Licensed Practical Nurses: A Dying Breed?

Rebecca Hendren, for HealthLeaders Media , April 12, 2011

“What MRP requires is that there is a role definition for all nursing staff members the hospital utilizes,” says Barbara J. Hannon, MSN, RN, CPHQ, MRP director in the department of nursing at the University of Iowa Hospitals & Clinics. “If you utilize LPNs in a caregiving role in your institution, you must define how this level of provider fits into your care delivery system. MRP hospitals use all kinds of health delivery models, but each one must be laid out in your documentation, along with how each role is filled and how you utilize the State Board of Nursing to define the health delivery roles.”  

“As our patients get sicker and medical care, nursing care, and treatment get more complex, this mid-level provider (LPN) role is not cost effective because there are so many things the state boards of nursing restrict them from doing,” Hannon says. “Because there are so many things they cannot do, our LPNs are included in the unlicensed personnel count. We have to have a full complement of RNs anyway, so it becomes difficult to find a role for them in a hospital with such complex patients as ours to find them something they can do independently.”

This restriction of practice is the biggest reason LPNs are being cut at acute care hospitals. State boards of nursing decide the scope of practice for RNs and LPNs, restricting who may provide nursing assessment and nursing diagnostic decisions. Many states restrict LPNs from dispending medication.

One organization that has successfully moved away from LPNs is North Shore-LIJ, a 15-hospital health system in New York, which dispensed with them in the late 1990s.

“We realized that the acuity of patients in the acute care setting was increasing and that those patients required much more assessment,” says Maureen White, RN, senior vice president/CNO. “We would not be able to rely on LPNs for delivery of those care needs. We assessed it and felt that hiring LPNs in acute care settings would not be advantageous to the delivery of care that we need to deliver.”

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4 comments on "Licensed Practical Nurses: A Dying Breed?"


Sandy Partain (2/2/2016 at 9:26 AM)
Rebecca, I do agree with the other writers.. Please check your facts before stating this insulting information. I have worked as a LPN and known many other LPNs who have functioned professionally in all areas of patient care. I currently have a staffing company for healthcare providers. The hospitals, clinics and long term care facilities are eager to request an LPN when the job description allows. It keeps their overhead down. I have several LPNs who are extremely proficient in their skills and are continuously preferred over the high paid RN. Again please check your facts.

Jack Steffen (12/18/2015 at 7:13 PM)
This is all about money, as most things in this world today are. Hospitals stand to gain millions of dollars if they convert to all RN staffing. Hospitals of course don't want to miss out on any of this money. It's not about nursing skills or so called critical thinking. As an LPN who does patient assessments, med passes, wound and respiratory care, I would consider it an insult to be categorized as "unlicensed personnel". But some people don't care about that - this is what money and the chase for it does to people. As another commenter here noted this story was probably written by someone with a vested interest in seeing LPNs eliminated for more money.

Joanna Schlabotz (5/22/2013 at 6:29 AM)
I just read an article that linked to this one and I must say I'm appalled at the misinformation and defaming of LPNs. To even mention the subject of a process that goes on in one's mind (that would be "thinking" Rebecca, critical or otherwise) as something that can be measured shows a decided lack of the same in the author. In short, Rebecca, I believe this site is most likely sponsored by someone with a stake in the issue. Sometimes it takes time to peel the onion, but it will be done nonetheless for the benefit of unknowing readers who are unaware of how unscrupulous these groups can be.

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