, which includes LPN's in the structure. Pathway to Excellence is built on a foundation of sustained excellence, nurse engagement, retention, health work environment and inter-professional collaboration.
With the RN there is a higher layer of education, critical thinking, assessment and accountability. RN's are held to a higher level of responsibility.
It’s not just training that’s required. It’s education, from an accredited university. Then you must successfully pass the NCLEX exams. Some BSN nurses aren’t qualified to work in the hospital. They may only have experience in other nursing areas such as long term care, supervising, dialysis, hospice home care etc. There’s many areas of nursing and the skills don’t just transfer from one are to the next. I work in the ICU but I can’t just go apply to work in the OR or a pediatrics ICU. They want nurses who have experience in the area, usually about 3 years sometimes more, as well as the education to back them up.
It's an RN shortage. I agree LPN's are essential in some hospital units, offices and nursing homes. We do not use LPN's at the outpatient surgery and outpatient gastroenterology clinics where I work. IV pushes, sedation, legal reasons to have an RN present. We have GI techs in the endo room, Surgical Techs in the OR and Med Assistants in the office part. The hospital where I worked for 30 years as a RN had many wonderful LPN's. They still hire LPN's for the floors. Not in ICU, the OR or PACU. It seems RN programs around here are not filling up like they used to. After Covid, it seems people don't want to work Ada RN.
All the answers stating it's about money are not wrong. There was a study completed that suggested the more education one has the better the outcome for patients. That study brought about the term "magnent" hospitals. In short, there is government money tied to that magnet status and there may also be greater revenue gained from billing. LPNs/LVNs are incredibly skilled nurses unfortunately they don't have the scope of practice registered nurses have. Doesn't mean they aren't as smart, talented, or amazing as any other nurse. Not to add gasoline to the fire but, associate degree nurses are also having issues with employment when hospitals want a bachelor's degree RN. Hope this helps, good luck in the future.
However, LPNs have a limited scope of practice compared to RNs. State regulations and workplace rules often limit what an LPN can do. While it takes less time to become an LPN than an RN, a major draw for busy professionals, the entry-level educational requirements often restrict LPNs and licensed vocational nurses (LVNs)
It’s all about the money…
Because in most states, LPN's must be supervised by an RN. If there are not enough RN's, then who would supervise the LPN's. Also there are still many things that RN's can do that LPN's can't - like assessing, deal with PICC lines or doing patient teaching.
Our healthcare settings have become more advanced and our patients are coming in with many disease processes (Comorbidities). Adding aging to the many disease processes increases the risk factor of complications so Registered Nurses are getting more education plus more clinical hours of training so they can perform high skilled treatments that used to be done by doctors. So LPN’s now have a disadvantage because most hospitals are actually looking for RN’s. Before Covid hit in 2019, there was talk about phasing LPN’s out. I do know that Nursing homes and inpatient psychiatric hospitals continue to need the services of LPN/LVN’s.
LPNs cannot do 90% of what the RN does. The basis that the LPN cannot make an assessment is an essential issue. To assume that the LPN can do what the RN does is inadequate and ignorant.
Hello, You are deceiving yourself to think that you have the same education as a registered nurse or scope of practice as a RN. A new nurse with a bachelor's degree in nursing has a tough time with critical thinking and has a poor ability to rescue a deterioration patient. LVN's should be phased out of acute care nation wide like California. There are enough registered nurses to provide adequate care in today's hospitals. The problem is: management wants high profit margins and intentionally understaffs these hospitals. LVN's have a tougher time in long term care giving medications to 20 plus patients in long term care as a registered nurse.
"LPNs don't have adequate critical thinking skills." Intriguing. Here's my follow-up question for RNs and others with that belief: How do you think LPNs manage rather frequent SNF emergencies, on NOC shift, when there is no RN or clinician on site? We don't just give up and call 911. We have to assess---yes, assess---the resident ourselves, critically think about what care will be needed, and make certain the resident gets that care by coordinating it. Sure, we reach out to the on-call doc but often, we've already dealt with the situation within our scope of practice. LPNs (and CNAs, for that matter) are the lifeblood of skilled nursing for one of the most vulnerable populations, and critical thinking is an essential part of our everyday work (and not just on NOCs). But don't take my word for it. I challenge all RNs who doubt an LPN's ability to think critically and solve problems. Go work in a busy SNF for a month and notice what LPNs actually do, there. On another note, those of you telling LPNs to "just go back to school" may have forgotten how difficult it is, considering daily expenses and how few bridge programs remain. Most LPNs aren't fresh out of high school with no kids or bills, thank you very much.
To look good. Hospitals in my area really pushed for magnet status which meant more BSN nurses and less LPNs
Please, no. Ya'll RNs earned that money. We LPNs will gladly sit back. Ya'll got it. Please don't give me, an LPN working beside RN in a SNF, any more work for 1/3 of the pay. Nope, I am OK. LPNs STOP CLAMMORING FOR MORE WORK!!! GO TO SCHOOL, BE AN RN!!!! We LPN's stopped for a reason. *Rant over, signed, a young 15y OG LPN* -AD
A study that was originally called Healthy People 2020 (now 2030) and wanting to achieve “magnet” status- which goes to insurance reimbursement = less money coming in to hospital - so everyone requires minimally a ADN but prefer Bachelors Degree —- RN in hospitals are made to countersign the LPN notes and that makes them have to go and assess pt too… so ultimately it is the RN responsibility if something goes wrong! Which is unfortunate!!
Some of the best nurses I have ever worked with were LPNs and Diploma nurses! But comes down to passing the buck both literally and figuratively!
A good portion of Health Care systems have either achieved, or are working towards Magnet Status for nursing, which requires not just the RN, but a BSN as well. A majority of what LPN’s are able to do can also me performed by a trained Med Tech, which costs the Health System a whole lot less money.
You are correct; however, the LPN does not have the skill set to assess patients according to the nurse practice act as well as to critical thinking, recognize the subtle change in condition and critical t
All the RN instructors went to work in a healthcare setting rather than class setting. Why? money. As an instructor the money is not there, so the RNs during Covid went to work and made LOTS of money. Now we have a shortage of RNs.
Hospice is always looking for LPNs
In my state LPN can work in the hospital. The shortage is so bad that they are hiring more LPN for the hospital. I work in the hospital and I work along side a lot of dumb nurses who don’t know what they’re doing. To me. It’s about money but now at least in my state they can’t afford to keep having these shortages Rs. Nurses are leaving left and right. I’m a LPN student but I also applied to go to RN school directly after I graduate. That’s my choice because I want to be a NP. What I don’t like is that majority of RNs look down on LPNs when I can do literally 95% of what they can do but hang blood. I can press start, I can take it down and monitor, just not hang blood. I can do everything else.
In California nurse patient ratio law only allows 50% of staffing in any unit be VN; however RNs must monitor - sign for - and cannot administer IV medications.
For most employers (ie hospital setting) RNs are not willing to work with VNs and the later puts pressure on nursing administration. Sadly
LVN’s or LPN’s can do almost everything an RN can do in most states depending on that states Scope of Practice Act for each nurse but when it comes to the hospital setting the main factor is LVN/LPN usually are limited to a smaller patient nurse ratio and they cannot do an admission assessment. Certain medication they might not be able to administer either so the type of pt they can have could be limited on the floor, I think I had a TPN pt that the LVN couldn’t take but as a new graduate RN I could since I had those 6 extra months of schooling, she had years of experience on me.