Any individual who has the necessary skills in nursing and passed the relevant licensing requirements receives a practicing license that enables them to engage in nursing activities. Nursing, as a profession, demands that nurses adhere to the requirements of their code of conduct in their respective areas of practicing. Even though they, as human beings, sometimes make errors, professional nurses are required to practice with utmost care and minimize cases of professional negligence brought about by carelessness. However, situations might arise whereby error occurrence is imminent. This situation demands that nurses do what they can to minimize error, since they are charged with the responsibility of preserving lives of patients in their areas of practice.
The nursing profession provides an opportunity for many people within a society or community to regain their health and overcome the disease. The nursing profession can be divided into various categories. For example, some nurses have the responsibility of caring for children, others look after the adult population, and still others work with the mentally challenged and the people who have disabilities and disorders when it comes to learning activities. The process of transition from a licensed practical nurse (LPN) to a registered nurse (RN) usually provides an opportunity for any practicing nurse to progress to the position of a practicing registered nurse. The manner in which the process is designed ensures that the existing knowledge and expertise is advanced through gaining of experience and skills to enable practicing nurses to easily obtain the RN license. This transition is essential since there are changes continuously occurring within the nursing sector. The rising demand for more registered nurses is another reason why the transition is necessary. It can also be attributed to the fact that there is a shortage of nurses within the nursing industry. In addition, many modern and global changes that take place within the industry make the nursing profession more complex with time. The objectives of the transition are therefore to nurture and distribute nursing duties better, thus making them more accountable.
The frameworks of nursing practices enable nurses to develop the knowledge critical in this field through the acquisition experience. This is evident in their ability to ascribe and achieve the set standards as dictated by the nursing code of conduct. In earlier days, nurses had a limited opportunity to rise through the ranks for the management positions. This training, therefore, provides the practicing nurses who have the necessary leadership skills with the opportunity to take up leadership positions as well. With their acquired practicing license, nurses are able to undergo an evaluation process that will also see them grow in the circles of the nursing profession.
The expectation of the general performance levels by the nurses has subsequently increased. In early days, both the licensed practicing nurses and the registered nurses performed similar duties with no clear difference in them. However, in the recent years, registered nurses have received more medical obligations because of the changes taking place in the nursing industry. The licensed practicing nurses, who have successfully gone through the transition period, can perform a patient evaluation test at the initial stages of treatment. They can therefore diagnose patients and prescribe treatment for them when required. They can also develop a patient’s care plan and initiate the nursing actions that provide basic services to patients.
There are various challenges that may arise during the transition period. For example:
- Currently, there are few training programs for nurses during the transition period.
- The licensed nurses within the licensed practicing nurses category are not motivated enough to undertake the training process. Their lack of motivation has been mainly caused by the lack of clear guidelines on how they will apply their acquired new skills in their current field of practice.
- There is a general difference in the self-concept of learners and their levels of experience coupled with the differing backgrounds that makes nurses substantially different from other categories of learners.
- The level of willingness to learn by the licensed practicing nurses is low. This has mainly been influenced by the different life circumstances that they find themselves in, which require that the licensed practicing nurses have a better understanding of the common life situations.
- There is also the challenge of nurses learning orientation, with a majority preferring a problem-solving orientation to an information-related orientation, when it comes to real issues of life. This has drastically reduced their participation in the learning process.
- There are also natural issues that might make one either motivated or de-motivated to take up learning activities. Such issues like the intrinsic rewards of self-esteem, satisfaction, and quality of life have superseded material rewards like better salary increments in motivating some nurses to undertake learning activities.
- A differing attitude and opinion by some licensed practicing nurses also affects their willingness to take up learning activities. A majority believe that they are already practicing in the same capacity as their registered colleagues, thus they see no need to take up learning activities that will see them go through the transition.
Even though the nursing field is faced with the above-mentioned problems, its success will largely depend on how the following strategies are actually implemented.
An effective system of the LPN-RN transition program has to be developed within the curriculum associated with nursing practices. This may involve increasing the population of those who graduate from the nursing schools and later licensed for practice nursing. Mobility of career should also be enhanced so as to enable the licensed practicing nurses to successfully proceed through the transition period. This can be achieved through the initiation of associate degree programs that will hasten the transition process as compared to the current degree programs in nursing. Such courses like theory in professional nursing practices, nursing science, and nursing pharmacology can be offered. Communication courses should also be taught.
There should be transition courses that will help the LPN students in facilitating their transition process to higher-level courses (Ullom, 1984). These courses might include a 15-week bridging course. The transition strategy may involve the development of a stable and consistent faculty that will oversee the teaching of these bridging courses. Certain topics that were covered during the early years of the programs by nursing students should also be included. According to Ullom (1984), collaboration should exist between the nursing schools and the technical colleges by combining their available resources in order to use them more effectively. This can be achieved through the sharing of faculties, curricula, or the physical properties involved in the training. A transition course should be included in the case of licensed practicing nurses, whereby an exam is administered before they are admitted in the RN program. This will help in the analysis of their knowledge base, helping them complete the course successfully. They will then be graded and given credits that will allow them to be admitted in the RN program. This collaboration could cover a bigger geographical area, thus establishing standard processes for transferring credits and advancing admissions between the participating institutions.
E-learning has been called to eliminate the tiresome act of travelling over long distances and ensure there is financial sustainability and increased enrollment. E-learning is flexible and offers wide support for students. A system involving wide articulation program can also be adopted, hence ensuring there is quality by providing an equitable and consistent policy for advancing the placements in institutions. A committee should also be established to evaluate and improve the process.
E-learning and face-to-face learning should be merged together so as to improve flexibility by bringing positive responses and increased confidence level with the licensed practicing nurses. Mentoring should also be done to help advance the placement of licensed practicing nurses to the RN program. Besides, licensed practicing nurses should be offered a 6-quarter associate degree program in nursing in order to transition them (Nurses' Protocol, 1988). Bridging courses should also be offered to the licensed practicing nurses helping them become an RN, thus overcoming feelings of lack of involvement and social integration. During mentoring, students are paired by associating degree students. Mentors then volunteer to take them through the process.
The licensed practicing nurses challenge program is crucial as it enables them to proceed through the courses in the transition’s first semester program (Guidelines for Registered Nurses, 1997). Fast tracking is also done to increase flexibility and speed up the process of completion. It combines 5 semesters into a 3-semester program. Learning based on experiments and adaptive competence profile should be initiated to ensure career mobility and that transition process occurs smoothly.
In conclusion, highlighting the difference in the role and scope of practice between the licensed practicing nurses and the registered ones is critical. The notion that the licensed practicing nurses are already operating within the categories of their registered counterparts should pass, as it brings resistance to learning on the part of the licensed practicing nurses. This will help them perceive the transition process in an optimistic way.