Licensed Practical Nurse to Registered Nurse Role Transitions - Report Example

LPN to RN Role Transitions Abstract The essay aims to address a two-fold objective to wit: (1) to explore and apply the different concepts of role transitions from LPN to RN; and (2) to include some facts and standards about LPNs and RNs scope of practice according to the OhioState Board of Nursing. Introduction Striving for a registered nurse role (RN) is the most challenging task an LPN (licensed practical nurse) could face. Pursuing a registered nurse role may require a lot of time, effort, and financial support. But despite the sacrifices necessary to become a registered nurse, the initiative to go beyond the comfort zone and experiences will make an LPN grow personally and professionally. Harrington& Terry(2009) define role transition as “the passage or shifts from one role to another and involves changing the way one thinks and acts” (p. 54). Role transition from LPN to RN role is a unique experience as it changes and broaden the LPN’s responsibilities, thinking, practice and experience, and the overall view of the nursing world. The decision to become a registered nurse uprooted to the two of the most important goals I have at the moment: one of them is to continue my nursing education and explore a vast array of knowledge, skills, and experiences apart from being an LPN, and the other one is to pursue this long-time dream of being a registered nurse that helps people as well as the increase in income. The road to become a registered is not easy and requires understanding of the differences between the LPN and RN roles, management of conflicts, application of classroom discussion to role transition and, knowing and understanding the exisiting facts and standards of the state board of nursing. Specific Role Changes The LPN transitioning to become an RN faces variations in the roles they perform. Often times, distinguishing the differences between the roles they perform becomes difficult as they are bombarded with several role variations. However, there are two specific role changes differences between an LPN and an RN. One of the first specific role changes is the difference in the nature of client care. LPNs focus on the “how to” of client care while RNs focus on understanding “why” of client care(Ham, 2002, p. 11). LPNs main concern is the delivery of standard care needed by the client and not the underlying concepts behind the procedures. RNs, on the other hand, consider a variety of nursing skills in order to understand the patient as a whole. RNs are trained in a variety of settings such as client’s homes, long-term care settings, clinics, and hospitals where they are required to have a broader scope of nursing knowledge in order to handle complex client problems. LPNs and RNs work under the same setting with the LPNs under the supervision of RNs. The second specific role change is the orientation to the use of thinking skills (Ham, 2002, p. 12). RNs must prove that critical thinking is being thought and practice in their curricula. RNs are required to make routine decisions or judgments upon rational analysis of information. Meanwhile, LPNs are just provided with the information necessary to apply client care but may not have been introduced to principles and theories that enhance learning. Role Conflicts Role conflicts can be intrapersonal and interpersonal and occurs when a person’s role has two or more conflicting or incompatible expectations (Duncan& DePew, 2011, p. 34). An LPN transitioning to an RN role may experience conflict emotionally and physically. For example, an LPN who is emotionally contented about his job feels pressure from his employer requiring the LPN to become a registered nurse. Conflicts may arise because the LPN might find it difficult to differentiate the role of the LPN and the role of the RN. As an LPN, he/she knows the “how to” of the procedure but during the process of learning, the LPN should unlearn and relearn certain methods in doing the procedure in order to pass. Also, while working as an LPN and studying an RN program at the same time, the LPN/student may struggle in being able to perform a certain procedure as an RN student but not while working as an LPN. Since the role expectations are incompatible, role conflict may arise resulting to the development of hypertension, peptic ulcers, and other psychosomatic illnesses(Duncan& DePew, 2011, p. 34). In preparing for a transition role, avoidance and management of conflict is necessary. Conflict resolution can be achieved by prioritizing tasks, using effective communication skills, and appropriately delegating responsibilites. In the example stated earlier, the transition nurse can resolve conflict by prioritizing the tasks according to settings, an LPN role for the work setting and an RN role for the student setting. Second, if the LPN struggled on the two conflicting roles, the LPN can communicate it with the employer to discuss conflicting roles. Lastly, understanding delegating respinsibilities will resolve potential conflict in certain circumstances. Application of Classroom Content related to Role Transition A. Role Socialization Role socialization refers to the integration of personal identity with the professional identity (Duncan& DePew, 2011, p. 28). As you strive for a higher degree of education, your professional identity as an LPN will merge to the new education process to expand your clinical nursing skills, acquire new critical thinking ability, and internalize a new personal identity. Harrington& Terry (2009) enumerated Cohen’s four goals of role socialization, namely: acquisition of technical and theoretical skills, taking values of the profession, modification of the professional role to the accepted personal and professional role, and balancing the professional roles with other roles (p. 53). For instance, an LPN entering the RN completion program experienced different emotions ranging from excitement or fear from the new role. Along with fear is the anxiety towards associated learning expectations. During the process, the LPN acquire technical and theoretical skills different from their previous role.Self-doubt and insecurity may be experienced in the process of role socialization due to perceived difficulty of the RN role compared to the LPN role. But once the LPN begins to view that there is something challenging to learn, they began to take the values of the new profession and modify according to RN role. As the LPN adopts the knowledge, attitudes, and behavior of a registered nurse, the LPN will be able to balance the RN role and the LPN role. B. Role Elements Being a registered nurse requires the acquisition of different nursing skills. Each nursing skills is referred to as the role elements, the essential duties and functions of a nurse as a valuable member of a health care team. 1. Care Provider The most recognized function of a nurse is being a care provider (Ham, 2002, p. 7). RN ensures that the best possible health for client is achieved by carrying out interventions geared toward positive health outcomes. A nurse giving tepid sponge bath and administering antipyretic medications to a client with fever demonstrates the role of a nurse as a caregiver. 2. Manager The nurse as a manager supervise, plan, and coordinates plan of care to the members of the health care team, clients, families, and communities(Ham, 2002, p. 9). An RN acting as a manager must have good decision making and problem solving skills. The nurse as a manager is observed in the acute care setting, with the nurse acting as the chief nursing officer managing client care. 3. Advocate The advocate role of an RN protects the client and family from harm (Ham, 2002, p. 9).The nurse provides honest and complete information about client care and respects the right of the client to autonomy and self-determination. A good example is a nurse questioning the doctors order of parenteral antibiotics to a patient who had (+) ANST. 4. Change Agent Being a change agent challenges most of the RNs as they must be willing to take the risk of persuading others in changing their present health behaviors (Ham, 2002, p. 9). This element is the most valuable asset amongst client care as it often pertains to the adoption of healthy lifestyles. The nurse encouraging the client about the benefits of quitting smoking reflects role of the nurse as a change agent. 5. Teaching Skills RNs are equipped with the teaching skills required to provide the client with the information on medications, dietary restrictions, treatments, etc. (Ham, 2002, p. 8). Health promotion activities requires the RNs teaching skills such as in explaining the dietary restrictions of a client with diabetes mellitus. Honeymoon Stage in Transition to School Stage 1 is the honeymoon stage of RTSS (Returning to School Syndrome). It is the shortest and the most benign stage in which the reality of the situation of being an RN has not already been absorbed by the LPN. This is the stage of emotional variations when an LPN entering an RN completion program sees the experience as congenial but later on, feels fear and anxiety due to invaluable experience and upcoming clinical evaluation. Ohio State Board of Nursing: Facts and Standards about LPN to RN Transition In order for LPNs to understand the transition process, the Ohio State Board of Nursing addressedthe most frequently asked facts associated with the two roles. The following text is adapted from the April 2009 Ohio Board of Nursing RN/LPN Frequently Asked Questions. “The scope of practice for nurses can be found in Ohio Revised Code (ORC) Section 4723.01(B) for RNs and 4723.01(F) for LPNs. Asspecifically noted in their scope, RNs may assess health status for the purpose ofproviding nursing care. RNs may fully utilize the steps in the nursing process including assessment, analysis, planning, implementation and evaluation, Rule 4723-4-07, OAC. Licensed practical nurses provide nursing care requiring the application of basic knowledge of the biological, behavioral, social and nursing sciences at the direction of a licensed physician, dentist, podiatrist, optometrist, chiropractor or RN. Assessment of health status is not included in the LPN scope of practice. LPNs contribute to the assessment of the client by collecting and documenting objective and subjective data related to the client's health status and reporting that data as appropriate to other members of the healthcare team. Likewise, LPNs contribute to the development, maintenance, evaluation or modification of the nursing component of the care plan and communicate the care plan with any modifications to appropriate members of the healthcare team, Rule 4723-4-08, OAC”(Ohio Board of Nursing, 2009, p. 1). “The Nurse Practice Act does not prohibit a licensed practical nurse with the necessary knowledge, skills and abilities, functioning at the direction of a physician or RN, from performing peripheral venous blood draws. Rule 4723-4-04, Ohio Administrative Code (OAC), holds licensed practical nurses responsible for maintaining and demonstrating current knowledge, skills, abilities and competence in rendering nursing care within their scope of practice”(Ohio Board of Nursing, 2009, p. 1). According to Section 4723.01(B), ORC, the supervision and evaluation of nursing practice is established within the RN scope of practice. Rule 4723-4-06(O), OAC, further states that only a registered nurse may supervise and evaluate the practice of nursing by other RNs or LPNs. Licensed practical nurses are not prohibited from participating in activities which contribute to the delivery of care such as scheduling for coverage of nursing services and observation/documentation regarding care provided by assistive personnel. A non-nurse supervisor may evaluate a nurse employee in matters other than the practice of nursing (Ohio Board of Nursing, 2009, p. 3). References: Duncan, G. & DePew, R. (2011). Role Transition. Transitioning from LPN/VN to RN: Moving Ahead in Your Career (2nd ed.) (21-42).New York: Delmar, Cengage Learning. Ham, K. (2002). Role Transition. From LPN to RN Role Transitions (p. 2-21). Philadelphia: W.B. Saunders Company. Harrington, N. & Terry, C.L. (2009). Role Development and Transition. LPN to RN Transitions: Achieving Success in Your New Role (3rd ed.) (p. 33-58). Philadelphia: Wolters Kluwer Health. Ohio Board of Nursing. (2009). RN / LPN Frequently Asked Questions. Retrieved on July 24, 2011, from http://www.nursing.ohio.gov/PDFS/Practice/RN_LPN_FAQs_6_09.pdf Read More