Licensed Practical / Vocational Nurses (LPNs / LVNs)

Licensed practical nurse (LPN) is a professional title used in the the vast majority of the United States and most provinces in Canada to refer to a specific type of nurse who provides basic patient care, primarily at the bedside. This article discusses the role of LPNs in the U.S. Nurses LPN/LVN Article

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Licensed Practical / Vocational Nurses (LPNs / LVNs)

In the nursing profession, LPN is a commonly utilized acronym that stands for licensed practical nurse. According to the Merriam Webster dictionary, a licensed practical nurse is defined as a person who has undergone training and obtained a license to provide routine care to the sick. 48 states in the union and virtually all of the Canadian provinces utilize the LPN title. The two most populous states in the union, California and Texas, employ the acronym LVN, which stands for licensed vocational nurse. The Canadian province of Ontario identifies practical nurses as RPNs, which is short form for registered practical nurse. In spite of the somewhat dissimilar titles, LPNs, LVNs and RPNs are terms that basically refer to the same type of nurse.

Duties / Responsibilities

In the US, LPNs practice nursing under the supervision of a registered nurse (RN) or physician; however, in many cases LPNs are the only licensed nurses physically present in numerous facilities during certain work shifts. As a general rule, LPNs in all states execute basic nursing care such as medication administration, finger stick blood glucose testing with glucometer machines, data collection, observing and reporting changes in condition, vital sign checks, dressing changes, wound care, blood draws, specimen collection, indwelling urinary catheter insertion and care, removal of sutures and surgical staples, tracheostomy care, care of artificially ventilated patients, incentive spirometry, ostomy site care and maintenance, recording intake and output, and cardiopulmonary resuscitation. LPNs also chart and document nursing care in accordance with facility policies and procedures. LPNs may supervise and direct certified nursing assistants in specific types of healthcare settings.

The duties of an LPN are very much subject to the regulations of the American state or Canadian province in which he / she practices nursing. Various state boards of nursing, such as the ones located in Oklahoma and Texas, exercise particularly wide scopes of practice that permit LPNs to do practically anything that facility policies and procedures will permit. The LPNs who practice in states with the widest scopes of practice can perform many of the same skills that their RN counterparts carry out, such as starting IV lines, administering medications via IV push, central line care and site maintenance, and so on. Other state boards of nursing, such as the ones found in New York and California, make use of rather restricted scopes of practice that especially limit the skills and tasks that LPNs are permitted to perform.

Work Environment

LPNs normally work in climate-controlled settings such as nursing homes, residential care facilities, inpatient hospice houses, home health, private duty cases, jails, psychiatric hospitals, prisons, rehabilitation facilities, community health centers, group homes, clinics, research trials, doctors' offices, assisted living facilities, agencies, private residences, extended care facilities, and schools. LPNs also secure employment in acute care hospitals, but LPN opportunities in this type of setting are on the decline in many regions in the US as a result of issues that revolve around limited scopes of practice. The vast majority of these workplace settings demand 24-hour patient care, so many LPNs work days, evenings, nights, weekends and holidays. Contact with blood, urine, feces and other bodily material might occur; however, any risks can be diminished through proper use of personal protective equipment when providing the types of direct care that are likely to result in exposure.

Educational Requirements

People who want to become LPNs may select from two distinct educational paths. Certificate / diploma programs and associate degree programs are the primary ways in which one may become an LPN. The first method requires attendance of a state-approved program that results in a certificate or diploma upon completion. Most LPNs in the United States received their training at the certificate / diploma level. These programs are offered at community colleges, vocational schools, technical colleges, adult education centers, and private for-profit entities. Graduates of certificate / diploma programs will need to pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN), the exam that results in state licensing as a practical nurse. The second avenue to an LPN career is graduation from a state-approved program that awards an associate of applied science (AAS) degree in practical nursing. Associate degree programs are offered at community colleges, state universities and technical colleges. Graduates of associate degree programs also need to pass the NCLEX-PN to attain a nursing license.

Salary

According to the Bureau of Labor Statistics, the median annual pay of licensed practical and vocational nurses was $40,380 in 2010. The median hourly pay rate in 2010 was $19.42 per hour. Pay rates can be influenced by factors such as cost of living, specialty, company, geographic region, and experiential level.

Resources

Licensed Practical and Licensed Vocational Nurses : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics

NAPNES | "Every Nurse Counts!"

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TheCommuter

About TheCommuter, BSN, RN

TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

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Specializes in Psychiatric Nursing.

Very good article! Incidentally, Tennessee is a state that utilizes a fairly limited scope of practice for the LPN. I am proud to have been an LPN for 11 years. The average national median salary was higher than I realized. I have never earned more than $33k as an LPN. I actually am getting ready to graduate with my ADN at the end of this month and am looking forward to getting my prize...RN!

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Thank you, Commuter. Perhaps this will help RN's realize what we are trained for. I don't understand why a major union doesn't want to include LPN's, we are nurses after all, according to definition!

mc3:cat:

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Specializes in NICU.

In Ontario, RPNs can do most of the same skills as RNs...but it depends on the facility. I just did a placement on a surgical trauma floor and the RPNs did mostly everything. The only things we didn't do were hang heparin, access central lines and iv push...other than that the job was the same. And it's a 2 year program in Ontario

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Specializes in Psychiatric Nursing.

I am curious which states allow LPNs to administer medication via IV push. In Tennessee, this is a skill that only RNs are allowed to perform per our Nurse Practice Act. When I was a brand new LPN, I was warned several times by other nurses (RNs and LPNs) to never give meds via IV push, unless I wanted to lose my license.

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Specializes in Emergency Nursing.
I am curious which states allow LPNs to administer medication via IV push. In Tennessee, this is a skill that only RNs are allowed to perform per our Nurse Practice Act. When I was a brand new LPN, I was warned several times by other nurses (RNs and LPNs) to never give meds via IV push, unless I wanted to lose my license.

Ur northern neighbor, Indiana allows LPNs to perform all tasks the LPN is deemed competent in performing including IVP and even PICC insertion!! I access ports, draw ABGs, perform a wide variety of IVP and administer blood products.

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I'm an LPN in the province of Alberta.

The skill set is so similar now, it's absurd. The only duty I cannot perform on my acute care unit is that of Charge Nurse. I assess, medicate, educate, and discharge my own patient load. I report only to the Charge as does the RN working along side me. There is no selection of patients (which is suitable for the R or L). I access PICC lines for flushing and medication.

Blood and Travisol is a two nurse procedure, so although I cannot spike the bag (the RN has that duty in the med room) we both walk to the bedside and perform the identification checks. The patient remains my responsibility throughout the TPN process or the blood administration.

I work along BScNs and the old diploma RN.

It is a full two year programme of education which is the old RN diploma along with university transfer Arts courses.

I am a union member and last year made $55K working part time.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I am curious which states allow LPNs to administer medication via IV push. In Tennessee, this is a skill that only RNs are allowed to perform per our Nurse Practice Act. When I was a brand new LPN, I was warned several times by other nurses (RNs and LPNs) to never give meds via IV push, unless I wanted to lose my license.
LVNs/LPNs in Texas and Oklahoma are permitted to administer medications through IV push. There are multiple other states with wide open LPN scopes of practice, too.
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Great Article! Many times the public and our peers have no idea what a LPN is. I was a LPN for 2.5 years before receiving my RN. Having my LPN gave me a valuable experience and I never regret going the LPN route first.

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In Wisconsin the scope of practice is so loosely written that it's pretty much open to however the reader interprets it... The area I live in right now the LPNs seem to have a pretty restricted role depending on the facility and the facility's DON. I recently had one DON who reprimanded me for documenting lung sounds, she said that was an assessment. She would not allow the LPNs to document lung sounds and edema. Nor could we do a full head to toe on a patient. And she didn't want to me to draw blood. The next DON said LPNs can and should document lung sounds and edema. And she was shocked that the LPNs were not IV certified! The next DON didn't want LPNs in the facility at all! Obviously LPNs in this facility cannot do IVP meds. I had asked in the past about becoming IV certified but the DON and NHA had no interest in that.

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Specializes in Emergency Nursing.
In Wisconsin the scope of practice is so loosely written that it's pretty much open to however the reader interprets it... The area I live in right now the LPNs seem to have a pretty restricted role depending on the facility and the facility's DON. I recently had one DON who reprimanded me for documenting lung sounds she said that was an assessment. She would not allow the LPNs to document lung sounds and edema. Nor could we do a full head to toe on a patient. And she didn't want to me to draw blood. The next DON said LPNs can and should document lung sounds and edema. And she was shocked that the LPNs were not IV certified! The next DON didn't want LPNs in the facility at all! Obviously LPNs in this facility cannot do IVP meds. I had asked in the past about becoming IV certified but the DON and NHA had no interest in that.[/quote']

I don't know the difference between assessment and data collection. The distinction just doesn't seem clear to me .

My LPN boards included breath sounds that I was to identify. I tell my RN counterparts that and the more reserved ones who consider that to be assessment material are frequently shocked

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Specializes in Psychiatric Nursing.

It's so interesting to learn what LPNs are allowed, or in some instances, not allowed to do. I love this forum! Great to connect with other good nurses. I'm lucky to have had DONs who were appreciative of LPNs and didn't treat us like second-class nurses. The fact that our Nurse Practice Act in Tennessee is so restrictive was part of my motivation to advance my education.

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