The Metamorphosis of the Practical Nurse

The Metamorphosis of the Practical Nurse

October 23, 2006

The Metamorphosis of the Practical Nurse

It takes a great deal of courage to let go of what is known, familiar, and comfortable. Change is a driving force in everyone. Like a butterfly, individuals in the nursing field may go through similar stages of metamorphosis, which is a process of growth, change, and development. (Wikipedia Foundation, 2006) Nurses have a vast amount of opportunity for growth and change in the healthcare field. "The nursing profession has often been viewed as the target of change rather than a force that proposes, leads, and implements change." (Habel, 2005) Many individuals are choosing to evolve and expand their careers and obtain their bachelor's degree in nursing. While the LPN performs much of the same skills, the student professional nurse must refine his or her skills in clinical judgment, collaboration, leadership, and delegation to effectively care for their patients as a professional nurse.

The Role of the LPN

Licensed practical nurses have an enormous responsibility- to their patients and coworkers alike. The LPN may work in a supportive role and can be paired up with Registered Nurses, creating a "team nursing" approach to patient care. Team nursing is a method in which different nursing personnel work together and perform separate functions for the same patients. Each member of the team has a specific role in patient care. (Wikipedia Foundation, 2006) The LPN has several responsibilities which include: monitoring the patient for abnormalities, checking and recording vital signs and measurements, administering medications, and providing basic bedside care. In the hospital setting many LPNs are used in medical/surgical floors which tend to occupy very acute patients. Although the practical nurse has many of the same technical skills as the professional nurse, the practical nurse may choose to advance their career and train to be a professional nurse to achieve a higher level of critical thinking skills, leadership skills, and delegation.

Transitioning

Role Transition for the LPN

Although change is necessary for forward movement and growth, it can sometimes cause stress and anxiety for the LPN. The LPN can face many challenges during their transition into the field of professional nursing. Duncan and Depew (2005) examined the stages of work transitioning according to Nicholson and West in relation to the practical nurse's pursuit of his or her professional nursing degree. The four stages of transition include: "preparation, encounter, adjustment, and stabilization." (Duncan & DePew, 2005, p.42) "The preparation stage is mostly concerned with psychological preparedness for the transition that is to occur." (Duncan & DePew, p.42) During this time the student nurse is struggling with personal reflection; the student is deciding if he or she has what it takes to become a professional nurse. This period is dominated by thoughts of self-worth and self-confidence as well as the student nurse questioning if this is the "right" decision. "During the encounter phase, the LPN makes the necessary contacts to enroll in college, makes financial arrangements, and revises his personal schedule to accommodate class and clinical schedules." (Duncan & DePew, p.42) The student nurse could face periods of anxiety and struggle to rearrange their life and may also have difficulty financing their education. "In the adjustment stage, one focuses on and establishes a new set of priorities." (Duncan & DePew, p.42) The student nurse is struggling with role conflict- they still feel like an LPN but they have the basic foundation of education as do RNs. The student nurse may feel torn between the two different roles and must collect their own set of rules. "In the stabilization stage, the LPN takes on the values of the RN roleÐ'... and makes adjustments and minor changes as needed and enjoys the successes of the new role." (Duncan & DePew, p.42) During this time the student nurse has completed, or nearly completed the education and is learning to be confident in their new role. As Duncan and DePew have explored, the LPN faces several conflicts during their role transition; however, their experience as a practical nurse is valuable to the patients that await them in the future.

Clinical Judgment

Each member of the health care team has an enormous responsibility to their patients. In the context of ethics, accountability is described as the state of "willingness to contribute to an expressed or implied outcome." (Wikipedia, The Free Encyclopedia, 2006) Professional nurses must exercise their critical judgment and critical thinking skills to remain accountable and autonomous with patient care. Professional nurses are given the freedom to make their own choices, within the limitations of the scope of practice and state law, and to conduct patient care according to the nurse's own judgment. Professional nurses must practice good critical thinking skills in order to make good decisions for their patients and their team.

Collaboration

During the early years of nursing, women were predominantly used assist physicians in caring for the wounded. As early as the Civil War, the role of the nurse changed; nurses provided more insight and collaboration with physicians and assisted in the planning of patient care. (American Nurses Association, 1998) Scopes of practice were originally intended to divide roles and responsibilities between healthcare providers and to reduce conflict. Now that healthcare has evolved and the nursing team is working with other members of the healthcare organization, collaboration is a key element in providing complete and individualized patient care. Each member of the healthcare team is dependent on the other to provide complete patient care; no individual component of the team can effectively care for the patient alone. Each department is specialized and provides exclusive knowledge and expertise in their field of study. The professional nurse must collaborate with all members of the healthcare team to provide superior care to each patient.

Leadership Skills

Nursing requires good leadership skills to achieve excellent patient care and to satisfy the needs of the nursing staff. "Leadership used to be most often associated with solitary heroic figures, usually men, who