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Counting Nurses

California has enacted a law (AB 394) that will change nurse-to-patient ratios. Because I work in Critical Care, Title 22 already mandates that I must only have 1-2 patients in CCU at any time. Even if my patient has transfer orders to a stepdown unit or med/surg floor, I still must only have 1-2 patients, because I am working in a critical care setting.

Henceforth, I’m not sure what the current working ratios for med/surg are. I floated once to telemetry and had 5 patients. I thought that was okay, but one in particular took up a LOT of my time, thus leaving less time to deal with the other 4. AB 394 puts forth minimum staffing ratios. Critical Care will remain 1:1-2, but most other floors (excluding nursery, ante- and post-partum) will eventually phase to 1 licensed nurse to 4 patients. I believe this to be fair.

However… did you notice I said licensed nurses, not registered? There are two classifications of nurses – RN’s and LVN’s. LVN’s (or LPN’s – they’re the same thing) are Licensed Vocational (Practical) Nurses. I have searched for quite awhile tonight to find out just exactly what the difference is between RN’s and LVN’s and haven’t really come up with anything concrete.

From what I’ve heard over the years, LPN’s can’t do as much clinically as an RN. I’ve read sources saying that LPN’s cannot assess patients, and sources saying that they can. Most LPN’s cannot give IV medications, but some can if they are specifically trained to do so. As a rule, an RN is to thoroughly assess their patients and formulate a nursing diagnosis for each, devise a plan, implement the plan, then evaluate the outcome and change the plan as needed. Nursing care plans are the bane of a nurse’s life. But more on that another time :-) It is my understanding that LPN’s may assess patients in more of a “fact gathering” capacity than an “assessment” capacity and are not able to formulate a nursing diagnosis. Big deal, I say. Nursing care plans are overrated!

Unfortunately, I’m also getting the idea that LPN’s can only work under the supervision of an RN. THAT is distressing to me. Say that AB 394 is implemented in January 2004, and hospitals must then staff their floors at 1 RN for 4 patients (1:4). Theoretically, this means that hospitals can hire LPN’s – after all, an RN’s scope of practice is wider than that of an LPN, so RN’s cost more. Hiring LPN’s to pick up the staffing slack would make a lot of sense. However, this also means that because an LVN works under an RN, it is possible to assign one RN to 10 patients, if the LVN takes 5 of them. This would meet staffing ratios, but would then require the RN to care for her own 5 patients and supervise the care of the LVN’s patients as well.

Most RN’s I know hate supervising anything. After all, if you want it done and done correctly, you do it yourself! Certified Nursing Assistants are invaluable to nurses in helping them turn and clean up patients, empty foley bags, and check fingerstick blood sugars. Other than that, it’s Me RN who will be control freaking on every other aspect of my patient’s care. If I had to o.k. an assessment that an LPN under me does, or determine that one of their patients can have some IV pain medication and then have to go give it, what is the point? It still takes up my time.

I know that there are many areas that are perfect for an LPN/LVN. CCU will never be one of these, but I doubt that that would happen anyway – I’m more concerned about the above happening on med/surg and telemetry floors. There is also a raging debate going on regarding how RN’s treat LPN’s (as though they aren’t “real nurses.”) Regarding LPN’s, I say go for it – use them if that’s the best fit. Just don’t ask me to supervise.

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In California, an RN supervises the LVN and must be the one responsible for administering all IV medications. RNs take responsibility for the LVN under his/her charge.

Frankly, I have no problem with this. Of course, I work with some of the best LVNs in the world and often go to them with questions. They are a fount of knowledge. Many of whom have been tending patients for over 20 years.

Now, the kicker. LVNs are given a limited scope of practice based on their education. They are not a degreed professional. And, I do consider them professionals. I question anyone who goes into nursing as an LVN at this point, when it’s merely a matter of a couple of months more of school. I trust those LVNs who’ve been practicing in that role for years. Not the new ones.

I’m sure that sounds biased. Again, I can only say that it makes no sense to me to pursue a career where your role is limited. I wonder if that means you have ambition but lack the desire to accept responsibility or if you doubt your potential.

I’m sure that cleared up things little for you. That’s just what came to mind after reading the post.

The oher difference between RN’s and LVN’s is the level of education and hours of clinical they do. A&P requirements are less, and I don’t think they are required to take microbiology, and I know that their clinical time is less, and that the overall LVN program is less time than a RN one. Beyond that, their scope of practice differs from state to state. They can’t hang blood without a special certification class, and then it is dependent on each hospital’s protocol. I don’t think they can hang any IV meds, only fluids. and you are right — the care plan thing is just so much noise for an RN or LVN. But they are significantly less expensive than RN’s — I forsee some problems if this moves forward …I also think that if more LVN’s are employed, there will be less CNA’s (and a lot of “get your LVN quick” transition courses for CNA’s (who don’t really want to be LVN’s, but may need to do so to keep a job). Not exactly the motivated, skilled and driven/inspired personnel we would want to entrust the healthcare of our loved ones — especially with a harried RN overseeing it all — dealing with ill patients, concerend families, and LVN’s resentful (perhaps justifiably so) of having everything they do overseen.

Just read the notes from “da goddess” and I have to say, that even if it sounds biased, I also agree with your surmise about lack of ambition, drive, self confidence, our whatever, to take those few extra steps, classes and time, to become an RN. There’s something missing in the equation. I have actually heard people talking about an “LVN being the easy way” to a good paying, union protected type job. Again, doesn’t bode well for the future of nursing, and certainly taints things for those truly devoted and talented LVN’s who work so hard, and are so heavily depended upon.

In response to da goddess, I believe the differences in the LVN’s education and the RN’s education are more than “a couple of months more of school”. The last time I looked at the requirements, the LVN program is a four semester program and includes some prerequisites. The Associate Degree RN program requires 1 to 2 years of General Ed requirements and at least 2 years to meet the RN requirements. Big difference.

I think for many who chose to become LVN’s it’s due to financial/family and/or time constraints. Also many become LVN’s on their road to becoming an RN so that they can earn an income along the way.

I have also heard and read of the difficuly of getting the general ed classes due to the over enrollment in community colleges and difficulty in getting the nursing requirements as well. Not to mention the time and expense of a BSN program. And I just read recently in NurseWeek magazine that there is a growing shortage of instructors and educators for the nursing programs which will limit the number of classes available and lengthen the time required to get through a program.

I think there is some elitism in the RN community in the attitude toward LVN’s. With the nursing shortage, this does not make sense to me.

I’m sure there are some LVN’s who don’t move on to become RN’s due to laziness or lack of ambition, I don’t believe this is the norm or the majority. I have also heard RN’s and LVN’s state that they would rather be more of a hands on nurse than have an administrative role which involves dealing with an ever growing mountain of documentation and regulations. An LVN is more likely to be that hands on nurse.

In my opinion, as an RN, I think that the nursing profession has shot itself in the foot with some of the elitist attitudes about making a BSN the entry level requirement for an RN and the attitude toward LVN’s.

I’ve worked with some marvelous LPN’s. But every single one of them went on to become RN’s.

I’ve also met some scary-stupid LPN’s. I’ve met scary-stupid RN’s and MD’s too. The difference is, my license isn’t on the line every minute of every day because a stupid RN or MD is working under me. That’s the difference.

So does this staffing proposal apply to ER? Why is it that an ER RN can have 4 to 18 patients. (Many of whom wind up in the unit)In 20 years ER of nursing…..rare is the time that I have cared for less then 4 at a time. Often on multi drips, needing blood and a lot more. Oh yes, then there is the friends and family to deal with.

I am a student nursing going to school. I got laid off from a factory job after 10 years and got the chance to go to school for nursing. Now, here I am trying to finish school to be a LPN and I clicked on this site looking for a little help in nursing and all I found is this bad mouthing of LPN’s {LVN’S}. What happen to the Nurse’s code of ethics? I am going back to school after 15 years of being out. I have two childern that I raise and spend one-third of my time helping with homework. I always have a book in my hand studying. I only have time to watch the News twice a week if I am lucky. I did not want to go into to RN because I didn’t know much about the medical field and did not want to get in to deep. I decided to go for Lpn because I takes less time to do,{I needed to provide for my family. and I did not what that much responsibility on me not knowing much about the medical field. I plan to go back for RN later if I decide to. I have already taken A&P 1&2. But the way the RN’s are talking about the Lpn’s, I not sure if I would like to be one of those people. You knew when you applied for nursing school for RN classes you would be responsible for LPN’s. If you didn’t want this responsibility maybe you should have been a LPN. I am glad I am in a different state maybe the RN’s are really nurses around here. To say that LPNs have a lack of ambition,drive,or self-confidence makes you not a very good nurse, you are supposed to have compasion for people, not put them down. People always say RNs may have book smarts but no common scence or bedside manners. Part of nursing is no stero typing, you have no idea what a person is like until you met them. You call yourself a Nurse?

student, your comments and enthusiasm are appreciated, but I don’t recommend you judge any of the RN’s on this website until you meet them. Also, if you re-read the story and other comments, you’ll find more than just “bad mouthing of LPN’s”. You claim that that is all you found here. If I didn’t know any better, I’d think your only intention with your comment was to pick a fight.

I think the LPN program is an excellent program. However, some people do not have the finances for transitioning to RN. This doesn’t mean they are lazy or non- ambitious.

I was hoping to find online courses to go from LVN to RN and am checking every web site that comes up under this search. I wish I had not read the pompous ass remarks made about LVNs. I am glad I live where we are treated like NURSES and not glorified aides. I work very hard as an LVN and do all but hang blood, and make out those wonderful careplans, yes there are a few medications we cannot give IV Versed for example, (OH that breaks my heart). I can assure you that I can run circles around many RNs and don’t receive the same pay. The only reason I would want my RN is to be able to say I did this for me and to receive the pay that I deserve. I have put it on the back burner in order to do other things for my family, number one to bring home a paycheck. I think there are too many nurses with that RNitis. I think there is a translation missed somewhere. I see that RNs are not responsible for LVNs, there are responsible for making patient assignments, doing care plans and give those occasional meds that LVNs cant give. I could see where a specialty area would require specific quilifications. But if you pass your comp. exams with your facility you are hired with then then why would your skills be questioned. So to end on that note, I would like to say hello to all the LVNs out there and keep up the good work and hope that all that go on to RN status will remember what was dealt to them and treat anyone without that two letter title with respect and professionalism that anyone deserves unless they prove utherwise and not based on that three letter title.
Thank you Thank you very much

Hi all,
I live in Houston and have been waiting , full of anticipation, for months to find out whether or not I’ve been accepted into the LVN program that I applied for at a major hospital here. I have read many of the posts here and it doesn’t surprise me that some people want to criticize others. It doesn’t surprise me that they are condescending either. It just means that they have issues with themselves. So don’t let it rattle you. I wonder what the world would be like without LVNs. Hmmm. Anyway, to all LVNs/LPNs out there–keep your heads up and stay positive. Discover and celebrate your purpose and don’t let that cynicism and negativity get you down. Do your job and do it well and do it with honesty and integrity. Stay focused and in control. People are going to talk about you and criticize you no matter what you are doing, but at the end of the day all that matters is that you put your all into your job. Continue to set examples for the people that work with you. Maybe some of that sunshine will brighten even the darkest attitudes.

I will be graduating in two weeks from an LPN program in Philly. I applied to RN schools and the wait was 2 years due to the lack of faculty and demand for the major. I never knew the difference between an LPN and RN, of course I do now. I am a single mother and wanted to become a nurse, make a decent living and know that I woulld always have a job. I know that LPNS are valuable and wonderful with an overabundance of knowledge. I also have a BA in human service and only mad $30,000 a year! LPNS here in Philly are high in demand both in hospitals and LTC with a starting salary of $20-$25 an hour entry level. I would never see that maybe with a Master’s and 5 years experience. I am proud of the route that I have taken. LPNS do not get discouraged we are nurses and never think less. The education that we must acquire is far more difficult than 4 years of collge. I hope this help someone out.

I will be graduating in two weeks from an LPN program in Philly. I applied to RN schools and the wait was 2 years due to the lack of faculty and demand for the major. I never knew the difference between an LPN and RN, of course I do now. I am a single mother and wanted to become a nurse, make a decent living and know that I woulld always have a job. I know that LPNS are valuable and wonderful with an overabundance of knowledge. I also have a BA in human service and only mad $30,000 a year! LPNS here in Philly are high in demand both in hospitals and LTC with a starting salary of $20-$25 an hour entry level. I would never see that maybe with a Master’s and 5 years experience. I am proud of the route that I have taken. LPNS do not get discouraged we are nurses and never think less. The education that we must acquire is far more difficult than 4 years of college. I hope this help someone out.

I need to know more about being a LPN nurse.

I have a masters in nutrition and worked as a clinical dietitian for many years .Now I am finishing up my LVN program, rather than RN because of the long wait period (1-2 years) to get into the RN program here in the state where I live.Eventually I want to be an RN, but I know that this program has definitely helped me.

HELLO OUT THERE….IM A STUDENT RIGHT NOW IN THE LVN PROGRAM BUT I WISH TO CONTINUE WITH MY EDUCATION TILL AT LEAST IVE COMPLETED MY RN. THE ONLY THING IM WONDERING ABOUT IS IF I CAN STILL GET CREDIT FOR MY EDUCATION AS A LVN IF IM GOING THROUGH A VOCATIONAL PROGRAM?

Hello, I am a 21 year old LPN. I graduated LPN school when I was 19 Years old. I am very proud to be empowered with the title LPN. I used to be a CNA. After reading these articles on this web page, it has come to my attention that nursing isn’t what it is suppose to be. Nursing is soppose to be about the PATIENT not the title behind your name. Although, LPN’s are more qualified to be a nurse than RN’s are. Here in Tennessee LPN’s are real nurses. We get to do everything,even push IV medications. The only thing is we cant hang blood. We can monitor it, just not spike the bag. LPN’s here in Tennessee learn the same curriculum that an RN learns except we learn it in ONE year instead of TWO. Now thats hard work. Many people have tried and failed. Just remember the world revolves around the patient, not your title. Also, If you have a license you are responsible for yourself, not the RN. Rn’s aren’t responsible for LPN’s. That is why LPN’s have a license. It doesn’t matter what kind of license you have, its the quality of care you provide. Because remember you might take care of me one day.
Thank you Joshua Patrick, LPN

Very interesting website. For those who are interested in becoming a nurse (LVN) it seems to be a bit discouraging to see the in-fighting that still takes place among RN vs LVN. It’s a shame that as professionals we can’t get along as a team and take care of our patients. This is my half-a-century year and I will be returning to school to pursue my goal of becoming a nurse. I have been out of school for 30yrs+. I decieded to become an LVN and if time permits later as an RN. As you can see it is time not laziness that is my enemy here (pre-req’s for the RN program.) The medical field is big enough for us all to be utilize within our scope of practice. And for those who choose to be a “NURSE” let us remember what is important our patients well-being, not a title!

Here in Arizona, LPN’s do have to work under an RN. A major problem with our LPN’s is that if they got their LPN from a trade school, or non-college program (miltary or hospital based) they have to go back to school and repeat all of the pre-reqs to get into the RN program.

I am in the first block of my RN schooling, and it has been suggested by our instructors that we get take our LPN boards after block two (when we are qualified to take them) and start working to gain experience. The sad truth is that hospitals in this area will not hire LPN’s anymore, due to the limits on their scope of practice by the state board. The only job a new LPN can get is at a nursing home. It is easier, and you make just as much, to be an extern in a hospital and wait out you RN.

U.S. Department of Labor
Bureau of Labor Statistics
http://www.bls.gov/oco/ocos083.htm

BLAH BLAH BLAH. Stop putting down LPN’s!!! RN’s are such moody, pestimistic and worn out/old health care workers. Many need to leave nursing and find a different career, not to mention, lose weight. Why is it that you lot seem to be getting heavier and fatter each time I see you?

I. myself, am an LVN. I have worked in the hospital setting for the past 2 years in the neurosciences unit. I can hang blood, assess a patient completely (as I was trained to assess and formulate nursing diagnoses in school), hang and administer IV meds as well as push IV meds. I can do just about everything an RN can do, and if I do not know how I will find out. My education program was 1 year in length, and any RN program that I wish to attend is an additional year and a half after prerequisites. That is at least 3 and a half years more of education, not a “couple of months”. I have worked side by side with some of the best and worst nurses, RN and LVN. It does not matter what your certification is if you do not wish to use and further your knowledge.

I was looking for books etc. on LVN’s, also on preparing for her licenses at end. My daughter graduates June 05′. I am bias on a LVN or RN, but I agree with others on the bad mouthing of the LVN’S. If the RN’s overseeing of the LVN’s bothers them,they should tell someone above them, try to get their jobs lightened, less work. Recently with loss of my mother, I had little anything for the hospital and staff where she died. After reading my daughters letter as to why she wanted to become an LVN, this changed alot. She is raising 4 kids alone. Later wants to go on, or continue to become a RN. I only hope she’ll become the best damn LVN and/or RN that she can be. And will never become one that only sits back and boo hoos about having to oversee or help someone that probably has her same desire to help people no matter what position she has. It takes all the pieces to put a puzzle together, the same as it takes all the positions in the medical field to help and save lives or make their last days comfortable.

For the poster who stated “LPN’s are more qualified to be a nurse than RN’s are,” you are just delusional. It doesn’t matter how much you try to educate people that there is a difference. Some people are just bitter and will say things like I’m an LVN and can run circles around RN’s. Like I always say, if there were NO difference, everyone would be RN’s.

I ended up here wanting to know the difference between RN and LVN because I am taking my pre-req’s right now and was told by a advisor that after I finish these I should go Nurses Aide and then apply because I would get accepted quicker. Well to my knowledge a lot of people went for LVN. Well now I am glad I ended up here if your going to spend the time in school to go LVN why not just spend the extra time and go RN? I do have a question though, the school I am attending only has a 2 year associate degree and I really wanted to get my bachelors in Nursing, what would be the big difference? Also if I have to wait for the RN program in the mean time what do you RN’s think about going paramedic then crossover to RN when slots are available?

Thanks full of questions?
Chasity

I have read with interest the opinions on this sight of MY CHOSEN PROFESSION. I am a current LPN student here in Minnesota, fulfilling my life-long dream of being a nurse, I am also 50 years old, and may I add I have a 4.0 GPA in a program where 97% is the bottom A, and 96% an A-. In Minnesota, most of the programs graduate 30-90 LPN’s per year, of those programs, only 20% offer the RN advancement step, admiting only 30 students per year from an applicant pool of 700+. Give me a break, I am NOT lazy, or unmotivated, just realistic and old. Why on earth would anyone in their right mind give one of those precious spots to someone who will be of retirement age in 20 years, when it could go to someone 30 years my junior. I am aware of 4 programs here, and there is not one student in them over the age of 30. I have worked as a nurse’s aide, and am fully qualified to pass meds and do treatments and have been since the mid 70′s. I have worked just about every hospital department INCLUDING NICU in my day. I made sure I was an educated caregiver for my late husband, who was a diabetic, he also developed ESRD, and had a renal transplant after 3 years of dialysis, and he went blind. Still, I would not presume to say that I have even 1/4 of the knowledge that a RN has, and when I graduate this summer I MAY consider that I have 1/3.

I have been reading this blog with quite a bit of interest. I am an LPN in FL with 10 years of hospital experience and 6 years of ICU experience. I have gotten as far in training and experience as I can get without actually becoming an RN (critical care, emergency, advanced IV, etc.) I do my own IV starts, a-lines, cvp’s, chest tubes, vents, drips, IV push meds, blood draws, and calculations (just no Swans or cardiac outputs). I have found the attitudes of RN’s I work with to vary in the extremes. Some who think I don’t belong in ICU due to the three letters of my professional title to be the wrong ones, and those who would trust me with their family members, over other RN’s.
I am now facing leaving the field due to recurrent abdominal hernias and subsequent MRSA infections (from working in the ICU so long, and spending long periods of time with infected patients, thank you very much) and to tell you the truth, I think as a whole, nurses in general get little enough respect from the Doctors and the administration, we should be sticking together and support each other. I heard a statement years ago “Nurses eat their young” and I see here why thay comment is true.
The nursing shortage will only get worse if we fight amongst ourselves and don’t work together, and the patients will be the losers.

I have worked as an LPN in 2 hospitals. Each job was in a role usually only reserved for RN, but as usual when staffing is low they will hire LPN or LVN to fill a void. The first position was in NICU I stayed there 13 years. I heard all the rumors about phasing out LPN or LVN’s. I saw many come and go both LVN and RN. I trained both. There are as many great LVN’s out there as there are bad. There are bad RN’s there are good RN’s. The very worst NURSES out there are the ones who know everything. My current position is in a clinic. We have one RN and five LVN’s we trained our RN. She was new just out of school. Shes a good NURSE. The six of us are GOOD NURSES together. Out of six nurses I am the only one who has ever set foot in an intensive care area, I’m proud of the fact that as an LVN I was able to support myself and my child. I was able to do a job I love. I am able to help my favorite people in the world, the children. I didn’t go on to college for my RN because I would have had to commute two hours each way. My mother is an LVN with 30 years in a surgical field. Twenty five of those years at the same hospital unit. I’m proud of what I do. I’m proud of my mother and of all the GOOD nurses out there whether you are an RN or an LVN. I’m sorry for all the cynical nurses who think you can only have two letters behind your name to be of any substance. I now live in a major metro area where i could go to school and recive my RN. It’s not a priority for me at this point in my life. I have the job I want, the hours I want and I’m content with myself. I just wanted to post for all the LVN and LPN students out there who are reading these post. If you WANT to be an LVN or LPN to move forward in your life, DO IT! However, please be the best nurse you can be.

Happy as a Lark in Texas

I am very upset about the way the people on this websight talk about lvn’s. It angers me that the RN’s think that there title makes them better than others. I am currently doing ROP program in sacramento. I am in the LVN program. I chose to do this because it was free, and I couldn’t afford to go to another college. It is a really good program and my hopes are high that I will have a better life for myself and a family one day. I am only 21 years old so I do plan on going on for my RN, but right now I really need to have a good paycheck . It is expensive to live in california and especially when you make minimum wage. I am proud of myself for doing this for me. I don’t care what those RN’s think.

As a doctor, I find this debate about RN’s vs. LPN’s trivial, and meaningless. FACT: 56% of all plastic surgery accidents in the United States will be caused by female nurses in 2005. Don’t believe it? Look it up yourself in the trade journals. My point is, nurses (in this case, female) are incompetent, and shouldn’t be allowed to oversee a patient alone. At best, two nurses should watch a patient at all times, and those nurses should only act as the eyes and ears of the doctor. The doctor is the brains.

As a doctor, I find this debate about RN’s vs. LPN’s trivial, and meaningless. FACT: 56% of all plastic surgery accidents in the United States will be caused by female nurses in 2005. Don’t believe it? Look it up yourself in the trade journals. My point is, nurses (in this case, female) are incompetent, and shouldn’t be allowed to oversee a patient alone. At best, two nurses should watch a patient at all times, and those nurses should only act as the eyes and ears of the doctor. The doctor is the brains.

Please!!!
If doctors were able to handle everything on there own there would be no need for nurses. Proven fact you cannot do it alone, and you need the assistance of a nurse. In fact nurses are the backbone of the hospital and patient care. We are the first person the patient see’s and we are the one that deliver the information to you DOCTOR. So critisize us for helping you with your job…We have gone to school too…and it doesn’t make us any less smarter than you!!!

Oh my GOODNESS! I roared as I sat here reading these silly posts! There were a few who seemed to actually have a “real” head on thier shoulders. Hahaha…you ladies and gents (and I use those terms LOOSELY)…need to go to bed tonight and pray that the Good Lord open your hearts to your patients needs and not to your own glory. LPN’s and RN’s are nurses(YOU didn’t invent the title “Licenced Practical NURSE”)…as for the DOC who posted…In my opinion, you need to see a collegue for therapy! LPN’s are no longer CNA’s and are NOT under RN’s (at least not where I live) and they both have a totally different scope of practice. I say, go to work, do YOUR JOB and get off your high horses….remember….those who judge, will also be judged someday…and it wouldn’t hurt to take the advice of my eight year old…”what goes around, comes around”…seems to me that she is smarter than alot of you who think so high and mighty of yourselves…look after your patients and forget about yourselves…you’ll be wayyy better blessed.

Hi,
My name is Val and l am a L.P.N working at one of the largest hospital is western Canada.l work on the cardiac unit with some great R.N’s.l’m taking the R,N program and l am doing a paper on the debate between the L.P.N’s and the R.N’s,pros and cons.lf anyone can give me some positive input l would sure appreciate it. Thank you.

LPN Prereq: Human anatomy with Lab, Physiology with lab, Alg. II, English 1, and anything you need to get you up to these levels prior to them. Then you can take core courses for PN school…Hello..we are missing Micro….but we have a dif. scope of practice. I am not the best….I am not the worst…I am still learning. I need more money/time to go on for RN, but at least Im bettering myself. TY for all your negativity..there isnt enough in the world.

From a patient’s pov it’s about good care, regardless of what role you play. Thanks to all of my nurses past and present.

Bottom Line: What a nurse (LVN or RN CAN do:
provide great care and support for someone’s loved one’s in their absence or presence.

pray for and with patients
when they are alone & frightened.

provide assistance for a patient when no one else can or will

quit a job one day if they don’t like it and be gainfully employed the next day without losing a salary and still provide
the same level of care aforementioned.

This is only the beginning of the list.

not even that doctor with all the brains can do all of that.

Since the age of 4 years old I have wanted to become a nurse. I am now 23 years old and nothing has changed my mind. I will be entering a private nursing school to become an LVN. In California the wait is so extreme at any junior college I just couldn’t wait any longer. I will get my LVN and mover foward to get my RN. Now let me say one thing… I will be just as proud to be an LVN as I will be when I become an RN. No matter how you look at it…. You are there to take care of people regardless if your title has 2 or 3 letters. I LOVE taking care of people and I want to make a difference in someones life. Of course RN’s have more education… WE ALL KNOW THIS! GET OVER IT! It should always be about the patient and you should always love what you do. If you dont love what you do, get out. Please stop fighting about the title that you have and work together to make a difference in someones life.

Hey y’all! I’m a nurse manager for the stepdown unit at Northeast Baptist Hospital in San Antonio, Tx. I would LOVE a chance to interview ANY of you to work for us! I’m not judgemental or anything. Oh- my skill mix is off, so all you LVN’s with experience come see me, OK?

So, all these bickering and power struggling are the reasons why we patients are not the main focus of nursing anymore. Is this why we are not getting the best care we deserve -because nurses are so busy putting each other down? Set your egos aside please.

My aunt was a LVN in my small hometown in Wisconsin. She had an opportunity to go to a tech school at age 40. She retired at 65. She assisted in births of first and second generation babies. The doctors often didn’t arrive on time for the delivery.
I’m a third generation RN. My grandmother was a nurse in France during WWI. Afterwards, she was the county public health nurse and biked to make visits at farms throughout Treampleau County, WI.
I was out of school several years and worked in the neuro ICU ward at Los Angeles County Hospital. The LVN’s were the best. Their work was task oriented, but the patients received the best of care. Many of us have different levels of education. My aunt worked on her family farm, raised 6 kids and then was able to go to a tech school that had just opened up. She was proud to be a LVN. My grandmother, mother, myself and aunt all had different levels of education. Much depends on opportunity.

I’m trying to decide which I want to be when I grow up. After next semester, I should be able to graduate with a General Studies-LPN track Associates degree. BUT, do I want to apply for the RN or the LPN program after that?
Are the truly any differences, besides salary, in the job duties in Massachusetts?

God bless anyone who sets out to become a nurse–any kind of nurse! I am an RN in Pennsylvania, where we are responsible for overseeing all aspects of nursing care for our patients, including those cared for by LPN’s. Fortunately, my experiences with LPN’s have been been very, very good. I am pleased to work side by side any day with good nurses, whatever their education or credentials. Each state regulates the scope of practice for licensing purposes, thank goodness, and each facility has strict guidelines and policies for nursing practice. We know what we need to do and how to do it–as a team.

Where to start in your career? Consider where you want to go, how much time you have, and how you will pay for your education. Keep in mind that some organizations require a BSN for entry level, such as the V.A. The profession desperately needs educators–could you be a great teacher as well as a great nurse? Why not set high goals?

I personally recommend getting an education in the beginning that includes heavy clinical experience, and then taking advantage of employer onsite or reimbursed courses toward attainment of the RN license and BSN. And college loans are available that can really help, and that may be forgiven, e.g. Perkins loans, for nurses who practice full time. Explore all your options, talk to financial aid counselors, and do whatever it takes. Please, be a nurse!!

Nurses, female or male, are not stupid, ‘Doctor’s Orders,’ but perhaps no one should ‘oversee patient care alone.’ Surely you don’t, do you? Who are the team members on whom you rely to be those eyes and ears? Have any of the ‘accidents’ to which you refer happened to any of your patients?

I graduated nursing in 1969…..wound up being President of the Michigan League for Nursing @ one time….and can tell you that we were argueing about the LPN verus RN issue back then, as well as the same staffing ratio issues, same old – same old, seems like nothing has changed. Hey guys and gals, there are good and bad in all health care professions. Amazing.

I wonder when we questions people’s drive and ambition for not spending a “few more months” if this applies toward RN’s with an A.S. degree as opposed to a nurse with B.S. as opposed to a nurse with an M.S. Are the nurses with the A.S. less competent? I say no! Same with a LPN. There are many reasons not to persue an advanced degree and it is just plain wrong to question people’s drive and ambition based on their education.

Nursing is such a noble profession, and it is in crisis. I have practiced as a nurse for many years, started as a nurses aide, then went for RN, BSN and within the last few years went back again for a masters and Nurse Practitioner certification. One of the things I have learned is that there is a place for every nurse regardless of education. Nurses make a tremendous difference in the lives of the their patients and the families. Granted the degree of education does (and should) determine what scope of practice the nurse operates within. If not for obvious general safety reasons then also to prevent further chaos and even more confusion (for the medical community as well as the lay public). As much as I had learned being a nurse aide, I had no business carrying out the duties of the LPN or RN. It is disheartening to hear some say “well I am just as knowledgable as so and so”. Perhaps so, I have met and worked with those LPN’s who are absolutely superb. However, their exceptional nursing ability is not the sole basis thier licensure should be based on. There must be a way to evaluate and maintain an accepted standard of practice. This is accomplished through our different levels of education and licensure….which sets up different titles within the same field, and this seems to perpetually cause friction among ourselves.

It’s time to stop. And this will change one nurse at a time….Every nurse is valuable, every nurse is necessary. Focus on what you can do not what you can’t, make a difference not a distraction.

I also want to express my sincere sympathy to the MD who posted the entry about how incompetent female nurses are. If you choose to openly share this with your coworkers you are making your life so much more difficult than it has to be. I hope your statement was just a rue but if you really have accepted this as truth, you have unfortunately been mislead along the way. As an educated person I assume you realize statistics can be factored in very misleading ways, therefore the stat you mentioned is by itself not impressive. I suspect it is out of context as stated.

be proud of who you are. keep your opinions to yourself, and concentrate doing what your being paid to do. some of you need to be online researching medical information to continue the best care for your patients instead of worrying about what your credentials are! as for me i am a medical assistant, with and associates degree in business administration. i plan on getting my LPN diploma, and work in LTC, after that i will continue my education in business and one day become a nursing home administrator. so for all of you continuing your education, “keep trucking.”

I find it very interesting that this argument is going on? The truth is LVN’s work just as hard as RN’s and are needed just the same. LVN’s in California make just a good money as an RN with a BSN and maybe that’s the real issue. Maybe many are upset because LVN’s with 1 year of education are doing the same job and getting paid pretty much the same salary as RN’s…lol

I think were all being a little to critical of each other. I was an LPN then an ADN, then a BSN. Now Im working on my MSN. I would take a good competent LPN anyday over some highly uptight RN. I am the Director of Emergency services at my cities hospital, I have worked ER there since I was an LPN. I like the LPN’s and I hire them all the time to work ER. I know some that are ten times smarter then any RN.

I think Nurse make a tremendous differences in the lives of their patience and families.

The definition of what educational curriculm entitles one to call oneself a “nurse” rages on. The fact of the matter is– there is a great deal of difference between the two roles, RN and LPN, yet– both are vitally important to the care of patients. Stop fighting and carry on. If nurses want to see the day that they are compensated commensurate with the profession, they must act like professionals instead of as schoolchildren. We must support each other, encourage each other, and above all take good care of our increasingly sicker and sicker patients. Embrace the differences, respect the contributions of both roles and above all act like the true professionals that most of us try very hard to be.

I’m just about to start school for LPN. I hope the nurses I have the opportunity to work with value everyone on their staff. Patients’ lives are too important. Maybe this is idealistic, but if everyone is more positive, life is just that much better!

I am an experienced, competent LVN working in Houston for 16 years.I became an LVN because I had two small children and it was the best way for me to increase my income and maintain my full time role as a mother. I am almost finished with my RN. I make more money than many RN’s. I have taken a postion in an outpatient surgery center as a pre-op/ pacu nurse, as I have done for many years. I have been questioned of my ability to sign orders, push medications, recovery a patient, etc., by a RN who was hired the same time as I was. I am apaulled and offended. I never claimed to be as “educated” as an RN, but I am a very experienced, educated LVN. I have contacted the BNE, and Texas Practice Act to learn more of the legal realm of practice of an LVN. There is a tremendous shortage of nurses in this country, and it will not get better any time soon. We must utilize our resources and work together for the betterment of our patients. P.S. … and to “Dr. Know it ALL”… there are healthcare professionals from CNA’s to Physicians that are incompetent. It is mainly your fault that caring professional nurses go home feeling unworthy and unwanted. I feel sorry for the Nurses that have to work with you, for you, in spite of you,and around you!

25 Years ago, I went to school to become an LPN. I have since worked in hospitals, doctor’s offices, hospice, rehab, acute care nursing and long term care, but mostly in hospitals: med-surg, stepdown units, telemetry units and respiratory units. All have served me well and I could not go back to school, what with 3 children spaced 2 years apart AND a single Mom taking all of my pre-requisites for the RN course.
So, you think you need to supervise me? May-be you do.

Hello to all of your wonderful nurses. I graduated from a Vocational-Technical school in 1989 with a Practical Nursing degree in Louisiana. I then moved to Texas and have been a practicing nurse ever since in various areas (PACU, Med-Surge, Physical Rehab., Neuro-surgery, Home Health, Private duty, Pain Management, etc.) I have worked with RN’s and LVN’s, most of whom were wonderful, hardworking and dedicated. I have also run across some who were dead-scary. I attended LVN school because it was affordable at a time when I had little money. I could not wait the 2-3 years that it would have taken me to be able to get into RN school, if I had been able to get on the waiting list. Our program was 15 months, and very intense. Our instructors were exacting (RN’s by the way), who expected nothing but our very best efforts and they allowed absolutely no non-sense. If you couldn’t do the work, you didn’t make it. We have such a shortage of nurses. Please, anyone who wants to become a nurse, do so, whether you go to an LVN or RN school. It is an incredible, sometimes thankless profession. But we are so needed. We are the eyes and ears and the front line for out patients. God Bless all nurses!!!!

i think that it is ridiculous that all of these folks are debating the differences between Lpn and Rns.The reality is Rn have a broader base to start with and Lpns begin with a base not as detailed,however it is the nurse personally who determnes what they will be.I am a Lpn and in December i hope to graduate with my asscosiates degree.I started as a nursing assistant and was fincially challenged and needed to step up and grow as much as i could at that time.I am now trying to complete my education a little more.I want to have the responsibility and the autonomy so i can provide more quality care for my patients.Even when i obtain my Rn it will depend on me as to the type of nurse i will be.

ok folks. can the lpn’s and rn’s just be happy that they don’t have my job? i am a cna in a nursing home. lovley huh? but i love it no matter how smelly it is. and by the way thanks to all the lpn’s for giving thoes lovley laxitives and the rn’s for care planing them. that’s the thing people we should all be a team. nursing needs the cheifs and the indians, and in order for our residents to get the care they need and deserve we need to work together and stop bad mouthing each other and just do our own little jobs. yes i am about to start lpn school to make better money and so i don’t have to come home smelling like butt every day. and then i hope to get my rn so i can come home without my feet hurting every day. then i have high hopes of becoming the head honcho one day so i can lay down the law and try my best to get everyone to get along to make everybody’s life a little easier. until then though im happy keeping my residents free of bedsores and diaper rash.lol my point is folks, if you don’t like your job, do something about it, otherwise quit complaining.

I have been an lvn for 30 years and the one thing that disgusts me the most is competition and arrogance.Hopefully whomever decides to become a nurse has humility,without it you can’t give good care or cooperate and be a team.Teamwork is the key,not status,as a predominately female field I think it is good to remember that many of us are single mothers.Perhaps We would all be Rn’s instead of lvn’s if We didn’t have families to support.I know some of you had the ability to be a single mom and get the Rn,too.Point is when We compete and compare We lose.The patient is the first to suffer our lack of respect for each other.Don’t forget our nurses aides and remember they break their backs and hardly get a living wage. thanks rebecca

I have read all these comments
about RN/LPN?LVN.
First No one should put anyone down.
Everyone’s job is important and
NO ONe should think they are better
than anyone else. I hear frequently
Glorified Nurse Aide!
What is that? I am a Nursing
Assistant and so what does that
glorified mean? I sumply try to
do my job and yes it takes working
as a team to get the job done.
What is glorified? Just because
an assitant can do certain things??? Does that make them glorified,or just trying to do thier
part of the nursing team?
Sounds like to me there are many
ego problems and if a person does
not want to be a nurse of “ANY”
kind,go to wal-mart to work or
somewhere else or quit complaining
and putting other people down for
what they do or dont do.
I know I have been put down many times and it certainly uncalled for.
Thank you!





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  • profileI am Gina. I have been a nurse for 15 years, first in med/surg, then CVICU, inpatient dialysis, CCU and now hospice. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!

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