Imagine: It's year 2023. Last year was 2 years since COVID struck the world and further divided our nation. Healthcare workers have left the bedside due to physical and psychological torment, leaving the world with limited caretakers and a lack of motivation to fight day in and day out. Your loved one started having a severe headache while they were outside playing with your children. You contemplate waiting it out but you figure, "The ER treated my headache before, let's go!" You drive them to the hospital as their speech starts to slur. You pull up to the hospital and you are unable to find a nurse to help them from the parking lot into the ER waiting room. After 10 minutes of trying to help your loved one, you find a triage line of 15 people ahead of you. Why is there only one person at the triage desk? Do they not hear you screaming for help? Your loved one is now having trouble walking or staying awake. After 20 minutes, the triage nurse notes that you are top priority now that her OD patient has been taken to the back. He/she calls for help, but no one is able to respond. After 5 minutes of the nurse trying to find an empty gurney or wheelchair, your loved one is taken back to get a STAT CT, but the current machines are in use or unmanned. 10 minutes pass before a trauma patient is wheeled out and they are allowed in. A disheveled critical care team is present but minimally, due to the amount of patients they are currently trying to maintain. Your loved one, unresponsive now, has been found to have an active brain bleed. Your critical care team looks worried as you overhear them talk about not having an open STAT room. The ICU is at capacity for the staff available. The ER rooms are full, as well as the gurney's lining the hallways. You don't even see a healthcare member but for a second as they run to the next patient. You are furious. You feel like the life of your loved one is being disregarded. Any second you could lose them while their team has to decide who's life is worth risking at this very moment. Your loved one or someone else's?

Can you see it?

If you can't, I need you to open your eyes. This is happening now. This is not the future scene of an apocalyptic movie. This is our reality. This HAS been our reality, and while not every day is like this.. many days are and will come to be.

I start this petition, not to create a big change, but to plant a seed.

According to NCSBN’s Environmental Scan A Portrait of Nursing and Healthcare in 2020 and Beyond, there were 4,096,607 RNs and 920,655 LPN/LVNs in the United States as of October 2019 (NCSBN National Nursing Database, 2019a). These numbers all calculated prior to COVID ravaging our healthcare system and also prior to the incoming COVID vaccination mandate that has already begun as of August 2021.

According to The American Nurses Association (ANA) in December 2020(start of COVID), more RN jobs will be available through 2022 than any other profession in the US. It was estimated that over 1 million additional nurses be needed to meet the demand in 2020 alone. Obtaining data from multiple sites, The United States has about 155,000 RN graduates per year. Research also shows that nearly 1 million nurses will retire by the year 2030, adding to the shortage and creating even more need. And the nursing shortage goes beyond replacing current nurses  These statistics also prior to the mass exodus we are about to experience in both education and the workforce. Fun fact, employment opportunities for nurses are projected to grow at a faster rate (15%) than all other occupations from 2016 through 2026 resulting in 11 million additional nurses needed.(NCBI)

So let's recap:

Current RN's(all work settings): 4,096,607

RNs needed to prevent further shortage in near future: 1,000,000+

RN graduates per year(prior to NCLEX): 155,000

How is this looking to you?

I've stated already, this is not to create a big change. There are currently LPN/LVNs that will also be leaving the field of nursing for the same reasons RNs are leaving. Among those that are left, less than half have the experience needed to meet the criteria I personally have in mind. 

*5-10+ years active experience

*Ability to pass NCLEX-RN without an academic course

*Ability to achieve competency as an RN per facility protocols

*Possible further education needed after crisis is over to remain compliant due to lack of RN course.

*Offered only in a nursing shortage crisis

This wouldn't be a lot of help, but it would be SOMETHING and it would give those that are deserving of the title a way to obtain it.

Now, I realize there are a lot of reasons why someone would push back on this idea, but my question to you would be.. What do you have to lose if this were to be allowed? I've gathered my own data while coming up with this petition and I'll answer a few questions or concerns I've heard.

1. Letting LPN/LVNs test for their RN will make RNs want to test for their NP.
- I understand how this could be a concern and I don't invalidate it, but.. we are talking a floor staff nursing crisis. NPs have their roles as providers and usually leave their direct patient care to RNs. We need more floor support. More floor support means supporting our providers better. This can maintain a better working condition to prevent our providers from compassion fatigue. 

2. LPN/LVNs don't completely understand what it is to be an RN.
- Yes, while we do learn more about patient care management, potent drips, and ACLS they are still nurses with, at least, basic knowledge to care for a patient. When you were a brand new RN, what did you feel like you truly knew when you were on the floor? They will adapt. That's why I've asked that these LPN/LVNs have 5-10+ years of consistent, active experience. 

3. Won't LPN/LVNs just wait for their time to test instead of going back to school?
- This is why I say this should only be valid in a nursing shortage crisis. But also, so what if they did? Would you rather have a patient ratio of 6+:1 or have an extra nurse beside you to take on the load? 

4. I worked for my degree. I earned this!
I have personally obtained my BSN. Would I refuse a life ring while I'm drowning? Nope. Other's success does not demerit our own.

5. They'd make our work even harder with mistakes!
- You're a nurse. Teach. Let them shadow you. If a facility isn't comfortable, have the new LPN/LVN -> RN work as a "battle buddy" for 6 months. It's still competent HELP. We can also make mistakes when we are tired and taking on more patients than we should.

Like I said, I truly do understand the concerns. Some are very valid and will have to be reviewed by those in charge. However, we have already lost so many great LPN/LVN's chasing unrealistic healthcare goals. They DO deserve a chance. We deserve safe staffing ratios and healthy work environments. Our patients deserve safe, timely, and competent care. 

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https://www.journalofnursingregulation.com/article/S2155-8256(20)30022-3/fulltext

https://www.ncsbn.org/6212.htm

https://www.ncbi.nlm.nih.gov/books/NBK493175/

https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet