I would like to know why there is such a RN shortage when an LPN can do around 90% of what an RN can do in must states, when there are a lot of LPNs looking for work? Why not use the LPNs where they can work and let the RNs do the work the LPNs can'

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.

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.

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.

So some are responding that on the job training is more important. Does that mean I can be a doctor since I have 15 years of nursing experience?? I went to school and worked my trail off to get my degree, so it's disrespectful to say that because you have on the job experience that you can do what I can. No you can't.

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 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.

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.

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.

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.

RN's and LPN's must work in their scope, you put your license at risk when you don't. Stay on the right side of the law. Until the law changes stay in your scope.

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.

"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.

Ha
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

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.

Politics.
I was an LVN for 11 yrs prior to becoming an RN. And you're right about doing 90% of all that an RN does. Go back to school if you can. Or come work with me in Washington state as we're short-staffed and they're hiring LVNs.

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.

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.

I don’t really think there’s a nursing shortage more so there’s a slim amount of nurses willing to work in shitty conditions. And yes LPN’s are helpful but at the end of the day, RNs still have a larger scope of practice.

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

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.

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.

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.

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.

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)

RNs have a broader scope of practice and require considerably more education to earn licensure. RNs can also work independently in most areas. LPNs, however, must work under a physician or an RN’s supervision.

LPNs perform various duties, such as:

Collecting and charting vital signs
Distributing oral medications
Checking blood sugar levels
Ambulating, assistance with activities of daily living (such as getting dressed or eating/drinking)
Assisting with bathing and toileting
Other various patient care tasks

RNs also perform many of the same LPN duties as well. However, the scope of practice for the RN is broader. It includes other responsibilities, such as:

Assessing patients
Starting IVs
Distributing oral and IV medications
Collecting blood samples
Performing physical exams
Conducting various diagnostics tests
Educating patients and families
Working with physicians to determine patient treatment plans
Counseling patients
Coordinating treatments with ancillary healthcare professionals (such as physical therapy, nutrition consults, wound care consults, or diabetes specialist consults, to name a few).

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.

I have worked with some amazing LPN's but they can only do so much within the scope of their practice. They go to school for a third of what RN's do. Their practice is monitored by RN's, and they could be held liable if something goes wrong and they were not under the direct supervision of an RN. I have also worked with LPN's who have nearly killed kids in the ER, and would have without my intervention. One tried to give an entire amp of EPI to a 3 year old who was having an allergic reaction and they required a SQ dose of EPI. Education DOES matter and if you are comfortable facing a lawsuit from a grieving parent then go for only using LPN's. This is insulting. Just like nurses aids who tell people they are nurses, they aren't. Go to school if you want to be an RN.

I was an LPN for 8 years before I went back to school and became an RN 23 years ago. I had more skills and better assessing skills than the RNs I worked with and recieved half the salary. States require a certain level of education. So I always encourage the youth that ask me to go to RN school. Now it takes so much time to become an LPN you might as well go to RN school (at least in Illinois). When I became an LPN in 1982 the courses were only 1 year.

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.

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

LPNs can not work independently and must work directly under the instruction of a RN.

Magnet status requirements

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.

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

It’s all about the money…

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.

While I agree that the extra hands would be beneficial, stating that LPNS can do 90% of the tasks are stretched a little, probably more in the 60- 70 percent range. There’s a long list of things not allowed to be done based on the hospital practices of course. All admissions assessments not allowed, not allowed to give all hypertension medications IV form, not allowed to manage cardiac drips, not allowed to give IV pain medicines. Can’t follow behind on next shift another LPN, back to back shifts. Some phone orders, if not all.. have to be entered by an RN. Of course wound care, patient care is allowed. Most LPNS are highly experienced, but unfortunately very limited on the tasks the hospital will allow

More like 95%

As a BSN and also a past nurse educator for LPNs, I can speak to that. While I agree that there is no replacement for experience, work ethic, and the knowledge that an LPN/ LVN has, it does come down to the education itself, not just how many papers someone had to write to get their degree. LPN prepared nurses are trained at the systems level for education. The ADN/ BSN nurses are required to have classes that speak to the cellular level of physiology and disease processes. This is important for understanding disease development and progression, medication effects, and treatment efficacy, which impacts the care planning for the patient.
The LPN/ LVN are a valuable part of the healthcare system- but in my area they have been phased out of acute care because of the data that shows better patient outcomes overall associated with higher level prepared direct care nurses.
I think the current shortage of bedside nurses in general does need to be seriously considered when implementing care options- team nursing and acuity based staffing models are examples that could incorporate the LPN into bedside care again. Unfortunately the trend is moving towards virtual healthcare options, which do not always serve the patient better (they still need that human element). However, I have seen that LPNs are part of some of those healthcare models, doctors offices, and clinics, so there are opportunities available other than the nursing homes.

Because LPNs are not allowed to write nursing care plans or do nursing diagnoses/assessments. That is why BSN are needed. You may be able to do the task, but you do not have the liability or the education and licensing to write care plans or be case managers. RN's are responsible legally for the care the LPN's carry out on the patients.

Because most places are requiring a BSN at minimum now.

In Washington State, the WA State Nurse Practice Act defines the scope of practice for RNs and for LPNs. LPNs are not allowed to do "around 90%" of what a RN can, so that is misinformation. The scope does allow RNs to do anything that an LPN is allowed to do, and more, so they are more useful in that sense, can be utilized in more ways and more areas, and therefore provide more "bang for the buck". Mary W, MN, BSN, ADN, RN

By law LPN and RN have different scope of practice. Just like a RN and NP do. Just because I know what meds to order does not mean that my scope of practice allows me to do so.......I work for a hospital that utilities LVNs.....I work hand in hand with them and do cover 1 of their patients every time I go to work ,all though I am grateful to have them there......I would say that the majority do not have the critical thinking skills required to work in a hospital setting........I believe their skills sets can be utilized in a settintg that have stable patients

I’m not sure about other states but here in NY LPNs are not allowed to make assessments for some reason, I don’t know wether it’s just NY or it’s the same in other states or if it’s just not in their scope of practice. But all I can say is that in certain positions yes LPNS would be amazing, out patient, clinical where they swab and give injections, teaching medical assistant clinical classes, I’m sure a lot of other roles that don’t require assessments but in a critical/ acute/ setting or a setting where emergency’s can happen fairly quickly if that LPN isn’t allowed to assess the patients and there’s no other RNs working with them that’s not fair to patient or the LPN. Because the patient needs that assessment with quick actions to save the persons life to asses for hypoglycemia/ stroke/ aneurism/ blood clot/ seizure/ tons of things ect all things when finding a patient unconscious and know how to assess and keep the patient alive. If they can do that great but if they are not allowed in NY or other states… that puts them at a disadvantage for some spots, but I myself have been a patient under some great LPNs in the past for more less acute issues and you guys are appreciated for what you do, which is also a lot too! So thank you.

To look good. Hospitals in my area really pushed for magnet status which meant more BSN nurses and less LPNs

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.

Scope of practice !!! RN’s and LPN’s have different scope of practice. If you, as an LPN want to work as an RN job, you can go back to school and get your RN degree. Simple as that ! There’s A LOT of skills that an RN learn while in school for 3-4 years (4 years for BSN). Our training as an RN is more in depth that’s why we are in school longer than an LPN.
I’ve worked with amazing LPNs but no matter how good of an LPN they are, we still have to practice within our scope of practice. Patient safety is important.

as an RN i don't like working with LPNs because I am legally responsible for their entire assignment PLUS mine

Actually, in southern Maryland hospitals are beginning to bring back LPNs to acute care. It's called team nursing and it's a team of 1 LPN 1RN and 1 or 2 PCTs taking care of a team of 8 to 10 patients.

It's been a bit of a rough start, but people are beginning to get it.

The same reason ADNs are coming up against "BSN required" despite having 20+ years of nursing experience. After a study regarding level of nursing education in relation to patient outcomes, the percentage of the nursing staff that are BSNs is a quality marker for Magnet status and many websites. Hospitals are more concerned with how they look on paper and websites than with filling positions and relieving the overworked RNs already in staffing which was also shown to greatly affect patient outcomes, but isn't a quality marker that's easily quantifiable.

Because people are not thinking. I went to a diploma school in 1974 ( I only went 1 year). I learned WAY MORE there than when I went and got my BSN. The BSN is a waste unless you want to get out of patient care. I graduated in 1994.... and we were not even allowed to start IVs on each other or give each other shots. Thank God I was a medic on the Fire Dept so I did have an advantage. I know many LPNS that can run circles around BSNs and also make WAY MORE MONEY when you get out of bedside nursing and go into other fields of nursing. CDI, Case Management, Medical IT. Shortage is because people do not want to work the floors anymore. Too short, too much risk to your license... too little pay. Sad state of affairs!!!!!

Debating LPN/RN gets old, I've heard and seen it all. Lpns that can run circles around RNs, RNs that put doctors to shame, and then some of both that don't know how to do anything unless given step by step instructions. Daily. This has been an ongoing debate for the last 38 years that I know of, and it's not going to go away any time soon. However, this question reads like there are tons of LPNS out there desperate for work. Where? I know of places that would kiss their feet if they'd come work for them. The number of LPNs available seems to have dropped, a lot of the experienced have retired or moved to less stressful fields, some got out of nursing because of COVID and the risk to themselves and their family. And those that make the rules just add more regulations and less staffing requirements to add to the mess. Honestly, I'm in my mid 50s, and if I could find something outside of nursing that pays close and doesn't require a Bachelor Degree, I'd probably change careers

LPNs do not have the nursing theory behind what we do. I don't mind working with LPNs but I don't want them hanging my IV under my license.

Hospitals are now hiring LPNs so please look again. Many jobs are posted and more will come.

The scope of practice of an RN and LPN are different with the LPN working under the supervision of an RN. The training for that scope of practice is also different with the emphasis on different area of performance. The scope of practice is detailed in the state licensing- it varies by state- please check your state training and criteria. It is not fair to compare the two roles, as it is not fair to ask the LPN to function as an RN. Credentialing is done for a reason.

Depending on the state you work in, LPNs can’t do certain things, like IV pushes.

Trying this at our facility and it’s awful

I agree..

The hospital I work at in Colorado has implemented an LPN model. It is up and running on one of the units and rolling out to the other Acute Care units.

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.

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.