Mayo Health System cutting LPNs...
Here's intriguing news from Mayo Clinic's Austin Medical Center, which is part of region-wide Mayo Health System.
Austin Medical Center apparently plans to discontinue the job positions of a dozen licensed practical nurses because of the trend of patients arriving at hospitals nationwide sicker than they did, say, 20 or 30 years ago. That means patient needs are severe enough that they fall outside the scope of practice of LPNs. Mayo as a whole is transitioning away from LPNs.
The Austin Medical Center LPNs will have until New Year's Eve of this year (2010) to "explore options for their future career plans."
"Austin Medical Center’s patients have been gradually changing over the years and now are coming to the hospital with increased complex needs, diseases and often needing more frequent care. Because the needs of our patients come first, Austin Medical Center continues to evaluate its care models and services on an ongoing basis to make sure the patient’s needs are being met," an announcement from the medical center says. "After considerable review and careful evaluation of the current care model at Austin Medical Center, it was determined that Licensed Practical Nursing (LPN) staff in the hospital setting, including Telemetry, Medical/Surgical/Pediatrics, Psychiatric Services, and Home Health Care and Hospice, will be changed to a Registered Nurse (RN)/Nursing Assistant staffing model. A total of 12 LPN’s will be affected by this new care model, which will directly impact their positions at Austin Medical Center."
[Post-Bulletin file photo of a snowy Austin Medical Center in Austin, Minnesota. Copyright.]
AMC's Chief Nursing Officer Diane Twedell (who is a registered nurse and also has a doctor of nursing practice degree) called the decision "absolutely the right thing to do for patient care."
"The hospital admission and discharge process for patients has become more complex over the years and patients need more frequent assessment by Registered Nurses, and our care models need to reflect that change,” she is quoted in the announcement as saying.
The medical center offers a question-and-answer list. Here it is, in the medical center's own words:
What does this decision mean?
It means that in the remaining months of 2010, AMC will be transitioning to a Registered Nurse/Nursing Assistant model in Telemetry, Medical/Surgical/Pediatrics, Psychiatric Services, and Home Health/Hospice.
Who does it affect?
It will affect the Licensed Practical Nurse positions in Telemetry, Medical/Surgical/Pediatrics, Psychiatric Services and Home Care/Hospice.
What areas will continue to utilize LPN’s?
Outpatient Surgery, Urgent Care and the Clinic will continue to utilize LPN’s.
Is AMC doing anything for the LPN’s?
Earlier this afternoon a meeting was held with the LPN’s and we will be meeting with them individually over the coming weeks to assist them in whatever way possible as they look for other opportunities. Some of the options we are prepared to discuss could include tuition reimbursement, early retirement options, or transitioning to other available roles at Austin Medical Center, Mayo Clinic, or other Mayo Health System sites.
What were the factors in making this decision?
There were multiple factors in making this difficult decision. These factors include:
The LPN scope of practice. The complexity, acuity, and disease chronicity of our patients has increased through the years. The admission and discharge process has become more complex. The patients we’re caring for today are more acutely ill and often require more frequent assessments by RN’s.
All of other Mayo Clinic and Mayo Health System sites have already transitioned to this model of care.
With the implementation of the new Mayo Health System Electronic Medical Record in 2011, the ability of an LPN to document care is drastically reduced.
It comes down to our primary value – the needs of the patient come first. We evaluate our care models and services on an ongoing basis to make sure they are meeting our patients’ needs.
What is the difference between an LPN (Licensed Practical Nurse) and an RN (Registered Nurse)?
The main difference is assessment versus observation. An RN is able to perform a comprehensive, physical, medical, social, and emotional assessment of a patient. An LPN utilizes observation to collect data and provide the data to the RN who then completes the overall assessment.
An RN recognizes alterations in the patient’s condition compares them to the patient’s previous condition, analyzes data, makes nursing judgments, and develops the comprehensive care plan. An LPN may recognize alterations in the patient’s condition and then reports pertinent observations to the RN and may suggest intervention modifications.
An RN is independent in nursing decisions.
For further information, please reference the “FAQ Nursing Assessment and Care Planning” section on the Minnesota Board of Nursing website.
Why is this change being implemented now?
AMC goes live with the new Mayo Health System Electronic Medical Record in 2011, and because AMC values the LPN’s many years of service and contributions, we want to give them time to find another position, apply for educational programs, or to make other decisions that will impact their careers in the future.
Have other sites made this change?
Yes, all of the other Mayo Clinic and Mayo Health System sites.
Will the LPN’s continue to practice as they have until December 31st?
As you know AMC has had long standing policies regarding RN Accountability and the LPN’s scope of practice. We will be holding staff accountable in following AMC’s policies and procedures and compliance with the Minnesota Nurse Practice Act. RN’s will still be able to delegate appropriate responsibilities.
Will this change impact the role of Nursing Assistants?
Nursing Assistants will continue to play an important role in the healthcare team. In addition to their current responsibilities, AMC will be providing training to the Nurse Assistants so that they are able to perform to the full scope of their role.
Is this a reduction in staff? Will the staff in these units be required to care for more patients?
No, this is not a reduction in the number of staff. We will be hiring additional RN’s and Nursing Assistants.
Could one of the affected LPN’s apply for other available positions at AMC?
Yes.
Will other LPN’s at AMC be impacted in the future?
There has never been a question that LPN’s provide excellent care within their scope of practice, and AMC’s intent is to continue to employ LPN’s in our Clinic, Urgent Care, and Outpatient Surgery areas. In fact, with the aging population, national publications indicate there will be a greater need for LPN’s in clinic and long-term care settings.
Did this decision have anything to do with finances?
No, this decision was not part of any cost reduction effort; there is no correlation between finances and this decision. We are adding new RN and NA positions.
How could AMC do something like this to staff?
We recognize this is a significant change in our organization. Difficult decisions such as this are a result of careful deliberation and rigorous evaluation, and they have to be made when necessary to ensure we continue to place the needs of our patients first.
What can I do for the staff members that are affected?
This is a difficult change for the LPN’s but we recognize it is also a difficult change for you, their co-workers and friends. We want you to be able to support the staff member as needed, offer to help or to listen.
The announcement quotes Austin Medical Center CEO Dr. Dave Agerter as saying he understands and recognizes that the decision impacts LPNs in the hospital who "have made significant contributions to the care of our patients for many years."
"We are helping the affected LPN's by working with them to explore options…," he said.
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904
Twitter Hansel's Pulse: @Jeff Hansel
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