LPN vs RN home health nurse

caliotter3 · Jan 13, 2015

This entirely depends upon the role that the RN HH nurse takes. In extended care: RNs and LPN/LVNs can both do extended care case work; most employers will pay the RNs the same as LPNs because most extended care work is rated at the LPN level. RNs also have open to them the role of the clinical supervisor. This individual will make considerably more money than the LPN but they will have case manager, supervisory responsibilities. They may also be responsible for opening/closing/recertifying cases. There is a different kind of paperwork requirement in this role. The RN who chooses to do shift work, whether paid at the LPN or RN level, will have the same paperwork: a nurses' note for their shift and any other associated documentation, such as a supplementary physician's order form.

The RN who does intermittent visit type work will also have the same paperwork as the LPN/LVN who does visits, but they will be paid the RN rate for visits. An RN supervisor in this environment will have a specific paperwork load involved with opening, closing, and recertifying cases.

In both the extended care and visit venues, an RN will be paid more when they are responsible for "RN level" procedures or tasks.

Libby1987 · Jan 14, 2015

I don't know where you are located but in my corner of the world the difference in pay is substantial, as are the responsibilities.

In intermittent HH, LVN's (as well as what we call re visit nurses) are task oriented, primarily performing procedures, teaching and focused assessmemts as lined out/changed by the admitting RN/RN case mgr. They do assessments but not in the sweeping manner and eyes of an RN case manager.

I'm not a task oriented type, I prefer having my own cases that I admit, manage and discharge in hopefully better condition than what I got them utilizing and coordinating all the resources available as well as initiating changes in care. That might only mean that the caregiver is made more competent and confident but even that is a successful outcome. I like orchestrating that, I find it very fulfilling.

Others are more task oriented, they prefer to have the plan laid out for them and they follow instructions. They may only see a patient once or they may get to make repeated visits on a high frequency patient ie wound care.

The RN case mgr has the most paperwork of all of the services, even a perdiem RN has less. It is a tremendous amount and has ran off many nurses IME.

In my area a case mgr makes a better living and has the most job security. My company in particular (Medicare certified intermittent skilled services) no longer hires LVN's but will always meet with a strong RN candidate. We also have a private duty program, in the past, our shift LVN's made approximately half of a case mgr's wage, much more than a $3 difference.

brillohead, ADN, RN · Jan 15, 2015

It depends on what kind of "home health" you're talking about doing.

If you're talking about shift work, where you're in a client's home for 8-12 hours straight providing care, that's also called Private Duty Nursing (there's a separate forum here on AN for PDN: https://allnurses.com/private-duty-nursing/). Those cases may or may not pay the same/similar rate for LPN vs RN. All of the cases I've been on, through three different agencies, pay RNs more than they pay LPNs for the same case. The paperwork is identical for the shift work, although as an RN I can also do the monthly "supervisory visits" which have their own separate paperwork (and for which I am paid separately to complete). There are some PDN cases that LPNs are not allowed to work, too, based on the patient's acuity level.

If you're talking about home health visits, as others have already stated, there are things that RNs can do (that also involve extra paperwork) that LPNs simply are not allowed to do.

My recommendation would be to go for an RN program, but preferably one that has an LPN component as well. Around here, you can sit for your LPN boards after the first full year of the RN program, so then you can work as an LPN while going to school to complete the RN curriculum. If you're doing Private Duty Nursing on overnights, chances are that you'll have free time during which you can study... while being paid! (I'm posting this from my own PDN shift, in fact.)

By getting the RN license, you're opening up a lot of additional job options down the road. You may love home health (or private duty) nursing and never want to do anything different, but then again you may change your mind in the future. You'll also find that if an agency has the option of hiring an LPN or an RN, they're going to choose the RN because that employee will be able to do more types of cases (in other words, they'll make more money off the RN).

maryen · Jan 15, 2015

I am an LVN and have been doing 8-12 hour shifts for the past 10 years providing one on one direct bedside care. I sure do wish I had gone on for my RN- I would love to do admits, infusions and supervisory visits but in my neck of the woods only RN can do it. I am getting very tired of being on my feet providing direct care and if I was an RN I would have more career options. And RN pay is significantly higher in my area.

brillohead, ADN, RN · Jan 15, 2015

I am an LVN and have been doing 8-12 hour shifts for the past 10 years providing one on one direct bedside care. I sure do wish I had gone on for my RN- I would love to do admits, infusions and supervisory visits but in my neck of the woods only RN can do it. I am getting very tired of being on my feet providing direct care and if I was an RN I would have more career options. And RN pay is significantly higher in my area.

maryen, go ahead and finish your RN degree!

Life is short, enjoy it more. It took me 40 years to figure out what I wanted to be when I grew up, but now I'm 45yo and doing a job I love.

It's never too late to go back to school....

Archerlpvn, LPN, LVN · Feb 1, 2015

RNs in general doing intermittent HH will have more paperwork by far related to them being able to open, re certify, transfer, resume, supervise and discharge patients. While LPNS mainly do the routine/re visits that typically require much less paperwork. Im an lpn in CO and work for a company that pays 35 a visit and another that pays 40 and mileage. That rate sometimes rivals that of an rn for a routine visit and sometimes exceeds theres from some rns ive talked to but that's all dependant on the individual company. RNs are also to my knowledge reimbursed much higher for other non routine visits! I can't complain about my rates :)

KelRN215, BSN, RN · Feb 4, 2015

$3/hr is more than $6000 a year for a full-time employee. That's 2 vacations for me.

You will be limited in your role as an LPN. I don't hire LPNs at all to do visits for me. Our admitting nurses follow the patients they admit and LPNs cannot do admissions. Our primary population is also oncology and they cannot do the chemo pushes we do in the home.