This seems to go in cycles. Someone, usually some health care bureaucrat with no actual experience of nurses or the realities of hospital care, decides the skill mix is too rich, RNs make too much money, so the solution is to hire cheaper RPNs/LPNs — because they “basically have the same competencies” or some such nonsense.* Then five thousand studies come out that show patient morbidity and mortality drops with RNs doing patient care versus RPNs/LPNs, which actually ends up costing the system more. This is besides killing people, which in the end analysis, is probably more important. And then RNs are back in fashion, and the cycle begins anew.
Funny how the same arguments get trotted out every few years. And how come I know the literature, a lowly humble staff RN, and when I trot out all the usual arguments in the Parade of the Blindingly Obvious, managers look at me like I’m speaking Swahili?
*Memo to senior health care leaders suits managers: it’s not about whether about RPNs or LPNs can insert IVs more cheaply than RNs. That’s a skill any monkey can do. It’s about whether an LPN/RPN will recognize you’re about to go into septic shock and die. Which requires hands-on, bedside nursing by RNs.