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. Nurses LPN/LVN Article

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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.

Specializes in geriatrics, school district.

I am a LPN. I have an associate in applied science (AAS) from a 2-year college. My favorite subject was 2 semesters of Anatomy & Physiology for the general courses. I loved the challenge of memorizing 50 medications (trade and generic names, uses, dosages, common side effects, patient education, and contraindications). I learned so much during 3 months of clinicals. I took the NCLEX for licensed practical nursing. I have worked as an LPN my whole nursing career. I regularly was a preceptor for new LPN'S, plus 2 and 4 year nurses at a skilled nursing facility. Our assignments were identical in practice working in the skilled nursing facility as a floor nurse. I always did the assessments for new and re-admit patients that I was assigned to. I have been a school district nurse for most of my career. My duties are exactly the same as 2 year RN's in the school health office. At one of the public schools I worked at, we saw around 100 student's a day. No doctor or NP to call on for complex and serious acute situations. This is in Minnesota. And the pay as an LPN has always been less than RN's. 

I agree that LPN's are under-appreciated but an integral part of our healthcare system

Love this article clearly defines the difference and educates us. :)