Above the certified nursing assistants are the licensed practical nurses (LPNs). Unlike the assistants who usually are allowed to perform administrative tasks and very basic and informal assessments of patients, LPNs are specially trained nurses who many contend have almost the same responsibilities of that of a registered nurse. They don’t get paid as much, but the training is easier to complete and the work is equally as rewarding and engaging. Plus, it isn’t that difficult for LPNs to become RNs and some employers may even provide on-the-job training or financial reimbursement to those nurses who want to advance their careers.
Most LPNs still work in hospitals, although there is evidence to suggest that more and more hospitals are using a combination of medical assistants and registered nurses to do what used to be the LPN’s responsibilities. But there are still plenty of jobs available in other places such as nursing homes, doctor’s offices, and long-term care facilities, especially for those looking for entry-level employment or those without years of experience in the field already.
Despite the relatively low barriers to entry, becoming a LPN still isn’t easy and requires a fair amount of hard work, but like most nursing professions, it is also one of the most rewarding jobs in any profession and can serve as a great stepping stone to a long nursing career.
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LPNs are essentially one rung below RNs on the hierarchical ladder. The RN has more training and thus must be the one who actually assesses patients formally, but LPNs are trained to perform tasks like caring for wounds, assisting with procedures, drawing blood, give shots and medicine, keep medical charts, and also help the RN supervise and manage the CNAs.
The demand for qualified LPNs is going up as well. According to the most recent LPN job outlook put together by the United States Bureau of Labor Statistics, there were more than 750,000 LPNs employed across the country in 2010 and employment of these nurses was expected to grow 22 percent from 2010 to 2020, faster than the average for all occupations.
The job itself is in a state of fluctuation as hospitals increasingly ask nursing assistants and registered nurses to carry larger burdens and employers in general continue to look for more education nurses. You still don’t need a degree to train to become a LPN, but a degree usually takes between 1-2 years to complete. Also, this profession is usually a full-time job and will require 40 hours per week on average.
Many feel that the job of the LPN isn’t all that different from the job of an RN. There is no doubt the registered nurses have more training and thus skill, but the LPNs are no slouches and provide plenty of essential care for patients in need. In the absence of a nursing assistant, LPNs are the people that will spend the most time with the patients. They are often tasked with getting to know patients on a personal level and are expected to know a patient’s medical history and observe the patient and report to the RN if anything about the patient’s condition changes.
They are responsible for some administration duties like taking vital signs, feeding and dressing and moving patients, and taking blood samples as well as important tasks like administering shots, caring for wounds, and performing an initial assessment of the patient and detailing the patient’s issues for the RN.
In addition, the 2013 Rasmussen College Healthcare Care Outlook says that, “An LPN also offers patients physical and emotional support by communicating treatment plans, speaking with families, and assistance with personal hygiene.”
LPNs work under supervision of physicians and registered nurses (RNs).
The primary landing spot for the majority of LPNs used to be hospitals. At hospitals the LPNs could perform essential nursing duties without needing a college degree and might have had the possibility to get their career-advancement training subsidized. But now, hospitals are cutting back on the number of LPNs they hire and the debate is on as to whether or not this rapid decline of employment will eventually lead to a nursing shortage.
Hospitals may still employ the most LPNs — The American Federation of State, County, and Municipal Employees recently estimated that 25 percent of all LPNs still worked in hospitals — but more and more LPNs are being pushed towards alternative places of employment such as nursing homes, physician’s offices, and long-term care facilities. They even occasionally find employment in clinics or in the homes of private citizens.
In order to become a licensed practical nurse, interested parties must first pass the National Council of State Boards of Nursing’s (NCSBN) Licensure Examination for Practical Nurses (NCLEX-PN). States are individually in charge of determining who is allowed to take the examination, but most states do not allow students studying to become registered nurses to take the exam for practical nurses (they have their own exam) and most states require students to have at least completed an approved program for educating vocational/practical nurses which can be a continuing education program or a program at a university that results in an associate’s degree or certification.
The NCLEX examination is not like other traditional licensure exams. The NCLEX examination uses computer-assisted technology to administer the items. According to the Council, the technology is “able to produce test results that are more stable using fewer items by targeting items to the candidate’s ability.” The idea is not to determine how much a candidate knows, but to determine the ability of the candidate in relation to the pre-determined standard for passing. There are a number of different ways to pass or fail the exam, but the most common occurs when the computer is 95 percent certain that the candidate’s ability is either clearly above or clearly below the passing standard, at which point it stops administering questions.
The council’s retake policy allows candidates to retake their exam 45 days after administration of the exam and some states, like Texas, have a limit on the number of years that the student can try for.