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Testing the Waters

An LPN is seeking support for an initiative that would allow practical nurses to challenge RN licensure exams.


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It's not hard to find LPNs who are unhappy with the politics of their profession, feel disrespected, unappreciated and, essentially, undervalued by RNs and administrators.

Many also argue that job restrictions and scope of practice prevent them from working to their full potential.

These discussions are becoming more common as more facility administrators are requiring practical nurses to go back to school to earn their RN degrees or face termination or reassignment.

If only the solution were that easy.

Many LPNs who claim they'd like to earn their RN also claim to have difficulty finding the time and/or money to go back to the classroom.

Then there's the hurdle of being accepted into a nursing school, they say, especially with the faculty shortage placing strict limits on the number of students who make the cut.

Instead, many veteran LPNs are wondering why their respective boards of nursing don't give them the opportunity to challenge the RN boards, much like schools allow them to challenge certain courses.

A few months ago, Lisa Morell, LPN, stopped talking about this possibility and decided to take action. Today, she's trying to effect change through an online petition she hopes will eventually lead to nursing legislation that would allow LPNs to "test out."

Specifically, she's proposing that any LPN in her home state of Connecticut with at least 10 years of hands-on nursing experience be permitted to attain RN licensure through state nursing boards by sitting for examination.

"I don't really know what I'm getting myself into, but I'm too involved now to not move forward," admitted Morell, who's worked as an LPN the past 30 years. "Even if I don't get anywhere with this, if I can at least make some noise by just speaking my mind as a taxpayer and as a nurse who feels underutilized, I'll be satisfied."

Starting Small, Dreaming Big

Morell's diligence toward this effort is starting to make others in the profession take notice. While, as she expected, some nurses openly disagree with her plan, she also has her supporters. And, surprisingly enough, the pro and con sides of this debate do not fall evenly between LPN and RN lines.

As of May 30, Morell had accumulated more than 150 signatures in favor of her "e-petition" since launching it the weekend of April 18. Any U.S. resident is eligible to sign the document (including those in the general public), though Morell is currently focusing her efforts in Connecticut.

"Every state's laws are different," she said. "And as much as I'd like to, I can't do what I'm doing for every state, it'd just be too much work. When I feel like I've received enough support, I plan to approach my congressman in Connecticut to take action."

A handful of signatures had come from Connecticut (including LPNs and RNs) but does this petition have legs in Morell's home state? While she couldn't speak for the entire board of nursing, Heidi Darling, LPN, a representative of the Connecticut BON, told ADVANCE she's strongly considering adding her name to the list.

"With the nursing shortage what it is today, this sounds like a great idea," said Darling, a 20-year nurse from Manchester, who's currently on staff in a dialysis center. "I think it's feasible, but I also think she's in for a fight."

That's at least one premise that Darling and Regina Thomson, LPN, president of the Connecticut LPN Association and Patricia Bouffard, RN, chairperson of the state nursing board, agree on.

The latter two believe it's a fight Morell can't win.

"The regulations are clear that an LPN program prepares you to be an LPN and the RN programs prepare you to be an RN," said Bouffard. "According to the regulations, the two don't mingle at all. While some skills may overlap from LPN to RN, the education preparation is different. I can't comment on the chance this has of becoming law, but I don't agree with it."

Thomson echoed these thoughts.

"[Morell's] trying to compare apples and oranges," she said. "I know other LPNs who think their license is similar to an RN's, but it's not. It's like saying being an RN for 10 years makes you a doctor. It doesn't. Her chances are slim to none."

Despite these viewpoints, as a board rep in the Constitution State, Darling said she'll exercise her right and responsibility to discuss this with board officials.

"I will bring this up; it should be brought to the board's attention that this is something people in our state our talking about," she added.


Testing the Waters

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I have been an LPN for 22 years and have faced many of the diversities as everyone else has. I too have heard the "why don't you become a Real Nurse" I always said LPN does not stand for "Let's Pretend Nurse". Many LPN's now have certifications unavailable 10 years ago. The profession is changing, and not always in our favor. LPN's with 10+ years experience should be allowed to challenge the board exam. I believe that our own profession has created this nursing shortage, and we are going to have to be the one's to fix it.

Susan Holland,  LPN/Charge Nurse,  Ambulatory CareJune 21, 2009
Bradenton, FL



To all the RN's out there....I understand and admire the fact that you were able to complete an RN program and I don't minimize that for a moment.

However as an LPN since 1981 I feel I have gained the knowledge in the "pitts" of nursing that can't be taught in a book or classroom.

I would have loved the chance to attend an RN program after completing the LPN program, but as I am sure all the LPN's are aware of out there we usually make far less then our RN counterparts. Making ends meet is hard enough.

I have worked just as hard as the RN's and in many instances harder. In all honesty I am tired of being asked "If I am a real Nurse?", "Why didn't I go back to school to be a real Nurse?" and being overlooked for positions because I have the wrong initials after my name, even though I could do the job as good if not better.

The sad part is that many LPN's are leaving Nursing because they either can't afford to go back to college, can't work and go to college ar the same time or they are tired of being treated like they aren't Nurses.

If you want to address the Nursing shortage there you go....there are not enough Nurses now and it is only getting worse. I would love to work at my local hospital but I'm not an RN so I can't get a job there. Instead I work for an insurance company.

I would love the opportunity to take the RN boards so that I could prove my worth and demonstrate the knowledge you only learn by doing.

I also happen to live in the not so great state of Illinois (the only state that does not recognize the Regents Program of home study for LPN to RN bridge), how do we 40+ year olds keep our jobs and go to school fulltime? Let's be honest most can't do both.

I am currently still taking the pre-req's a class at a time that are rrquired to even try to get into a program that may let me bridge out the first year. If I am so lucky to do that I would not be able to work and go to school fulltime, then what?

I do understand and in many ways agree LPN's should not just be grandfathered into being an RN but there could be criteria set. Like licensed LPN >10 years, completed the pharmacolgy course, completes courses and training for CEU's, etc.

All I ever wanted to be was a Nurse and to many people I still am not....it's all in the initial's I guess.

RN=REAL NURSE.....LPN=LICENSED PRACTICAL NON-NURSE
(Yes, that is what someone called me because they only wanted an RN to care for them because I wasn't a nurse)


Grace Rice,  LPN, Manager of Medical ManageJuly 18, 2008
Naperville, IL



Between 1946-1964 76 billion babies were born in America. Now they are getting old. I say let those LPN who workded 10 or more years that want to chanllenge the RN exam. They are experienced enough to make critical decision.

Mida July 09, 2008



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