In which way are an RN and LPN alike?

Answer 1

Depending on the country, there are several titles for various levels of nursing. If we also include "Aides" they too have several levels in the delivery of care.

Let's start where many Registered Nurses once started, as a personal caregiver in private settings or (hospital) aide.

A personal care aide (PCA) - typically has no experience, has a H.S. education or equivalency, and is often hired by families privately. The State of Ohio uses PCAs and has the "consumer" (the patient) train the PCA. Ohio also requires a PCA to be fingerprinted before beginning work, and requires 8-hours of Continuing Education a year. In Ohio, is supervised by an R.N. and report to an R.N. These workers can do personal care (bathing, dressing), lifting, positioning, help with daily living tasks, etc. They normally do not do Vital Signs as a daily task, if at all. If private hires, they also do housework and companion services. The duties are basic, and pay is minimum wage under the State, or less if privately hired. No benefits; no holiday pay; no worker's comp usually. Rather like being a housekeeper and "housekeeper of the body"--keeping patients clean and comfortable. Note: Sometimes an experienced "nurse's aide" or even CNAs take jobs as PCAs if no other job is available or fits the worker's needs. PCAs also work in Doctor's offices.

Hospital or Nursing Home Nursing Aide (Nurse's Aide, used to be called Nursing Assistants -- NAs). - These workers rebuffed the term "Nursing Assistant" back in the 1980s-1990s. The job duties haven't changed in any significant way though. If working in a hospital or nursing home, they bathe and change patients, lift, position... all of what a PCA does, but a Nurse's Aide typically takes Vital Signs as part of their daily job. They learn flow sheets, such as for I&O (intake & output). They feed pts when needed, and transport pts. if the transport dept is busy. Now, many "Aides" become Certified Nurse's Aide. Pay for Nurse's Aide is usually somewhat above minimum wage but not much. Nurse's Aides also work in Doctor's offices.

A CNA - Certified Nurse's Aide (or nursing aide) - These persons attend classes, over a matter of months, and become "certified" in basic, but more advanced skills. Although many experienced PCAs and NAs are very knowledgeable from working day in & day out, CNAs have the book learning and practice under direct supervision. They are expected to recognize more of the signs and symptoms of illness or complication, and act as an early warning person when a patient just begins to deteriorate. They take vitals, do I&O, and can do bowel and bladder retraining. Skilled CNAs in the right hospitals or nursing homes can get better wages and get assigned shifts they want (versus swing shifts). Many future Licensed Practical Nurses began as a PCA, NA, or CNA.

In different countries, the first level of educated "nurse" is called a "Practical Nurse" (I believe the United Kingdon, previously called Britian, still uses the term practical nurse), or a Licensed Practical Nurse. Different countries-- and even different USA States -- have some differences in what a Practical or Licensed Practical Nurse can do. I don't know overseas particulars, but I worked with a "Practical Nurse" from overseas who was only permitted to work as an "Aide" in the USA because of unknown differences in the examination between the countries. Overseas, they are also called OVN, Licensed Vocational Nurse-- vocational referring to the fact these students attended a short term vocational school to earn their OVN status. In the USA, the proper name is Licensed Practical Nurse (LPN). They are educated for 1 year with clinicals and book learning, then "sit" for an exam. They *can* do everything a PCA, an NA, and a CNA does, but an LPN also administers SubQ injections, passes oral medications, takes vitals, and reports to the R.N. In the 1980s and 1990s, many USA hospitals tried to eliminate all NAs so the hospital could pay one pay rate and benefits (if any) for 1 person to do everything from personal care to medication passes. At the same time, many of these hospitals only wanted a B.S.N.-- a nurse who graduated with a Bachelors in Nursing. Hospitals used L.P.N.s for all the back-breaking work while (many) B.S.N.s did desk duty with charting and paperwork. But while the push toward B.S.N.s remained, many hospitals went back to using a mixed staff of trained NAs and LPNs. Also, the traditional R.N., whether from a 2-yr or 4-yr education, kept many of the jobs despite the push toward BSNs.

A Registered Nurse - R.N. -- R.N.'s began historically as the "handmaiden" to physicians or as we'd say today, the physician's "right hand woman". Historically, these women did all "care" plus whatever the doctor ordered. This evolved into "the Nurse" or R.N. we know today. Most "R.N." schools were part of a hospital and were 2 solid years of education, on call day and night. The students, historically, slept at the school in dorms and, much like today's Residents (physician students), nurses literally lived at the hospital. The young women accepted into hospital based programs had to have very high morals, were not allowed to date or marry... But by the 1970s, nursing was in one of its repeated declines. Women decades before (1930s-1960s) had married, had children, and the husbands supported the family. Nursing shortages occurred. So as times changed from the 1950s...to the 1970s... schools settled on a 2 year, almost year-round program but accepted single, married, and divorced women. Students were no longer required to live at the hospital or school but went home every night unless they had clinicals in the hospital.

By the early 1980s, these 2-year programs supplied the country with excellent "diploma RNs", as they had for decades. But by 1983, two changes affected the nursing field. As I mentioned already, hospitals began hiring more BSN grads. The Diploma Grad was still very highly trained and excellent, but the powers in charge believed BSNs could deliver a better quality of care, especially in the written areas-- charting, care plans, research. The 2nd change that hit new grads in 1982-1983 was the failure of the country's steel mills, coal mines, and other labor industries like glass mills, especially in the northeastern states. Husbands were now unemployed and many of the RN-wives who had previously stayed home as housewives and mothers returned to the nursing field. Through the 1980's, it was harder for new Diploma grads to find work, caught between the older nurses and the BSNs. But many of the older nurses were unprepared for all the changes nursing had undergone while they had been at home. Many older nurses stopped working again, although many stayed.

At the same time, with the push toward BSN, about 1983-1985 was when many traditional hospital based schools partnered with a nearby college or university to create the first fast-track from Diploma to BSN. Students still take 2 years of "nursing" at the hospital-based school, but are also enrolled in undergrad studies going toward a BSN. These new Hospital-College unions still graduate some of the best Registered Nurses because of the strong emphasis on clinical nursing.

R.N's do get considerably more money than any other "nursing" employee. But they also attend high intensity classes, rotate through clinicals in all hospital departments, and study more concentrated areas than do LPNs. Nusing Boards (the licensure exam) is long and difficult, but graduate nurses from diploma based schools have an almost 98-99% pass rate. RNs can start and run IVs (LPns cannot), can assess and write care plans (LPNs cannot), reassess and take doctor's orders (LPns cannot). RNs are under a clinical supervisor, and in part, are still "under" the doctor. However, RNs still have quite a bit of power, although when caught between hospital administration, insurance limitations, and patient needs, most RNs often feel powerless and disregarded.... and, so, some excellent nurses decide to become--- doctors! But, luckily, the majority of our country's RNs love their jobs / the role they perform far too much to ever abandon the RN they each worked so hard to achieve.

Although this is more info than what was asked, I hope the description of the various roles and how each evolved helps readers understand the role of each caregiver.

Answer 2

There is no difference whatsoever. They are only called LVN's in California and Texas. All other states, they are referred to as LPN's.

Answer 3

an RN has more training than an LPN but the RN is allowed to do more things than an LPN is.