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. (The work of physicians and surgeons and registered nurses is described elsewhere in the Handbook.)
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 deliver, care for, and feed infants. Experienced LPNs may supervise nursing assistants and aides.
In addition to providing routine beside care, LPNs in nursing care facilities help 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.
Most licensed practical nurses in hospitals and nursing care facilities work a 40-hour week, but because patients need around-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 such as hepatitis. They are subject to back injuries when moving patients and shock from electrical equipment. They often must deal with the stress of heavy workloads. In addition, the patients they care for may be confused, irrational, agitated, or uncooperative.
Licensed practical nurses held about 702,000 jobs in 2002. About 28 percent of LPNs worked in hospitals, 26 percent in nursing care facilities, and another 12 percent in offices of physicians. Others worked for home healthcare services, employment services, community care facilities for the elderly, public and private educational services, outpatient care centers, and Federal, State, and local government agencies; about 1 in 5 worked part time.
All States and the District of Columbia require LPNs to pass a licensing examination 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 or are designed as part of a high school curriculum.
In 2002, approximately 1,100 State-approved programs provided training in practical nursing. Almost 6 out of 10 students were enrolled in technical or vocational schools, while 3 out of 10 were in community and junior colleges. Others were in high schools, hospitals, and colleges and universities.
Most practical nursing programs last about 1 year and include both classroom study and supervised clinical practice (patient care). Classroom study covers basic nursing concepts and patient care-related subjects, 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.
LPNs should have a caring, sympathetic nature. They should be emotionally stable, because work with the sick and injured can be stressful. They also should have keen observational, decisionmaking, and communication skills. As part of a healthcare team, they must be able to follow orders and work under close supervision.
Employment of LPNs is expected to grow about as fast as the average for all occupations through 2012 in response to the long-term care needs of an increasing elderly population and the general growth of healthcare. 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. An increasing proportion of sophisticated procedures, which once were performed only in hospitals, is being performed in physicians’ offices and in outpatient care centers such as ambulatory surgical and emergency medical centers, due largely to advances in technology. Consequently, employment of LPNs is projected to grow faster than average in these sectors as healthcare expands outside the traditional hospital setting.
Employment of LPNs in nursing care facilities is expected to grow faster than the average. Such facilities will offer the most new jobs for LPNs as the number of aged and disabled persons in need of long-term care rises. In addition to caring for the aged and the disabled, LPNs in nursing care facilities will care for the increasing number of patients who will have been discharged from the hospital, but have not recovered enough to return home.
Employment of LPNs is expected to grow much faster than average in home healthcare services. This growth is in response to 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.
Median annual earnings of licensed practical nurses were $31,440 in 2002. The middle 50 percent earned between $26,430 and $37,050. The lowest 10 percent earned less than $22,860, and the highest 10 percent earned more than $44,040. Median annual earnings in the industries employing the largest numbers of licensed practical nurses in 2002 were as follows:
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2004-05 Edition,
Licensed Practical and Licensed Vocational Nurses, on the Internet at
(visited July 09, 2004).