Integrating Licensed Practical Nurses in Emergency Departments

Chandell Kelly is a Clinical Nurse Educator at PHC and Emily Tang is a faculty member at BCIT’s  School of Health Sciences Simulation Program. Both are in the second year of the two-year part-time MHLP program and are working full-time while completing their master’s degrees.

In 2024, Chandell and Emily were each asked by their respective organizations if they were interested in working on a practice-based research challenge. PHC and BCIT have a partnership that provides an opportunity for the two organizations to collaborate on practice-based research, with the goal of improving patient care and bridging the gap between practice and academia.

The two were invited to be part of a four-member team tasked to investigate best practices for integrating Licensed Practical Nurses (LPNs) into emergency departments at PHC sites. Emily and Chandell both jumped at the opportunity to be part of this research to identify the barriers and opportunities for optimizing the scope of practice of LPNs in emergency departments and thereby alleviate some of the other pressures in the system and improve patient care.

The integration of LPNs into emergency departments at PHC sites has had a complicated history. At one site, LPNs were integrated into the department and then removed, and at another site they were historically only assigned to work within a very specific practice area.

“For this research project, we want to gain a better understanding of what contributes to the successful integration of LPNs in a specific practice setting,” says Chandell. “We’re also looking at team dynamics and how the RNs and LPNs work together.”

Serendipitously, just as the two were starting on this research collaboration, they discovered they were also MHLP classmates.

They began their research project in early 2024 by conducting a literature review, which revealed that there was limited work being done on LPN integration in high-acuity settings.

The timing of their literature review was fortuitous, as they were in the midst of a course on research and evidence-based practice.

“As part of the course, we had a librarian walk us through how to do advanced database searching – at exactly the same time we were doing the literature review for this project,” says Emily. “This is just one example of how we were able to apply concepts from the MHLP to this research work.”

Their study is focusing on emergency departments at St. Paul’s Hospital and Mount Saint Joseph Hospital. In the first phase of the project, they are conducting an online survey to gather quantitative and qualitative data from respondents who include LPNs, registered nurses, nurse practitioners, physicians, allied health professionals and support staff.

The survey is exploring areas around barriers and supports for teamwork, the impact of integrating LPNs on workflow and patient care, and suggestions for improvement from frontline staff.

After the survey closes and the research team has had a chance to analyze the data, they aim to provide leadership with recommendations by the end of 2025 or early in 2026.

Although it’s too early to discuss the survey results, the two are excited about their work and the opportunities it offers to identify strategies for optimizing nursing roles in emergency departments. As they point out, traditional RN models in high-acuity settings, such as emergency departments, simply aren’t sustainable. LPNs can play a significant role in these settings in providing patient care.

“From an educator standpoint, this research and work will provide, at the least some clear understanding, and hopefully next steps, of what LPNs need to be successful in critical care settings like emergency departments,” says Emily. 

“I think a lot of that comes through education and preparing LPNs in a standardized way within their allowed scope of practice.”

Adds Chandell: “We know that something needs to change because the status quo is not sustainable for our staff. And if we don’t look after our staff, we won’t be able to look after our patients.”

Presenting their work at the BC Quality Forum in March 2025 was a highlight for the two MHLP students, enabling them to reach a large audience of BC health care leaders.

While their research is separate from the MHLP curriculum, the students say that the skills and knowledge they are gaining in the program has strengthened their skills as researchers and bolstered their confidence as communicators and leaders.

“Doing this research alongside the MHLP is very experiential,” says Emily. “I am applying what I am learning in the MHLP in leadership, clinical education in real time.”