Online bachelor degree in nursing.

Question:
What is the difference between
CNA,
LVN,
RN???

I've looked online at some nursing school sites but can't seem to find much info. I would like information on the education/certification/licensure/training/skills/duties involved. Any help
would be much appreciated.

Answer:
I am licensed in California; there will be some variation in other parts of the country, let alone world

A Certified Nurses Aid (CNA), spends the equivalent of 3 months in preparation for basic nursing roles, usually in a Skilled Nursing Facilities ('SNF' pronounced 'sniff'; a convalescent hospital). Duties consist of changing beds and feeding, bathing, dressing, ambulating the patients and to a very limited extent, performance of data collection (Blood pressure, pulse, respirations and temps). An aide in a SNF is should be closely supervised by an LVN and the lot of them answers to an RN. To a lesser extent, they ply their trade in home health ('private duty') and are subject to much looser supervision if employed by a Home Health Agency than in a SNF. If they can pull down a job out of the want ads and ‘Special Duty’ one client until death do them part, they are largely unsupervised and are only as good as the references from their last position. CNAs are also utilized, in a very narrow scope, by some 'General' (ACUTE) hospitals. CNAs are not licensed to administer medications; as such they are absolutely forbidden to even enter the medication room in SNF or Acute
facilities and should not be administering medication in people's homes, either, but some do (along with other forbidden tasks like
tracheotomy suctioning, catheter care, et. al.).

A Medical Assistant trains for upwards of 9 months for positions - if you can believe daytime T.V. - . . . working with the doctor or running the front office! These folks are very loosely regulated by the state Board of Medical Examiners to perform any duty that the employing MD has trained them to do, as evidenced by a note to that effect on genuine MD letterhead and placed in their employee file. Registered Nurses, the class of Professional Nurses the AMA developed these dangers to replace, refused to supervise them, at least in the beginning. Curiously, The Board of Registered Nurses, for the most part comprised of Master's Degree prepared Nurses, softened that hard line approach about the same time the AMA bestowed upon Master's
Degree prepared nurses prescription writing privileges ('furnishing'). Paid a fraction of the salary commanded by a licensed nurse and unfettered by practice acts limiting their duties, they have multiplied like bunnies in MD offices and clinics to the extent that, when I rotated through there 10 years ago in Nursing school, the Kaiser Pediatric clinic employed but ONE Registered Nurse (to approx. 15 M.A.s). Her entire practice consisted of running from one terrified child to the next being the 'Shot Nurse', because the State demanded that only a Registered Nurse inoculate a child. The
Medical Assistants were performing all other treatments on the babies and children.

An LVN, Licensed Vocational Nurse, or elsewhere: LPN, Licensed Practical Nurse, is licensed to perform many of the same tasks that a Registered Nurse dispatches. On a SNF unit, LVNs even have supervisory 'Charge' status. So why spend at least two more years to do the same job? Because they aren’t the same any more than a draftsman is the same as an engineer because they both draw; or, a book keeper is the same as an accountant because they both use adding machines. At the core of nursing practice - anywhere, at any level - is the Nursing Process; a highly structured 5 step means of moving our patients towards the highest degree of wellness attainable for that person. The steps are Assessment, Diagnosis, Planning, and Implementation and, finally the Evaluation of the interventions implemented as detailed in a formal, written 'Nursing Care Plan'. All levels measure and collect assessment data (e.g. vital signs) but, by virtue of their training and legislative mandate, ONLY a Registered Nurse may assimilate that information into a universally accepted Nursing Diagnosis and ONLY a Registered Nurse may determine the goals and interventions to ensure those outcomes (the Planning function). This is where the confusion arises; even though any of us can (and do) make beds, ONLY a Registered Nurse may determine the appropriate delegation of those duties based upon the others' knowledge, manual skills and licensure. Another example; both LVN and RN administer meds and both must know what the desired and potentially undesired effects will be. However, ONLY the RN must know how those preparations interact on a cellular level to achieve that effect. ONLY a Registered Nurse my then evaluate the patient's response to Nursing AND Medical treatment and restructure the plan accordingly. Make no mistake - don’t be misled by the posturing of an LVN that claims to 'do the same thing as a Registered Nurse'. If you hear similar assertions from recruiters at private 'career colleges', please know that the person is telling you a bald-faced lie in order to hustle a down-payment from you.

Nurses with Master of Science Nursing preparation (MSN) may qualify for
'Advanced Practice status' and be designated NP(Nurse Practitioner) or CS
(Clinical Nurse Specialist).

I thought psych _RN hit the nail on the head. We only have a few LPNs left in our hospital, some are great nurses, but it gets quite busy at times to do a fellow nurses IV meds and hope that the admitting assessment given by the LPN was accurate since you are co-signing it, It is very difficult to try and tell a co-worker to have someone else co-sign because you feel uncomfortable doing so when you have not done the assessment. I know that some of the LPNs also feel this, but management continues to give them the assignments regardless of their scope of practice. I know in IA at least that nursing homes are required to have an RN in a nursing home only 8 hours a day, thus I worked as a new graduate LPN during my last year of school with 90 residents, usually 8 or so SNF and 2 CNA's. I learned a lot that year, but would not recommend that training! One of the main things I have learned with continuing my education that no job is worth jeopardizing peoples safety. So blurring the line between LPN and RN is not a safe thing
to do.

Sounds like psych RN gave some good advice but I'm doing agree with all of it. It also sounds like she may be biased against LVN/LPN’s (pardon if I'm misinterpreting). I've worked in Texas as a CNA for 4 years, an LVN for 5 years and I'm about to graduate a BSN (RN) program. One of the benefits of working my way up the nursing chain has been that I had the opportunity to see if nursing was what I really wanted before I spent all the time/money on a bachelor's degree. I've known way too many people who quit after graduation when they had to accept full patient loads and experienced the reality of floor nursing.
I agree with psych RN that RN's have a base of nursing theory that LVN's do not have. Obviously I find value in being an RN or I wouldn't have spent the time in school. In Texas and the 3 hospitals I've worked for, LVN duties vary in each facility. Where I am currently, I formulate care plans
(diagnosis/interventions/evaluations) modify them, do IV pushes, central lines, am totally responsible for assessing my patients, etc. The only thing within my institution that I can not do as an LVN is start a blood transfusion. As for a delegation goes, if a LVN on a SNF unit is charge nurse and no RN is on site, who do you think delegates to other LVN's and CNA's????
The biggest controversy in Texas isn't between LVN and RN, it's between RN’s (BSN Vs ADN). The BSN's think they're superior because all of their theoretical knowledge; ADN RN's think they are better because they have more hands-on skills and graduate with the ability to take on full patient loads (these are generalizations from people I've worked with and continuous debates in Texas nursing journals; I'm sure it's not true of ALL nurses, so no flaming me please!).
I'm not sure where she got her salary info. Those numbers may be true in
California but not in Dallas/Ft. Worth. As an LVN I make $17.00/hour plus any weekend differential. A starting salary for a new RN is MAYBE $30,000 if you’re lucky (most hospitals want to start you at $13 - 14.00/hr).
So I think what psych RN was trying to get at was that getting your RN is your best bet. HOWEVER, if you're not sure that you want to spend the rest of your life in nursing, working as a CNA or LVN/LPN is a wonderful way to gain experience, see what hospital work is really like and make a decent hourly wage. They money will come in handy if you are paying your own way through school!