More and more hospitals are hiring Registered nurses only. I chose this topic to educate licensed vocational nurses on the importance of furthering you degree, if you choose to work anywhere beside a nursing home, doctors’ offices are home health care. The importance of this topic I chose is to confirm the reason I decided to continue my journey to become a Registered nurse. In the changing environment of hospital based care, the transitional role from L. V. N to R. N has become increasingly mandatory. The Magnet program is requiring hospitals to hold their nurses to excellence patient care and the very best organizational skills.

(Scott, 2010) As hospitals strive towards magnet status, LVN’s must become part of the evolutionary process. Out-Patient clinics are also expanding their scope of practices to include more technical surgical and diagnostic procedures for their patients. This will require the legal skills of a registered nurse as opposed to what a licensed vocational nurse can legally practice. The economic data has become overwhelming that RN based care Is overall less costly due to their contribution in hospital based evidence of care philosophy. Fewer and fewer hospitals will be using LVN’s according to today’s research.

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It is more efficient to hire registered nurses in many causes because of his or her scope of practice is much broader than an LVN, said Dorel Harms, RN senior vice president for clinical services for California Hospital Association. (Larson, 2008) This is the trend for most hospitals in the United States. When a nurse is seeking a choice of employment, Magnet status hospitals can be a considerable draw for potential new employees. The economic realities and competition for RN’s can make Magnet status hospitals more a pilling for these nurses.

Due to the present economic conditions, many hospitals are being bought, and becoming part of a larger hospital system. Houston has four of such systems. The Methodist, memorial Hermann, HCA and Tenet are such systems. Medical economic survival is the driving force that these smaller hospitals are being incorporated into larger systems. These larger hospitals must compete with each other for patient care and medical dollars. One of the most important ways this is being expressed is by applying for and completing for magnet status.

Magnet status is becoming a vital status driven promotional feature. RN’s in Magnet hospitals are more likely to have a Bachelors degree than non-magnet hospitals. Magnet hospitals also have a higher RN – to- patient ratios than non magnet hospitals. (Scott, 2010) This is conjunction with, not forgoing the realities of containment of cost. (Larson, 2011) RNs have a broader base of skills and scope of practices and this is more cost effective. This trend is most likely going to relocate LVNs to primarily nursing homes are doctor offices.

As the technical aspect of medicine advances, it is becoming increasingly obvious that the role of nurses is expanding. Diagnostic and treatment modalities are becoming so complex, that it makes it difficult for the most advanced nurse to keep up. What was once a radical approach to a disease process has now become every day practice, such as conscious sedation? The problem is that the scope of practice for a LVN has not legally changed much at all, in the past few years. It becomes difficult for a hospital in the present economic environment to retain or hire LVN’s.

LVN’s not only must work directly under the license of a RN but cannot perform some of the more advanced, and now common procedures, such as moderate sedation, for treatment and medication administration. Limitations for Expanding Scope of Nursing Practice through the board of nursing also states that continuing education falls short of achieving licensure as a registered nurse would be insufficient to assure vocational nurse competency and patient safety with regard to both medication administration and patient monitoring associated with moderate sedation.

I have been a LVN for fourteen years; I have worked in different areas of nursing. I have been employed as both a Medical-Surgical and Post Partum nurse in a hospital based setting where, I have a more limited scope of practice due to my LVN status. The now common procedures that we schedule, such as Endoscopic, Pain management and Eye procedures require conscious sedation that my scope of practice does not allow me to participate in.

I ‘am not allowed to assist in the surgical or post recovery unit, again due to the e limitations of my LVN status I am finding that my employment and career opportunities are becoming narrow and more confining. I see my coworkers who are both RN’s and RN. BSN. s, not only gets compensated more than I, but has the ability to float too many different departments within our facility. This allows them more satisfaction on a daily basis and becomes more adventitious to their resume, due to the diverse skill sets they now have earned.

In the completive economic environment, and when the budget crunch shows its ugly face, I have become the expendable nurse. I will be the first person to have their hours cut, because I cannot work all the different and diverse areas within our facility. I have become very aware of the limitations that I possess. I also feel the undercurrent of how my RN coworkers feel about LVN’s. They feel all nurses should be RN’s. As I watch my coworkers go to other job opportunities it become painfully obviously to me that I cannot apply for those positions, due to my LVN status.

In the future I want to relocate to another part of the state. I realize that my job opportunities would be so diminished if I stay as a LVN; I run the risk of not even being able to find employment which would be satisfying for me as a nurse. I enjoy hospital based nursing and I realize my career will suffer greatly. This has become my driving force to make the personal effort to go towards my RN degree. I understand the market values and the technological need for more advanced degree. I do not want to be left behind and become a dinosaur in such a dynamic environment that medicine has become.