A Lesson in “Nurse” — 5 Minutes for Special Needs

A Lesson in “Nurse”

by Heather P


***I’m re-posting today because, ironically, I am at a mandatory class for my license!***



I am a red-blooded American Registered Nurse.

I earned the right to call myself a nurse when I passed the NCLEX (which is a fancy name for the worst test you will ever take in your entire life) and was granted a license–which coincidentally begins with the letters R and N.

There are a lot of other professions which somehow get lumped under “nurse.”

And, you see, this sort of makes me really mad. I worked my tail off to study and research and learn the clinical and intellectual aspects of my field. I do not appreciate it when others are flippant and refer to a nurse as “just a nurse” or “ugh, the nurse”— because 9 chances out of 10, she’s probably not a registered nurse.

So, how can you tell?

Let me give you a little lesson, OK?

Certified Nursing Assistant (CNA): this is a person who has taken mandatory state classes (usually 4-10 weeks) and passed a state exam which grants them a certificate (not a license) to work in long term care or nursing homes. Often, they will also do home care. Their scope of practice is narrow and often revolves around general patient care such as hygeine needs, vital signs, and simple tasks.

Patient Care Technician (PCT) (tech) (Nurse extender): this is a person who has slightly more training than a CNA. They are usually taught either in a brief class setting or on-the-job within the hospital. They can do all the things of a CNA, but they can also draw blood, run glucose testing, place catheters, and perform EKGs (among other things). Usually, PCTs are found in hospitals only.

Medical Assistant (MA): MA’s are usually found in physician’s offices. They often serve multiple purposes. Not only do they perform clincial tasks as delegated, but they can also assist with histories, injections, vital signs, and minimal assessments. (these folks are often the “nurses” you see at the doctor’s office)

Licensed Practical Nurse (LPN): This is a licensed. practical. nurse. She goes through some training to learn the basic skills of nursing. She is overseen by a registered nurse. They may deliver medications. They may not deal with blood products, and in some states, insulin. An RN often co-signs her charting and provides her direct guidance. These nurses often are found in smaller hospital units, nursing homes, and home care.

Registered Nurse (RN): This nurse has at least an Associate’s Degree in Nursing, but the trend is to actually require them to have a Bachelor’s of Science in Nursing. This is the nurse. She is prepared to assess, develop, plan, implement, and evaluate all aspects of patient care.

(I could go on, but I think at this point, you get it, right?)

Why do I say all this?

I often hear other SN Moms talk about nurses–from the ones at home to the ones at the doctor’s office. But, are you really getting nursing care? Have you checked? Lots of states allow LPNs to work in homes. If you aren’t satisfied with the care you are receiving–complaining will not get you very far! If your child is medically fragile enough to require nursing care…insist that you get the highest level of care available to you! I know there are boundaries with insurance and things like that…

…but you can investigate. Look around. There are more than one nursing agencies in most towns and cities. Find the one you feel comfortable with. Find the one that you feel gels with your family needs.

We do not get nursing care because: a) we have insurance, and b) as a nurse, I would trust no one other than myself to take care of my son the way I do. That said, if I were not a nurse, I would be asking for help. And believe you me, I would ensure that whoever came in to my home, was top notch.

After all, the guy who graduated last in medical school is still called “Doctor.”

And the next time you hear someone call themselves a “nurse” who isn’t—correct them. It’s actually against the law to call yourself a nurse without having a nursing license.

Email Author    |    Website About Heather P

Heather is a mom of two, wife, and nurse educator doing what she can to save the day! She lives in Orlando where she is routinely spotted driving while singing ABBA--all on a mission to advocate and educate!

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1 Janet February 18, 2011 at 1:39 pm

4 of our 5 current nurses at home are RNs. The other is an LPN.

We have learned that at other agencies, the likelihood of getting *anyone* capable of handling what we needed in the early days would be slim-to-none (as in, some people who show up to orient for the case have zero experience with trachs or vents, no matter what letters they have after their names, and no matter what the patient actually needs). So we stick with our little agency, and do our best to put up with the sometimes disfunctional-family style drama.

Sadly (because my grandmother too is an RN, and I understand the difference), in a crisis, I’d trust our LPN with 13 years of vent experience over 3 of my 4 RNs – although we don’t always see eye to eye personality wise, she knows her stuff. The same was true of another LPN we had, until she was offered a job that should have required an RN, but they knew that she knew her stuff, and they offered her the job anyway.

Not that all of our LPNs have been worth keeping mind you….but neither have all of our RNs. It’s just more likely that an RN will know enough and have enough presence of mind to be successful with a challenging patient.

2 Heather P February 18, 2011 at 6:01 pm

Girl..your situation…gah! I don’t get offended by LPN’s at ALL. Goodness! I happen to be quite tight with a bunch! It’s when people call “nurses” to people who are NOT nurses that I get my feathers ruffled! 🙂 Don’t you ever look back to the “early days” and wonder how in the world we even survived?!

3 Kate J February 18, 2011 at 3:26 pm

As an “old” nurse (RN/BSN), I remember when RNs handled all of the above, and the physical therapy and housekeeping besides. I can see how easy it is to confuse the current designated roles with the generic idea of “nurse”. Unless the staff has their qualifications clearly written on their badges, most people feel safe using “nurse”. Recently I ran into a Physician Extender, who told me that this now an umbrella term for just about anybody who is employed by the physician and engaged in direct care. Hmmm. OK.

4 Heather P February 18, 2011 at 6:02 pm

I tell my students all the time that nursing is glorified housekeeping with a little more knowledge! It’s so hard to tell now. Actually, one of the hospitals here make their nurses wear white. I kinda like it! 🙂

5 Chaney February 18, 2011 at 5:59 pm

Amen to that. I wish that my daughter could get RNs. I have no choice but to get help, but I would prefer my respite workers over my LPNs anyday. They are extensively trained by me and were actually paying attention. I find that LPNs these days think they already know everything. Or at least know more than me.

6 Heather P February 19, 2011 at 9:15 am

That’s why I teach! I want my students to come out in to the medical world trained and ready—yet very humble! 😉

7 mary1day February 20, 2011 at 1:24 pm

My sister is a LPN and I would trust her over most of the other nurses that I know.The next to last RN that they had on their floor(Rehab)did nothing but sit on her butt behind the desk and tell every one else what to do.The new RN they have is a different story.She takes her job seriously and is right there helping them all night.When my father was there and had a severe allergic reaction my sister saved his life.I studied her books when she was training and helped her study for her tests.the teacher they had taught them a lot of things that she said most LPN’s did not learn but that she thought that they might need.My position is that a RN is not always better than a LPN.After 35 years of experience and dedication to being the best she can be that beats a RN’s 5 or 10 years in my book every time.

8 Heather P February 20, 2011 at 6:39 pm

I don’t disagree one bit. Sadly, though, the “powers that be” are phasing out LPN programs. Those who are LPN’s will be grandfathered in, but new programs will probably not begin. I originally went to a 2 year RN program. Even those are being done away with. My point was never to discourage use of LPNs at ALL. My point was that I think that if you have an issue with a nurse who is working for your family, then YOU need to be proactive enough to remedy the situation—rather than complaining (like I hear a LOT of the mom’s do).

My best friend helped me study for all my nursing tests too…she swears she knows the anatomy of the skull to this day! 🙂

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