The separation of the two programs create an environment right from the beginning of a nurses career that there is a hierarchy in the RN versus RPN roles and they are not taught to effectively communicate effectively as a team. It also creates confusion as to what the role of an RPN versus an RN is and the parameters in which they overlap in ability as well as what delegations/tasks that need to be dispersed to the correct nurse based on the training, confidence level, patient care needs, and critical condition of the patients they care for is. It makes for an already confusing start to the nursing career when there is no collaboration when they are training and then expected to do it when they are in the working field.

When nursing students are educated in separate programs, I think it can create assumptions about each other’s roles and knowledge before they even enter practice.

In my RN program, I honestly did not learn much about what RPNs were taught. I knew the RPN program was shorter than the RN program, so I understood there were differences in depth and breadth of education. However, I did not really understand what those differences were, or where the roles overlapped. Looking back, there were many opportunities where this could have been addressed. For example, we had courses focused on professional growth and the nursing profession, but they focused on just the RN role.

I think this can affect communication in practice because nurses may rely on assumptions instead of a clear understanding of each other’s education, competence, and scope. It can also make it harder to recognize when workplace practices are based on tradition rather than what each nurse is actually educated, competent, and authorized to do.

what implications on communication can occur in practice when students are educated in segregated programs?
The implications are that great misunderstandings form the basis of poor RN/RPN relationships. From this point, the relationship can get worse or improve. It improves provided the RN & RPN are mature enough to ask questions and openly discuss their perceptions of each others roles and clarify with the reality of the functions carried out. Unit managers can play a significant role in clarifying RN/RPN role conflicts by inviting this cohort of care providers into a meeting to discuss and outline the respective roles.
Deterioration of effective RN/RPN roles is caused by immaturity , reluctance to cooperate and clarify roles and expectations, and by managers sidelining the problem. Educational programs could support these misunderstandings by taking an hour out of or adding into the curriculum details of the realities of working with multi-level nurses.