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Nurses' experiences of full scope LPN practice in acute care McTaggart, Elizabeth Sarah

Abstract

The practice of licensed practical nurses (LPNs) in acute care in British Columbia (BC) is undergoing a shift to incorporate the enhanced range of entry-level competencies introduced by the College of LPNs of British Columbia in 2000. The full range of new LPN competencies, which now constitute full scope, became a requirement for practical nurse licensure in BC in 2007 and are challenging LPNs and Registered Nurses (RNs) alike to reexamine and redefine the LPN role and LPN/RN relations in acute care. Research exploring the experiences of RNs and LPNs, in their own words, with full scope LPN practice in acute care staff mixes has not previously been conducted in BC. This qualitative descriptive study explored the perceptions of 5 RNs and 4 LPNs working in RN/LPN skill mixes, in various Lower Mainland acute care settings where the LPNs work to full scope. Conventional qualitative content analysis was used to analyze the data from one in-depth interview and 8 short-answer surveys. Analysis of one in-depth interview with an LPN yielded 3 categories: professionalism, receptivity, and appropriateness. Analysis of the 8 survey responses from RNs and LPNs yielded 3 categories as well, namely: defining the role, determining the impact and determining the fit of the role. Findings in this study indicate that overall, both RNs and LPNs report that clear communication, LPN role clarity, experience working together over time, and a supportive work environment contribute to positive experiences of the RN/LPN skill mix. Feelings of burden, inconsistent teamwork, lack of respect, concerns about patient acuity levels, and varied perceptions of the ability of LPNs and RNs to assume responsibility for patient care present areas of challenge in the workplace.

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