Who’s Who In the World of Nursing
If you’re interested in working in the medical field, you are probably already aware of the great need for nurses within America’s hospitals, nursing homes, and other institutions. Studying to become a nurse or a nursing assistant is likely a smart career move, as it is a field that will only grow as America’s population ages. But, you may be a bit confused by all the terminology floating out there. Registered nurse, licensed practical nurse, certified medical assistant, certified nursing assistant – figuring out what’s what will be easier once you’ve read the following paragraphs.
A Certfied Medical Assistant (CMA) works in doctor’s offices. They do some clinical work, such as taking blood pressure, and even blood, if trained in phlebotomy.
CNA is a Certified Nursing Assistant. You do the grunt work and you are not a nurse.
LPN is a Licensed Practical Nurse. Education for this takes very little time, but you’re not paid as well as RN, and you’ll most likely work in a nursing home.
ASN or ADN: This is an RN (Registered nurse) with an associate’s degree. It takes 2-3 years to complete. You make good money when you are finished and you have direct patient care in hospital and doctor’s office settings.
BSN: This is an RN with a bachelor’s degree. With this degree, you can get into more advanced nursing and go into management.
A CMA will work in a doctor’s office. She/He will take blood pressure; and if trained as a phlebotomist they can take blood. They can also do clerical/administrative work. So they do clinical and administrative work. They can work in urgent care centers, physician offices, and sometimes in hospitals, it depends state by state.
A CNA takes a state exam and once she/he passes they can work in a home health care facility, hospital, or physician’s office, etc. The CNA will do clinicals and if they train as a phlebotomist they can take blood. Physician offices like to hire CNAs as medical assistants in their offices, so that they can have someone that is licensed and also hopefully can do some administrative work.
CNA = certified nursing assistant. These folks do the bulk of the grunt work in patient care: baths, vital signs, cleaning of episodes of incontinence, transferring from bed to chair to bed again, daily weights and so on. This position generally includes a 40-60 hour training class followed by a cna certification exam.
LPN = Licensed Practical Nurse. These folks have nursing training (15-18months) and licensure. The tasks that they perform are governed by state boards of nursing and further governed by the institutions in which they work. They can do nursing assessments and pass medications. In nursing homes, they can be charge nurses overseeing entire floors of patients and CNAs. 12-18 months of education and clinical experience followed by a licensure exam.
RN = Registered Nurse. These folks have 2-4 years of nursing education and are licensed by the state board of nursing. All of the responsibility for daily patient care falls onto these medical professionals. They delegate tasks to the CNAs and LPNs, provide direct patient care, pass medications, chart care activity, communicate with the physicians and run entire units. 3-4 years of nursing classes, clinical experiences and academic courses followed by a licensure exam.
Here are big differences between the three.
keeping very basic and simple as not to offend any of the great work done by any of the three:
- CNA’s deal with ADL (activities of daily living)
- LPN’s deal with the hands on medical care
- RN’s deal more with supervision, and care plans and management of care.
You could become a CNA or an LPN in your free-time. To get your LPN doing just part-time you could complete in 18 months to 2 years.
To become an RN (Registered Nurse) you are looking at 2 years minimum of full-time classes to get an associates degree ASN,RN and 3 1/2 to 4 years of fulltime in college to get your BSN,RN.çç
Educationally, LPN’s go through about one year of vocational training to attain their title. RN’s must attend about 2 years of nursing school to obtain an Associate’s Degree. Not too common any more is an RN Diploma, which took about 18 months to achieve. Both RN’s and LPN’s take many of the same classes, such as Anatomy and Physiology, Medications and safety, Medical Terminology, Basic Charting Methods, Age Appropriate Care, Cultural Sensitivity, Developmental Psychology, Developing Care Plans, Nursing Diagnoses.. Each must also attend clinical experiences, in which they must provide direct care of actual patients in hospitals, nursing homes and clinics for psychiatric, medical/surgical, labor and delivery and geriatric patients. However, RN’s must attend classes which LPN’s do not. Most of these focus on theory and administrative functions. Some of these classes are on subjects such as Biological Chemistry, Role of the Charge Nurse, Community Health. They must also take classes which are focused solely on the educational requirement toward gaining a degree, such as elective classes on arts or languages. One state used to have a requirement of a mandatory history class.
In short, the actual medical educations of RN’s and LPN’s are nearly, if not completely, identical. In the clinical setting, there have been numerous references to patients being safer under the care of an RN than an LPN. Yet no studies have ever proven this. Ever. One thing that has been proven is that LPN’s typically are assigned more patients to provide direct care to than RN’s have been. Most of the time, LPN’s have been considered to be working “under the RN’s license“.
The trend in recent years has been to force LPN’s out of the hospital setting. The results have been many of the problems causing the lack of safety for patients in the hospital today.
The most obvious effect has been the lack of nurses, especially in the hospital setting. Though many LPN’s are competent, capable and experienced in acute care, most hospitals today will not hire them for that role. Leaving patients at risk.
Studies have shown that the more patients assigned to a nurse (LPN or RN does not matter), the risk of serious medical error increases drastically. On a medical/surgical unit, the advised ratio of nurses to patients is 1:5. Some studies state 1:4. However, in states which do not legislate a certain ratio, 1 nurse for 8-10 patients is not uncommon. Personally, I have been the sole nurse for as many as 18 patients on a surgical unit.
The higher the ratio of patients to nurses, the higher the risk of hospital-acquired infection rises. This is for one simple reason: The faster a nurse must move, the less likely they are to wash their hands or observe infection control methods.
With each patient assigned to a nurse, the amount of charting required increases. The more time a nurse spends with a chart, the less time that nurse can spend with the patients.