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Thread: LPN's vanishing from PA hospital settings

  1. #1
    Super Moderator cougarnurse's Avatar
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    LPN's vanishing from PA hospital settings

    Isn't this a crock? From the Tribune-Democrat: http://tribune-democrat.com/local/x1...pital-settings

    One local hospital’s decision to eliminate its last five licensed practical nursing jobs reflects a national trend experts say is redefining the profession.

    “The push over the past five to seven years (is that) they have been taken out of the acute care facilities across the nation,” said Missy Moore, president of the National Federation of Licensed Practical Nursers. “For the most part, they work in long-term care facilities, private clinics and physician’s offices.”

    Select Specialty Hospital of Johnstown completed the transition to an all-registered-nurse staff on Jan. 1, Chief Executive Officer Kelly Blake said.

    “External research and studies demonstrate a strong connection between higher levels of experienced RN staffing and better patient outcomes, safety and satisfaction,” Blake said.

    “These studies indicate that that safe staffing can be effective in improving patient satisfaction and improving nurse satisfaction which reduces nurse turnover.”

    When the decision was announced in July, there were nine full-time licensed practical nurses on Select Specialty’s staff.

    All were offered the opportunity to enroll in a registered nurse program at the hospital’s expense. None accepted the offer.

    But despite the changes locally and nationally, leaders say the future is bright for the LPN profession.

    “I have a feeling that it will be expanding,” Moore said. “When health-care reform really kicks in, we are going to be inundated with people who need care. They are going to need every LPN and every RN they can find. Everybody who knows anything about nursing.”

    The most obvious difference between a licensed practical nurse and registered nurse is training, Conemaugh School of Nursing Director Louise Pugliese said. Schools like Conemaugh offer registered nurse programs lasting from two to four years. Schools like Greater Johnstown Career and Technology Center train licensed practical nurses in a year.

    But Pugliese said the difference can be more subtle. Registered nurses receive more theoretical class time, learning about conditions, symptoms and treatments. Practical nursing programs are more clinically focused, teaching students the how-tos of passing medication and caring for patients.

    Pugliese understands the thinking behind hospital cutbacks in LPNs, but agrees that the future remains strong for the profession.

    “Hospitals are making some transitions and not using LPNs to the level they have in the past,” Pugliese said. “It has to do with the level of acuity.”

    Advances in health care, however, continue to extend life-expectancy, creating more need for long-term skilled care and personal care facilities. These homes rely heavily on LPNs, she said.

    Terri Custer has been an LPN for more than 15 years and is supervisor of licensed practical nurses for Presbyterian Home of Greater Johnstown’s assisted living facility. The latest cutbacks are nothing new, she said.

    “I remember right after I started, some nursing homes wanted to cut the LPNs,” Custer said. “It didn’t work. They had to bring them back.”

    The danger, Moore said, is when hospitals replace LPNs with unlicensed assistive personnel. These aides perform many nursing functions, if they are trained and cleared by the facility’s registered nurses and physicians. Sometimes the treatments may go beyond what LPNs are permitted to perform.

    “When you are licensed, the state says what you can do, and not do,” Moore said. “When you are unlicensed, whatever the facility says you can do, you can do under the supervision of an RN or physician.”

    Select Specialty has not used unlicensed assistive personnel to replace its LPNs, Blake stressed. Since July, the facility has hired 13 registered nurses to replace the eight LPNs and a couple others who left. Five LPNs remained when the positions were finally cut.

    “Nurse aides assist the nursing staff and help patients with different tasks, such as bathing, grooming and ambulation,” Blake said. “They work under the direct supervision of an RN and are not involved in nursing interventions or procedures.

    “They do have an important role in helping to ensure that certain nonmedical patient needs are met.”

    Select Specialty is a separate business within Memorial Medical Center’s Lee Campus. The hospital provides complete care for patients whose conditions require longer hospitalization than traditional acute-care hospitals are able to provide under current regulations.

    Memorial itself continues to employ LPNs and has no plans to eliminate the jobs, spokeswoman Amy Bradley said.

    “We have LPNs in our inpatient care areas,” Bradley said.

    “The RN maintains overall responsibility, but the LPN plays an important role in the process.”

    The state Board of Nursing recently expanded the LPN’s scope of practice, Bradley noted.

    More patient care, documentation, medication administration and patient assessment are now within the realm of the licensed practical nurse.

  2. #2
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    They've vanished from all the surrounding area hospitals here in Tennessee as well. The hospital I was working at as a CNA while I went through LPN school announced that they would create new roles for the LPNs in late 2011. These jobs included: a wound care team, A&D teams, and IV start teams. LPNs began quitting rapidly, and they were not hiring any to replace them. These "new roles" never came about and the LPNs that remained were utilized as Nurse's Aides, and on occasion would do go fix an IV that an RN didn't want to go check. When I left in December of 2012, there were still none of these teams they talked about, and the LPNs were still being aides.
    I certainly don't like that the only job opportunities I have in my community is either nursing homes or doctor's offices, but it seems to be the way it's going to be, unfortunately.

  3. #3
    Super Moderator cougarnurse's Avatar
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    *Sigh* And then you wonder about the supposed nursing shortage? Underutilization at its' best.

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