LICENSED PRACTICAL & LICENSED VOCATIONAL NURSES Source: U.S. Department of Labor Bureau of Labor Statistics
[Occupational Outlook Handbook, 2010-11 edition]
Nature of the 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 will work in any area of healthcare. However, some work in a specialized
setting, such as a nursing home, a doctor's office, or in home healthcare. 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 healthcare 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 work a 40-hour week. In some work settings where
patients need round-the-clock care, LPNs may have to work nights, weekends, and holidays. About
18 percent of LPNs and LVN’s worked part-time in 2008. 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
Training, Other Qualifications, and Advancement
Most practical nursing training programs last about 1 year, and are offered by vocational and technical
schools or community or junior colleges. LPNs must be licensed to practice.
Education and training.
LPNs must complete a State-approved training program in practical nursing to be eligible for licensure.
Contact your State’s board of nursing for a list of approved programs. 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. 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.
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 nursing,
pharmacology, nutrition, and first aid. Clinical practice usually is in a hospital but sometimes includes
other settings.
Licensure
The National Council Licensure Examination, or NCLEX-PN, 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 Client Needs categories: safe and effective care environment, health promotion and maintenance,
psychosocial integrity, and physiological integrity. Eligibility for licensure may vary by State; for
details, contact your State’s board of nursing.
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 healthcare team, they must be
able to follow orders and work under close supervision.
LPNs should enjoy learning because continuing education credits are required by some States and/or
employers at regular intervals. Career-long learning is a distinct reality for LPNs.
Advancement
In some employment settings, such as nursing homes, LPNs can advance to become
charge nurses who oversee the work of other LPNs and nursing aides.
LPNs may become credentialed in specialties like IV therapy, gerontology, long-term care, and
pharmacology.
Some LPNs also choose to become registered nurses through LPN-to-RN training programs.
Employment
Licensed practical and licensed vocational nurses held about 753,600 jobs in 2008. About 25 percent
of LPNs worked in hospitals, 28 percent in nursing care facilities, and another 12 percent in offices
of physicians. Others worked for home healthcare services; employment services; residential care
facilities; community care facilities for the elderly; outpatient care centers; and Federal, State, and
local government agencies.
Job Outlook
Employment of LPNs is projected to grow much 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 healthcare services.
Employment change. Employment of LPNs is expected to grow by 21 percent between 2008 and 2018,
much 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 healthcare services.
Demand for LPNs will be driven by the increase in the share of the older population. Older persons
have an increased incidence of injury and illness, which will increase their demand for healthcare
services. In addition, with better medical technology, people are living longer, increasing the demand
for long-term healthcare. Job growth will occur over all healthcare settings but especially those that
service the geriatric population like nursing care facilities, community care facilities, and home
healthcare services.
In order to contain healthcare costs, many procedures once performed only in hospitals are being
performed in physicians' offices and in outpatient care centers, largely because of advances in
technology. As a result, the number of LPNs should increase faster in these facilities than in
hospitals. Nevertheless, hospitals will continue to demand the services of LPNs and will remain
one of the largest employers of these workers.
Job prospects
In addition to projected job growth, job openings will result from replacement
needs, as many workers leave the occupation permanently. Very good job opportunities are
expected. Rapid employment growth is projected in most healthcare industries, with the best job
opportunities occurring in nursing care facilities and in home healthcare services. There is a
perceived inadequacy of available healthcare in many rural areas, so LPNs willing to locate in
rural areas should have good job prospects.
Earnings
Median annual wages of licensed practical and licensed vocational nurses were $39,030 in May 2008.
The middle 50 percent earned between $33,360 and $46,710. The lowest 10 percent earned less than
$28,260, and the highest 10 percent earned more than $53,580
