I am more than a little frustrated.

 I just read over the Texas Nurses association's list of 100 great nurses for North Texas.  This is an interesting and well respected method of nurses recognizing nurses.  The problem I have with that is that I am not capable of being recognized by the Texas Nurses Association because I am a Licensed Vocational Nurse.

An LVN is a Licensed Vocational Nurse which is a nurse that is licensed by the state to provide routine patient care. Some states use the term LPN or Licensed Practical Nurse rather than LVN. An LVN can work in a hospital, long-term care facility, convalescent home, doctor’s office or surgical center, providing many of the same services also performed by Registered Nurses (RNs).

The LVN, however, must be supervised by RNs or doctors, and cannot do everything an RN does. In some states, an LVN never starts an intravenous line (IV), while in others, they may be able to obtain IV certification to perform this procedure. In areas where they do not start IVs, most LVNs can take blood or administer injections. The LVN may have to do a lot of the clean up in hospital settings. Preparing rooms for new patients, bathing patients, or cleaning up a patient who has vomited are typical LVN jobs. These jobs are important, yet some LVNs feel that their supervisors abuse their authority by assigning them the dirtiest jobs.

I received my education over a decade ago through the John Peter Smith Institute for Health Career Development. I was pretty sure I was bound for bigger and better things at that time. Alas I find myself in the same position all these years later.  I am at the point in my career now where I have to wonder if I am experiencing the limitations of my licensure or simple and commonplace disrespect.   

I love teaching hospitals.  Early in my career I was fortunate to hire on to Brackenridge in the heart of Austin, Texas.  It was there I was first exposed to the concept of Nurse Magnet Status.

The Magnet Recognition Program® recognizes healthcare organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Consumers rely on Magnet designation as the ultimate credential for high quality nursing. Developed by the American Nurses Credentialing Center (ANCC), Magnet is the leading source of successful nursing practices and strategies worldwide.

 At the time it was the only hospital in the state.  I loved every one of the nurses I worked with and enjoyed the fast paced on the go vibe that the Tele/IMCU department offered.  I was the first LVN hired into the position in over 15 years. 

I stayed with Brack for a year or so then Moved back home to my DFW stomping grounds.  I was fortunate enough to find EXACTLY one hospital that employed LVN's.  I began my work with the Methodist Healthcare System on the Surgical telemetry floor.  Even here there were only a few LVN's in house.  I was fortunate to find an open minded Unit Manager.  At present an LVN that is searching for a position in an acute care setting will be sorely disappointed.  Go ahead and try it out yourself.  Go to any national job search website and look for an LVN position in an acute care setting like a major trauma center type hospital and you too will be disappointed.

So then where does an LVN find a home in the grand scheme of healthcare?  Long term care, such as nursing homes and rehab centers.  Long Term Acute Care facilities, Correctional health, and occasionally psychiatric nursing.  We are tasked with continuing the level of care that these patients receive within the major hospital systems.  I mean imagine this:  Your loved one has experienced a major decline in health and you are forced to confront the fact that your particular person is not going to be a candidate for a 6 week rehab and the discharge to a home environment.  Neither is your loved one just slightly infirmed.  Your loved one is not a suitable candidate for a nursing home.  You are then very likely to see your loved one in what is called an LTACH.

LTACH's specialize in Long Term Acute Care services, while a traditional hospital offers many general services such as emergency rooms, maternity wards, and other services. 
The second difference is that LTACH's may offer better care for patients that fit their specialization. The LTACH can focus very high standards on just a relatively small list of ailments, where the traditional hospital is more "spread-out" across a wide range of medical specialties. This is not to say that you cannot receive good acute care in a traditional hospital; its just that the Long Term Acute Care Hospital is set up to specialize in that care.

It is frustrating to realize that one's entire career is undervalued, it is hurtful that entities such as The Texas Nurses Association do not provide a methodology for recognizing the LVN's whom shoulder the brunt of the non acute care workforce.  I would argue that my nursing interventions are no less important.  My licensure does not restrict my ability to be a stalwart Patient advocate.  Not having the letters R and N after my name does not prevent me from offering true understanding empathy and in some cases respite to families in need. 

Is this really acceptable behavior?