LPNs? What do they do? Where can they work? Difference between LPN vs RN?

Many people ask the same repetitive questions about licensed practical nurses (LPNs). The intended purpose of this article is to answer a handful of these questions while facilitating more understanding regarding the unique role of the LPN.

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LPNs? What do they do? Where can they work? Difference between LPN vs RN?

I have heard and read the same questions rather frequently. Heck, I am almost certain that you have probably encountered these very same questions, too.

  • What is an LPN?
  • What type of stuff do LPNs do?
  • Where can LPNs work?
  • What is the difference between LPNs and RNs?

I will approach each of these questions separately with the genuinely heartfelt hope of clearing up some of the misconceptions surrounding LPNs.

What exactly is an LPN?

First of all, LPN is an acronym that stands for licensed practical nurse. Forty-eight American states and most of the the Canadian provinces utilize the title of LPN. The remaining two states in the union (California and Texas) use the acronym LVN, which stands for licensed vocational nurse. The Canadian province of Ontario refers to their practical nurses as RPNs, which is an acronym that stands for registered practical nurse. Despite the slightly different titles, LPNs, LVNs, and RPNs are one and the same. 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.

What do LPNs do?

Well, the answer to this question is highly dependent upon the state or province in which the LPN practices nursing. Some state boards of nursing, such as the ones in Texas and Oklahoma, have extremely wide scopes of practice that permit LPNs to do almost anything that individual facility policies will allow. LPNs in states with wide scopes of practice are usually allowed to perform most of the same skills that their RN coworkers can do, such as initiating IV starts, administering medications via IV push, maintaining central lines, and so forth. Other boards of nursing, such as the ones in California and New York, have narrow scopes of practice that severely limit what LPNs in those two states are allowed to do.

In general, LPNs in all states perform nursing care such as medication administration, data collection on patients, monitoring for changes in condition, vital sign checks, wound care and dressing changes, specimen collection, urinary catheter insertion and care, care of patients with ventilators and tracheostomies, ostomy site care and maintenance, cardiopulmonary resuscitation (CPR), and finger stick blood sugar testing. Proper charting and documentation of nursing care is also the LPN's responsibility.

The LPN works under the supervision of a registered nurse (RN) or physician in most states; however, the LPN is often the only licensed nurse present in many facilities. LPNs also supervise nursing assistants in certain healthcare settings. With the right mix of experience, LPNs can be promoted to administrative positions such as wellness directors, assistant directors of nursing, wound care clinicians, staffing coordinators, and case managers.

Where can LPNs work?

LPNs can and do work in acute care hospitals, although this type of employment seems to be on the decline in many regions in the United States due to issues surrounding scope of practice. LPNs also secure employment in nursing homes, hospices, home health, private duty cases, psychiatric hospitals, prisons/jails, rehabilitation facilities, group homes, clinics, doctors' offices, assisted living facilities, agencies, military installations, and schools.

What are the differences between LPNs and RNs?

Well, my answer might generate disagreement, although I do not intend to offend anyone. Some would say that RNs have attained a wider breadth of educational experiences that include pathophysiology, pharmacology, leadership, research, management, legal/ethical issues, and team functioning. In most cases, the LPN has completed an educational program that is shorter in length than his/her RN counterpart. The RN typically initiates the plan of care while the LPN contributes and adds to it. Finally, the LPN usually earns less money than his/her RN coworkers, though this is not always the case.

My overarching goal was to answer some of the most common questions that are asked about LPNs. The LPN is very much a nurse, as well as a vitally important member of the healthcare team. Together we can continue to facilitate more understanding regarding the role of the LPN to benefit our patients, colleagues, the public, and society as a whole.

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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.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

By the way, I have heard so many people saying, "The LPN is only a certificate/diploma program." This is not accurate.

LPNs in the U.S. can earn a certificate/diploma, associate of applied science (AAS) degree in practical nursing, or challenge a couple of state boards. Click on the link below to read about the different educational pathways available to people who want to become LPNs in the U.S.

https://allnurses.com/nursing-degrees-that-lead-to-t436611/

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Thanks for posting this. It's probably more accurate and informative than either wikipedia or the bureau of labor's description of the LPN role.

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Specializes in Telemetry, OB, NICU.
TheCommuter said:
By the way, I have heard so many people saying, "The LPN is only a certificate/diploma program." This is not accurate.

LPNs in the U.S. can earn a certificate/diploma, associate of applied science (AAS) degree in practical nursing, or challenge a couple of state boards. Click on the link below to read about the different educational pathways available to people who want to become LPNs in the U.S.

https://allnurses.com/nursing-degrees-that-lead-to-t436611/

Thanks for the post. I really really don't mean to start a RN vs LPN thread. Please don't get offended. But the bolded area, seriously, what does this mean? Has anybody ever heard of this? Which college/university offers this? Or where in BON can we look that up?

You either have Associate in Applied Science (RN), which could also be called Associate degree in nursing. Or you have Diploma in Practical Nursing (LPN). There is no such thing as "associate of applied science (AAS) degree in practical nursing". LPN is not a degree in nursing. Lowest degree in nursing is Associates and that leads to RN.

Thanks for the post, but that very section was not accurate.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Seas said:
Thanks for the post. I really really don't mean to start a RN vs LPN thread. Please don't get offended. But the bolded area, seriously, what does this mean? Has anybody ever heard of this? Which college/university offers this? Or where in BON can we look that up?

You either have Associate in Applied Science (RN), which could also be called Associate degree in nursing. Or you have Diploma in Practical Nursing (LPN). There is no such thing as "associate of applied science (AAS) degree in practical nursing". LPN is not a degree in nursing. Lowest degree in nursing is Associates and that leads to RN.

Thanks for the post, but that very section was not accurate.

I respectfully disagree with you. The associate of applied science (AAS) in practical nursing certainly exists at many community colleges and state universities in the U.S.

A person can choose one of three paths to become an LPN: certificate/diploma, associate degree, or challenging the board (a couple of states still allow this). Click on the first link below to read about the educational pathways that lead to initial LPN licensure. Click on the second link to read about the practical nursing AAS program at North Seattle Community College.

https://allnurses.com/nursing-degrees-that-lead-to-t436611/

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Specializes in Hospice / Ambulatory Clinic.

Informative article. I did not realize the scope of practice in CA was significantly limited compared to other states. I thought we were somewhere in the middle.

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Thank You Jesus because lpns are very important nurses too .

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Specializes in Adult ICU/PICU/NICU.

Excellent article about LPNs. As we can see, there are many people who have misunderstandings about LPNs...from not understanding about the various ways to train to be an LPN to not realizing that each state is different and facility is different in LPN scope of practice. I get so tired of posting "LPN scope is different in each state" when posters say things like "LPNs can't assess, LPN's can't push meds, LPN's only take care of stable patients with predictable outcomes." I blame the universities that train RN studentsfor not giving these kids this understading. Experienced RNs who work alongside LPNs know that a veteran LPN is worth her/his weight in gold and are not mindless automatons.... which I know is taught by some nursing professors in academia who have long since traded their reality for ideality.

Kudos on an excellent post

Mrs H.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I've noticed the certainty with which people claim LPNs cannot do this or that is inversely related to how long they've been a student or new nurse - so I think you're right, Mrs. H. -- that we can attribute a lot of the misinformation to nursing school faculty.

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Specializes in Acute Care, Rehab, Palliative.

One thing the article didn't mention was the length of LPN educations and how they vary.I am an RPN in Ontario and our programs are two years long.Excellent article.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
loriangel14 said:
One thing the article didn't mention was the length of LPN educations and how they vary.I am an RPN in Ontario and our programs are two years long.Excellent article.

I wrote another post recently that discusses in detail the different types of educational entries into practical nursing. However, I focused heavily on LPNs in the United States. Click on the link below if you are interested.

https://allnurses.com/nursing-degrees-that-lead-to-t436611/

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Specializes in Hospice / Ambulatory Clinic.

I think it's best to compare program length by contact hours. My LVN program was 1500 hours over 52 weeks. 1,040 hours were clinical the rest was theory hours. The course was 5 days a week 32-36 hours a week. They offered the same program over 1.5 years with 2 evenings and every other weekend.

Regardless of the number of hours as a percentage of contact hours I've noticed LPN/LVN do more well practical hands on. Not more overall but as a ratio.

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