Licensed Vocational Nurses

Significant Points

Nature of Work

Licensed practical nurses (LPNs), or licensed vocational nurses (LVNs), care for people who are sick, injured, convalescent, or disabled under the direction of physicians and registered nurses. (The work of physicians and surgeons and of registered nurses is described elsewhere in the Handbook.) The nature of the direction and supervision required varies by State and job setting.

LPNs care for patients in many ways. Often, they provide basic bedside care. Many LPNs measure and record patients’ vital signs such as height, weight, temperature, blood pressure, pulse, and respiration. They also prepare and give injections and enemas, monitor catheters, dress wounds, and give alcohol rubs and massages. To help keep patients comfortable, they assist with bathing, dressing, and personal hygiene, moving in bed, standing, and walking. They might also feed patients who need help eating. Experienced LPNs may supervise nursing assistants and aides.

As part of their work, LPNs collect samples for testing, perform routine laboratory tests, and record food and fluid intake and output. They clean and monitor medical equipment. Sometimes, they help physicians and registered nurses perform tests and procedures. Some LPNs help to deliver, care for, and feed infants.

LPNs also monitor their patients and report adverse reactions to medications or treatments. LPNs gather information from patients, including their health history and how they are currently feeling. They may use this information to complete insurance forms, pre-authorizations, and referrals, and they share information with registered nurses and doctors to help determine the best course of care for a patient.

LPNs often teach family members how to care for a relative or teach patients about good health habits.

Most LPNs are generalists and work in all areas of health care. However, some work in a specialized setting, such as a nursing home, a doctor’s office, or in home health care. LPNs in nursing care facilities help to evaluate residents’ needs, develop care plans, and supervise the care provided by nursing aides. In doctors’ offices and clinics, they may be responsible for making appointments, keeping records, and performing other clerical duties. LPNs who work in home health care may prepare meals and teach family members simple nursing tasks.

In some States, LPNs are permitted to administer prescribed medicines, start intravenous fluids, and provide care to ventilator-dependent patients.

Work environment. Most licensed practical nurses in hospitals and nursing care facilities work a 40-hour week, but because patients need round-the-clock care, some work nights, weekends, and holidays. They often stand for long periods and help patients move in bed, stand, or walk.

LPNs may face hazards from caustic chemicals, radiation, and infectious diseases. They are subject to back injuries when moving patients. They often must deal with the stress of heavy workloads. In addition, the patients they care for may be confused, agitated, or uncooperative.

Qualifications

Most training programs, lasting about 1 year, are offered by vocational or technical schools or community or junior colleges. LPNs must be licensed to practice. Successful completion of a practical nurse program and passing an examination are required to become licensed.

Education and training. All States and the District of Columbia require LPNs to pass a licensing examination, known as the NCLEX-PN, after completing a State-approved practical nursing program. A high school diploma or its equivalent usually is required for entry, although some programs accept candidates without a diploma, and some programs are part of a high school curriculum.

In 2006, there were more than 1,500 State-approved training programs in practical nursing. Most training programs are available from technical and vocational schools or community and junior colleges. Other programs are available through high schools, hospitals, and colleges and universities.

Most year-long practical nursing programs include both classroom study and supervised clinical practice (patient care). Classroom study covers basic nursing concepts and subjects related to patient care, including anatomy, physiology, medical-surgical nursing, pediatrics, obstetrics, psychiatric nursing, the administration of drugs, nutrition, and first aid. Clinical practice usually is in a hospital but sometimes includes other settings.

Licensure. The NCLEX-PN licensing exam is required in order to obtain licensure as an LPN. The exam is developed and administered by the National Council of State Boards of Nursing. The NCLEX-PN is a computer-based exam and varies in length. The exam covers four major categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity.

Other qualifications. LPNs should have a caring, sympathetic nature. They should be emotionally stable because working with the sick and injured can be stressful. They also need to be observant, and to have good decision-making and communication skills. As part of a health-care team, they must be able to follow orders and work under close supervision.

Advancement. In some employment settings, such as nursing homes, LPNs can advance to become charge nurses who oversee the work of other LPNs and of nursing aides. Some LPNs also choose to become registered nurses through numerous LPN-to-RN training programs.

Employment

Licensed practical nurses held about 749,000 jobs in 2006. About 26 percent of LPNs worked in hospitals, 26 percent in nursing care facilities, and another 12 percent in offices of physicians. Others worked for home health care services; employment services; residential care facilities; community care facilities for the elderly; outpatient care centers; and Federal, State, and local government agencies. About 19 percent worked part time.

Job Outlook

Employment of LPNs is projected to grow faster than average. Overall job prospects are expected to be very good, but job outlook varies by industry. The best job opportunities will occur in nursing care facilities and home health care services, while applicants for jobs in hospitals may face competition.

Employment change. Employment of LPNs is expected to grow 14 percent between 2006 and 2016, faster than the average for all occupations, in response to the long-term care needs of an increasing elderly population and the general increase in demand for health care services.

Many procedures once performed only in hospitals are being performed in physicians’ offices and in outpatient care centers such as ambulatory surgical and emergency medical centers, largely because of advances in technology. LPNs care for patients who undergo these and other procedures, so employment of LPNs is projected to decline in traditional hospitals, but is projected to grow faster than average in most settings outside of hospitals. However, some hospitals are assigning a larger share of nursing duties to LPNs, which will temper the employment decline in the industry.

Employment of LPNs is expected to grow much faster than average in home health care services. Home health care agencies will offer a large number of new jobs for LPNs because of an increasing number of older people with functional disabilities, consumer preference for care in the home, and technological advances that make it possible to bring increasingly complex treatments into the home.

Employment of LPNs in nursing care facilities is expected to grow faster than average, and provide the most new jobs for LPNs, because of the growing number of people who are aged and disabled and in need of long-term care. In addition, LPNs in nursing care facilities will be needed to care for the increasing number of patients who have been discharged from the hospital but who have not recovered enough to return home.

Job prospects. Replacement needs will be a major source of job openings, as many workers leave the occupation permanently. Very good job opportunities are expected. Rapid employment growth is projected in most health care industries, with the best job opportunities occurring in nursing care facilities and in home health care services. However, applicants for jobs in hospitals may face competition as the number of hospital jobs for LPNs declines.

Projections Data

Earnings

Median annual earnings of licensed practical nurses were $36,550 in May 2006. The middle 50 percent earned between $31,080 and $43,640. The lowest 10 percent earned less than $26,380, and the highest 10 percent earned more than $50,480. Median annual earnings in the industries employing the largest numbers of licensed practical nurses in May 2006 were:

Related Occupations

LPNs work closely with people while helping them. So do emergency medical technicians and paramedics; medical assistants; nursing, psychiatric, and home health aides; registered nurses; athletic trainers; social and human service assistants; pharmacy technicians; pharmacy aides; and surgical technologists.

Sources of Additional Information

Source: Bureau of Labor Statistics Occupational Outlook Handbook