Licensed Practical and Licensed Vocational Nurses

• Training lasting about 1 year is available in about 1,200 State-approved programs, mostly in vocational or technical schools.
• Applicants for jobs in hospitals may face competition as the number of hospital jobs for licensed practical nurses declines; however, rapid employment growth is projected in other health care industries, with the best job opportunities occurring in nursing care facilities and in home health care services.
• Replacement needs will be a major source of job openings, as many workers leave the occupation permanently.

Licensed practical nurses (LPNs), or licensed vocational nurses (LVNs), care for the sick, injured, convalescent, and disabled under the direction of physicians and registered nurses. (The work of physicians and surgeons and of registered nurses is described elsewhere in the Handbook.)

Most LPNs provide basic bedside care, taking vital signs such as temperature, blood pressure, pulse, and respiration. They also prepare and give injections and enemas, monitor catheters, apply dressings, treat bedsores, and give alcohol rubs and massages. LPNs monitor their patients and report adverse reactions to medications or treatments. They collect samples for testing, perform routine laboratory tests, feed patients, and record food and fluid intake and output. To help keep patients comfortable, LPNs assist with bathing, dressing, and personal hygiene. In States where the law allows, they may administer prescribed medicines or start intravenous fluids. Some LPNs help to deliver, care for, and feed infants. Experienced LPNs may supervise nursing assistants and aides.

In addition to providing routine bedside care, LPNs in nursing care facilities help to evaluate residents’ needs, develop care plans, and supervise the care provided by nursing aides. In doctors’ offices and clinics, they also may make appointments, keep records, and perform other clerical duties. LPNs who work in private homes may prepare meals and teach family members simple nursing tasks.

Most licensed practical nurses in hospitals and nursing care facilities work a 40-hour week, but because patients need round-the-clock care, some work nights, weekends, and holidays. They often stand for long periods and help patients move in bed, stand, or walk.

LPNs may face hazards from caustic chemicals, radiation, and infectious diseases such as hepatitis. They are subject to back injuries when moving patients and shock from electrical equipment. They often must deal with the stress of heavy workloads. In addition, the patients they care for may be confused, irrational, agitated, or uncooperative.

All States and the District of Columbia require LPNs to pass a licensing examination, known as the NCLEX-PN, after completing a State-approved practical nursing program. A high school diploma or its equivalent usually is required for entry, although some programs accept candidates without a diploma, and some are designed as part of a high school curriculum.

In 2004, approximately 1,200 State-approved programs provided training in practical nursing. Most training programs are available from technical and vocational schools, or from community and junior colleges. Other programs are available through high schools, hospitals, and colleges and universities.

Most practical nursing programs last about 1 year and include both classroom study and supervised clinical practice (patient care). Classroom study covers basic nursing concepts and patient care-related subjects, including anatomy, physiology, medical-surgical nursing, pediatrics, obstetrics, psychiatric nursing, the administration of drugs, nutrition, and first aid. Clinical practice usually is in a hospital, but sometimes includes other settings.

In some employment settings, such as nursing homes, LPNs can advance to become charge nurses who oversee the work of other LPNs and of nursing aides. Some LPNs also choose to become registered nurses through numerous LPN-to-RN training programs.

LPNs should have a caring, sympathetic nature. They should be emotionally stable because working with the sick and injured can be stressful. They also should have keen observational, decision-making, and communication skills. As part of a health care team, they must be able to follow orders and work under close supervision.

Licensed practical nurses held about 726,000 jobs in 2004. About 27 percent of LPNs worked in hospitals, 25 percent in nursing care facilities, and another 12 percent in offices of physicians. Others worked for home health care services; employment services; community care facilities for the elderly; public and private educational services; outpatient care centers; and Federal, State, and local government agencies. About 1 in 5 worked part time.

Employment of LPNs is expected to grow about as fast as average for all occupations through 2014 in response to the long-term care needs of an increasing elderly population and the general growth of health care services. Replacement needs will be a major source of job openings, as many workers leave the occupation permanently. Applicants for jobs in hospitals may face competition as the number of hospital jobs for LPNs declines; however, rapid employment growth is projected in other health care industries, with the best job opportunities occurring in nursing care facilities and in home health care services.

Employment of LPNs in hospitals is expected to continue to decline. Sophisticated procedures once performed only in hospitals are being performed in physicians’ offices and in outpatient care centers such as ambulatory surgical and emergency medical centers, largely because of advances in technology. Consequently, employment of LPNs in most health care industries outside the traditional hospital setting is projected to grow faster than average.

Employment of LPNs is expected to grow much faster than average in home health care services. Home health care agencies also will offer the most new jobs for LPNs because of an increasing number of older persons with functional disabilities, consumer preference for care in the home, and technological advances that make it possible to bring increasingly complex treatments into the home.

Employment of LPNs in nursing care facilities is expected to grow about as fast as average because of the growing number of aged and disabled persons in need of long-term care. In addition, LPNs in nursing care facilities will be needed to care for the increasing number of patients who have been discharged from the hospital but who have not recovered enough to return home. However, changes in consumer preferences towards less restrictive and more cost-effective care from assisted living facilities and home health care agencies will limit employment growth.

Median annual earnings of licensed practical nurses were $33,970 in May 2004. The middle 50 percent earned between $28,830 and $40,670. The lowest 10 percent earned less than $24,480, and the highest 10 percent earned more than $46,270. Median annual earnings in the industries employing the largest numbers of licensed practical nurses in May 2004 were:

LPNs work closely with people while helping them. So do emergency medical technicians and paramedics; medical assistants; nursing, psychiatric, and home health aides; registered nurses; social and human service assistants; and surgical technologists.

For information about practical nursing, contact any of the following organizations:

• National Association for Practical Nurse Education and Service, Inc., P.O. Box 25647, Alexandria, VA 22313. Internet: http://www.napnes.org/
• National League for Nursing, 61 Broadway, New York, NY 10006. Internet: http://www.nln.org/
• National Federation of Licensed Practical Nurses, Inc., 605 Poole Dr., Garner, NC 27529. Internet: http://www.nflpn.org/

Information on the NCLEX-PN licensing exam is available from:

• National Council of State Boards of Nursing, 111 East Wacker Dr., Suite 2900, Chicago, IL 60611. Internet: http://www.ncsbn.org/

A list of State-approved LPN programs is available from individual State boards of nursing.

Source: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2006-07 Edition