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License Practical Nurse/License Vocational Nurse vs Registered Nurse

Licensed practical nurses held about 726,000 jobs in 2004. About 27 percent of LPNs worked in hospitals, 25 percent in nursing care facilities, and another 12 percent in offices of physicians. Others worked for home health care services; employment services; community care facilities for the elderly; public and private educational services; outpatient care centers; and Federal, State, and local government agencies in abroad. One in five worked part time.

Job Outlook

Employment of LPNs is expected to grow about as fast as average for all occupations through 2014 in response to the long-term care needs of an increasing elderly population and the general growth of health care services. Replacement needs will be a major source of job openings, as many workers leave the occupation permanently. Applicants for jobs in hospitals may face competition as the number of hospital jobs for LPNs declines; however, rapid employment growth is projected in other health care industries, with the best job opportunities occurring in nursing care facilities and in home health care services.

Employment of LPNs in hospitals is expected to continue to decline. Sophisticated 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. Consequently, employment of LPNs in most health care industries outside the traditional hospital setting is projected to grow faster than average.

Employment of LPNs is expected to grow much faster than average in home health care services. Home health care agencies also will offer the most new jobs for LPNs because of an increasing number of older persons 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 about as fast as average because of the growing number of aged and disabled persons 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. However, changes in consumer preferences towards less restrictive and more cost-effective care from assisted living facilities and home health care agencies will limit employment growth.

Significant Points

Training lasting about 1 year is available in about 1,200 State-approved programs, mostly in vocational or technical schools.

Applicants for jobs in hospitals may face competition as the number of hospital jobs for licensed practical nurses declines; however, rapid employment growth is projected in other health care industries, with the best job opportunities occurring in nursing care facilities and in home health care services.

Replacement needs will be a major source of job openings, as many workers leave the occupation permanently.

Licensed practical nurses (LPNs), or licensed vocational nurses (LVNs), care for the sick, injured, convalescent, and disabled under the direction of physicians and registered nurses. Most LPNs provide basic bedside care, taking vital signs such as temperature, blood pressure, pulse, and respiration. They also prepare and give injections and enemas, monitor catheters, apply dressings, treat bedsores, and give alcohol rubs and massages. LPNs monitor their patients and report adverse reactions to medications or treatments. They collect samples for testing, perform routine laboratory tests, feed patients, and record food and fluid intake and output. To help keep patients comfortable, LPNs assist with bathing, dressing, and personal hygiene.

In States where the law allows, they may administer prescribed medicines or start intravenous fluids. Some LPNs help to deliver, care for, and feed infants. Experienced LPNs may supervise nursing assistants and aides.

In addition to providing routine bedside 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 also may make appointments, keep records, and perform other clerical duties. LPNs who work in private homes may prepare meals and teach family members simple nursing tasks.

Can a LPN practice independently? Section 6902 of Article 139 of the Education law and section 64.6 of the Regulations of the Commission of Education state that an LPN performs tasks and responsibilities under the direction of a registered professional nurse, nurse practitioner, physician, physician assistant, specialist assistant, dentist and podiatrist. Under the direction of a registered professional nurse means that a registered professional nurse must be present on the premises or immediately available by telephone when professional services are given by a licensed practical nurse. The degree of supervision should be appropriate to the circumstances.

LPNs may advance to supervisory positions. They may also continue their nursing education and become registered nurses whereas RNs with a bachelor’s degree may advance to supervisory or administrative positions. Generally, other career advancements for RNs require further education and/or training. Career opportunities include nurse administrators, nurse practitioners, clinical nurse specialist, nurse anesthetists, instructors of nursing programs and researchers.

Licensed Practical Nurses are prohibited from performing any of the following though, it is not possible to provide a comprehensive and exhaustive list of tasks that LPNs are prohibited from performing. In general, however, LPNs may not conduct a nursing diagnosis and may not conduct the assessment phase of the nursing process. The following delineates the responsibilities of a License practical Nurse from the responsibilities of Registered Nurses; in particular, LPNs may not:

perform triage services,
administer IV-push medications,
perform blood transfusions until satisfactory completion of a transfusion training program meeting criteria specified by the DOH and the SED and only when a registered nurse or a physician or other person authorized by law to manage transfusion reactions is immediately available on-site.

Earnings Median annual earnings of licensed practical nurses were $33,970 in May 2004. The middle 50 percent earned between $28,830 and $40,670. The lowest 10 percent earned less than $24,480, and the highest 10 percent earned more than $46,270. Median annual earnings in the industries employing the largest numbers of licensed practical nurses in May 2004 were:

Employment services	$41,550
Nursing care facilities	35,460
Home health care services	35,180
General medical and surgical hospitals	32,570
Offices of physicians	30,400

OTHER DISTINGUISHING FEATURES BETWEEN A REGISTERED NURSE AND A LICENSCE PRACTICAL NURSE

Skills Considered Important for Nursing Occupations
(Overall Importance & Ranked by Importance for Each Nursing Occupation)

Skills	Registered Nurses	Licensed Practical Nurses
Speaking - Talking to others to convey information effectively.	1	4
Service Orientation - Actively looking for ways to help people.	2	2
Reading Comprehension - Understanding written sentences and paragraphs in work related documents	3	3
Social Perceptiveness - Being aware of others' reactions and understanding why they react as they do.	4	7
Critical Thinking - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.	6	6
Active Listening - Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.		1
Judgment and Decision Making - Considering the relative costs and benefits of potential actions to choose the most appropriate one.	5
Monitoring - Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.		5
Coordination - Adjusting actions in relation to others' actions.	7

Source: O*Net Online, National O*NET Consortium, http://online.onetcenter.org , 2003

Nurses should possess the knowledge of medicine and dentistry, biology, customer and personal service, and chemistry to perform effectively their nursing duties. It is also important for RNs to know about therapy and counseling. Licensed practical nurses should acquire the knowledge of psychology to better assess human behavior and performance. Knowledge of administrative and clerical duties will also benefit LPNs. Depending on where they work, LPNs may be assigned some clerical duties.

Knowledge Considered Important for Nursing Occupations
(Overall Importance & Ranked by Importance for Each Nursing Occupation)

Knowledge	Registered Nurses	Licensed Practical Nurses
Medicine and Dentistry - Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.	1	1
Biology - Knowledge of plant and animal organisms, their tissues, cells, functions, interdependencies, and interactions with each other and the environment.	2	3
Customer and Personal Service - Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.	3	2
Chemistry - Knowledge of the chemical composition, structure, and properties of substances and of the chemical processes and transformations that they undergo. This includes uses of chemicals and their interactions, danger signs, production techniques, and disposal methods.	4	6
Psychology - Knowledge of human behavior and performance; individual differences in ability, personality, and interests; learning and motivation; psychological research methods; and the assessment and treatment of behavioral and affective disorders.		4
Therapy and Counseling - Knowledge of principles, methods, and procedures for diagnosis, treatment, and rehabilitation of physical and mental dysfunctions, and for career counseling and guidance.	5
Clerical - Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.		5

Source: O*Net Online, National O*NET Consortium, http://online.onetcenter.org, 2003

Abilities determined important for both nursing occupations include being able to communicate information and ideas effectively, to listen to and understand information and ideas presented, to tell when something is wrong, and to see details at a close range. Furthermore, RNs need to possess specific abilities such as communicating information and ideas in writing so that staff can understand, be able to piece together information to form rules or conclusions, and be able to order and memorize information.

Abilities Considered Important for Nursing Occupations
(Overall Importance & Ranked by Importance for Each Nursing Occupation)

Abilities	Registered Nurses	Licensed Practical Nurses
Oral Expression - The ability to communicate information and ideas in speaking so others will understand.	1	1
Oral Comprehension - The ability to listen to and understand information and ideas presented through spoken words and sentences.	2	2
Problem Sensitivity - The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.	3	3
Near Vision - The ability to see details at close range (within a few feet of the observer).	8	5
Written Comprehension - The ability to read and understand information and ideas presented in writing.	4
Arm-Hand Steadiness - The ability to keep your hand and arm steady while moving your arm or while holding your arm and hand in one position.		4
Written Expression - The ability to communicate information and ideas in writing so others will understand.	5
Inductive Reasoning - The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).	6
Information Ordering - The ability to arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations).	7
Memorization - The ability to remember information such as words, numbers, pictures, and procedures.	9

Source: O*Net Online, National O*NET Consortium, http://online.onetcenter.org, 2003.

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