at the hospital i work at, RNs have the 'clinical ladder', so they are either a Clinical Nurse I, II, III, or IV -- all depending on your years of practice. you also have to apply to reach 'clin. III or IV' level. you have to collect a bunch of data, experiences, etc. and then present them to the clinical nurse board and they then decide if you deserve to go up the ladder. and i think you have to have your BSN if you want to apply for your 'clin IV' with that, comes a little bit more pay and a few more bragging rights. our hospital used to have 'clin. V's' for NP's, but did away with that.
that being said .. our hospital used to have the same ladder for LPNs, but did away with it.
now, if you've been an LPN for longer than 10 years or so - they say you're 'LPN Sr.'
doesn't really make a ton of sense to me.
it's weird when i see hospitals looking for an LPN vs. an LPN-B vs. LPN Sr. vs. LPN II, etc..
you have experience, you have experience .. it's kinda that simple.
and, as far as i know, the LPN-B title has been phased out?
i don't even think anyone does the whole LPN-A thing anymore because all PN programs include pharmacology and medication administration into their coursework.
i still see some of the older LPNs sign 'LPN-B' after their name, though.
we were taught to just sign 'LPN' now that there is no differentiation.
someone correct me if i'm wrong.
and i hope i answered your question on some level. sorry if i wasn't super clear.