LPN in the Inpatient vs. Outpatient Setting
Practical Nurses with a license (LPNs) play a crucial role in healthcare and can work in various places like hospitals, clinics, nursing homes, and schools. In the past, LPNs used to work in emergency rooms and ICUs, handling tasks such as managing drips under RN supervision.
However, nowadays, you’ll mostly find LPNs working in outpatient settings. This shift has happened for a couple of reasons. Many hospitals aim to achieve “magnet status,” a recognition from the American Nurses Credentialing Center’s Magnet Recognition Program. Obtaining magnet status is a prestigious achievement for hospitals, showcasing their ability to attract and keep high-quality nurses, leading to better patient care outcomes. As hospitals strive for this recognition, they often prefer an RN-only care model, making LPNs less common in inpatient settings.
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Another factor contributing to the decline of LPNs in inpatient settings is the implementation of patient ratio laws. In the past, team nursing was prevalent, with a team of an RN, LPN, and CNA assigned to a set of patients. This model allowed for a high number of patients to be managed by the team, sometimes up to twenty patients. However, studies indicated that lower nurse-to-patient ratios led to better patient care outcomes. As a result, RNs advocated for and won ratio laws in some states.
While this was a significant victory for patient safety, it led many hospitals to transition from team nursing to primary nursing. In primary nursing, one RN independently manages a few patients, improving patient care outcomes and being more cost-effective. Unfortunately, this change displaced LPNs from hospitals to outpatient settings.
On the flip side, the outpatient setting has seen an increase in the need for LPNs, particularly in clinics and schools, where patient ratio laws don’t apply. Since outpatient settings usually handle less acutely ill patients, LPNs can perform most nursing care tasks, with RNs providing supervision but in fewer numbers than in hospitals.
While LPNs have become more prevalent in outpatient settings, experienced nurses emphasize that healthcare is cyclical and constantly evolving to meet patient care needs. The pendulum may swing back, bringing changes to the role of LPNs in the future.
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