Apples and oranges...

Ever have one of those conversations with someone and you realize, at the end of the conversation, each of you were talking about something entirely different?  Even though it sounded like the same thing? That's what it's like talking to people about the importance of having RNs in schools versus LPNs. 

If you've been following the Wichita Eagle article about RNs in schools, as well as letters to the editor, you are probably wondering what is the BIG DEAL?  You're probably saying, why is it necessary for RNs to be in school?  They are more educated, and cost the district more.  Why can't a caring person fill those shoes?  While frustrating to those who are licensed RNs, it does have some validity. 

I didn't become an RN until I was 34 years old.  I had always planned to be an RN, from the time I was about six years old.  But life got in the way.  So, when I was 32, I applied to nursing school, got accepted and went about my studies to get my associates (2 year) degree in nursing.  At the time, Newman University had just merged with St. Mary's of the Plains School of Nursing, which was a Bachelor's Degree (4 year program).  After graduation, I readily got a job in a hospital working in an area I had dreamed of.  I loved my job, loved taking care of my patients, and believed that I was just "as good" as those nurses with a BSN.  I dared to think that I would pit my technical skills against a BSN prepared RN anyday. After a few years, I had the opportunity to work at Newman in the nursing program, and while there I pursued my BSN.  The first nursing class was such an eye opener.  The realization that this degree was so much "more" than the technical degree I had received earlier, began to dawn on me. And the lights went on for me that this education really was the key to becoming not just a good nurse, but a great nurse.  I began to learn about life for "patients" outside the hospital setting.  The idea of community, continuum of care, intervening in the "whole" person, were concepts that I began to embrace and pursue.

So...apples and oranges.  LPNs are trained in the "technical" aspect of nursing.  Their education was designed to be a "helper" to RNs or doctors, in the busy hospital setting.  The ability to work automously is not a part of their education, or the expectation of their profession.  LPNs work very, very well with RNs in a hospital, or physicians in a doctor's office.  I've had the privledge of working with many very qualified LPNs in the hospital and homecare setting.  But, they worked in conjunction with me, my skills guiding their decision making, my knowledge guiding them in thier tasks.  Never by themselves.  And this is what "people" don't understand about RNs in schools. 

The first year I worked as a school RN, I was astounded at the "alone-ness" I felt.  I was used to having doctors telling me what to do and other RNs to lean on.  I quickly realized that this job would take all of my skills to perform and provide for children, families and staff.  I had to call on all the education, college and otherwise, that I had learned through the years.  My knowledge of hospital, physician and community services were called into play everyday.  I was the "go-to" person for families and staff when they had a medical question.  I utilized every assessment tool I had been taught by professors, other RNs and physicians.  And I did it outside of the health care system, with no physician to give me orders, no protocols to follow, no algorithms to adhere to, no RN by my side.  This is the real issue here.  The ability to work outside these "normal" situations.

LPNs have a very valid role in our world.  They are trained to work in close conjunction, with RNs and physicians, in nursing homes, medical offices and homecare.  But they are not qualified to work autonomously in a school setting without someone near them to help guide their interventions.  So, apples and oranges.  Just because they are both a fruit, they are not the same.

The RNs in Wichita schools are working hard everyday to educate the public.  It's a difficult task, but in the words of a phenomenal school RN, "It's only 50,000 kids."