To be certain, there’s plenty of misunderstanding about what exactly Nurses do, and who exactly Nurses are.
So, to clear the air, let’s set the record straight, and get a quick backgrounder before diving into the deep end.
In whatever state they choose to practice, all 50 states requires all Nurses to be licensed before they begin practice. Licensed Vocational Nurses (LNVs) are considered technicians, while Registered Nurses (RNs) are professionals.
The LPN (Licensed Practical Nurse), which in some states is called LVN (Licensed Vocational Nurse), most often has earned a certificate in less than a year, and has a significantly different educational track than a Registered Nurse (RN), even when the RN has an ADN (Associate Degree Nursing). The RN utilizes critical thinking skills, and the responsibilities the RN has are more complex, and therefore always supervisory in nature over the LVN/LPN. Because of the complexities and advances in healthcare, and patient care, LVNs are NOT permitted by license to do the same things as a RN. Pay, of course, comes along for the ride, and RNs are paid more.
Registered Nurses may begin practice by earning an Associate’s Degree Nursing (a two-year degree) typically at a Junior or Community College, or by earning a Bachelor of Science Nursing (BSN), a four-year degree most often earned from a University. Both the ADN & BSN must pass the NCLEX – the National Council Licensure Examination – before they can practice Registered Nursing.
Advanced Practice Nurses (APNs) are BSN-prepared RNs whom have obtained additional education and training, typically a Master of Science Nursing (MSN) in a specialty area of Nursing practice such as Gerontology (specialized care for the elderly), Family Nurse Practitioner (FNP), Acute Care Nurse Practitioner (ACNP), Pediatric Nurse Practitioner (PNP), Certified Registered Nurse Anesthetist (CRNA), etc. Frequently, following earning their MSNs, APNs have also obtained National Certification in their area of specialty, and many have prescriptive authority, depending upon the laws of the state in which they practice. Because they have more education, more experience, and more responsibility, they are also paid more. APNs may also continue education and training to the doctoral and post-doctoral levels.
In some states, APNs are allowed independent practice, and are not required by law to be supervised by a physician. Other states have laws that limit practice of APNs – even though they may be Board Certified – and require physicians to collaborate with them, or in some cases, to oversee their work. Alaska, Arizona, Colorado, Hawaii, Idaho, Iowa, Maine, Montana, New Mexico, Nevada, New Hampshire, North Dakota, Rhode Island, Oregon, Vermont, Washington, Wyoming, and the District of Columbia all allow APNs to practice independently. Alabama is one such state which does not allow Board Certified Advanced Practice Nurses independent practice. According to the American Association of Colleges of Nursing, “in at least 45 states, advanced practice nurses can prescribe medications, while 16 states have granted APNs authority to practice independently without physician collaboration or supervision.”
There’s an entirely different can of worms when comparing the practice of APNs and physicians. One of the ways they differ, are that Read the rest of this entry »
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