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By Amanda Sounart, associate editor

Kaiser Permanente is hoping to improve the quality of care in their Northern California hospitals by changing the educational requirements of their nursing staff. The recent decision will remove all licensed vocational nurses (LVNs) from the HMO’s acute care hospitals and will replace them with registered nurses (RNs).

The shift will take place over the next several months causing a change for approximately 25 percent of the region’s 1200 LVNs. Kaiser opted for the change in part due to state level restrictions that limit the LVNs' level of interaction with the patient. With more extensive training, RNs are better equipped to handle the multiple diagnostics required in an acute care setting.

“We began recognizing that patient care was becoming increasingly complex,” said Barbara Norrish director of education research and work force for Kaiser Permanente Northern California. “As the length of patient stays decrease, the complexity of their needs increases. Patient care requirements and the scope of practice have grown tremendously. There is more equipment and more technical needs that our nurses have to meet every day. Our patients and the care they require exceeded the scope of an LVN, so the decision was made.”

Currently, the shift is only being required in acute care facilities and will not effect LVN positions in the ambulatory care sector. The nurses who are being affected have been given several options by Kaiser, the most obvious of which is to seek employment at non-Kaiser facilities. This may prove to be difficult as several other hospitals in the area have been following suit and are working with entirely RN-based nursing staffs.

Other nurses will be offered a severance package, which is the option being utilized by many nurses to segue into retirement.

The third option for the nurses who wish to stay with Kaiser is to increase their skill set and become RNs or medical technicians. Kaiser is offering the nurses the opportunity to enter into training programs sponsored by the company. The programs are a joint effort between Kaiser and United Healthcare Workers West, the union that represents the nurses.

“Kaiser pays into a trust for UHW to provide educational opportunities for all of their nurses,” noted Norrish. “It’s an important investment given the nursing shortage.”

Approximately 140 open positions are available in the training programs for the nurses to upgrade their status to RNs or to go into other specialties including obstetric technicians or respiratory care.

The effected LVNs have been given time to decide which option is the right fit for them. They are currently in the process of receiving career counseling to determine the best opportunity to benefit the company and the nurse. Those that opt to stay with Kaiser will continue to be employed as they segue into their new careers.

“Kaiser is unique because we’re an integrated system with respect to redeployment. There are always positions available and there’s always mobility,” noted Norrish. “The model of care continues to shift as the need arrives. The basic idea is for the best in patient care and patient safety. With the nursing shortage, we need to be sure that we’re meeting everybody’s needs.”

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