Licensed Practical Nurses

• Nature of the Work

  Licensed practical nurses (L.P.N.'s), or licensed vocational nurses (L.V.N.'s) as they are called in Texas and California, care for the sick, injured, convalescing, and handicapped, under the direction of physicians and registered nurses. (The work of registered nurses is described elsewhere in the Handbook.)

  Most L.P.N.'s provide basic bedside care. They take vital signs such as temperature, blood pressure, pulse, and respiration. They also treat bedsores, prepare and give injections and enemas, apply dressings, give alcohol rubs and massages, apply ice packs and hot water bottles, and insert catheters. L.P.N's observe patients and report adverse reactions to medications or treatments. They may collect samples from patients for testing and perform routine laboratory tests. They help patients with bathing, dressing, and personal hygiene, feed them and record food and liquid intake and output, keep them comfortable, and care for their emotional needs. In States where the law allows, they may administer prescribed medicines or start intravenous fluids. Some L.P.N.'s help deliver, care for, and feed infants. Some experienced L.P.N.'s supervise nursing assistants and aides.

  L.P.N.'s in nursing homes, in addition to providing routine bedside care, may also help evaluate residents' needs, develop care plans, and supervise nursing aides. In doctors' offices and clinics, including health maintenance organizations, they may also make appointments, keep records, and perform other clerical duties. L.P.N.'s who work in private homes may also prepare meals and teach family members simple nursing tasks.

• Working Conditions

  Most licensed practical nurses in hospitals and nursing homes 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. They also face the stress of working with sick patients and their families.

  L.P.N.'s may face hazards from caustic chemicals, radiation, and infectious diseases such as AIDS and hepatitis. L.P.N.'s also are subject to back injuries when moving patients and shock from electrical equipment. They often face heavy workloads. In addition, the people they take care of may be confused, irrational, agitated, or uncooperative.

• Employment

  Licensed practical nurses held about 702,000 jobs in 1994. About a quarter worked part time. Two out of 5 L.P.N.'s worked in hospitals, about one-quarter worked in nursing homes, and over a tenth in doctors' offices and clinics. Others worked for temporary help agencies, home health care services, or government agencies.

• Training, Other Qualifications, and Advancement

  All States require L.P.N.'s to pass a licensing examination after completing a State-approved practical nursing program. A high school diploma is usually required for entry, but some programs accept people without a diploma.

  In 1993, approximately 1,098 State-approved programs provided practical nursing training. 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, administration of drugs, nutrition, and first aid. Clinical practice is usually in a hospital, but sometimes includes other settings.

  L.P.N.'s should have a caring, sympathetic nature. They should be emotionally stable because work with the sick and injured can be stressful. As part of a health care team, they must be able to follow orders and work under close supervision.

• Job Outlook

  Job prospects for L.P.N.'s are expected to be good if the current balance between jobs and job seekers continues. Over the past few years, the number of graduates from L.P.N. training programs has increased in pace with the need for additional workers. However, if enrollments in L.P.N. training programs level off or decline as they have on a cyclical basis in the past, job prospects will be even better.

  Employment of L.P.N.'s is expected to increase faster than the average for all occupations through the year 2005 in response to the long-term care needs of a rapidly growing population of very old people and to the general growth of health care. As in most other occupations, replacement needs will be the main source of job openings.

  Employment in nursing homes is expected to grow much faster than the average. Nursing homes will offer the most new jobs for L.P.N.'s as the number of aged and disabled persons in need of long-term care rises rapidly. In addition to caring for the aged, nursing homes will be called on to care for the increasing number of patients who have been released from the hospital and have not yet recovered enough to return home.

  Much faster than average growth is also expected in home health care services. This is in response to a growing number of older persons with functional disabilities, consumer preference for care in the home, and technological advances which make it possible to bring increasingly complex treatments into the home.

  An increasing proportion of sophisticated procedures, which once were performed only in hospitals, are being performed in physicians' offices and clinics, including health maintenance organizations, ambulatory surgicenters, and emergency medical centers*thanks largely to advances in technology. As a result, employment is projected to grow much faster than average in these places as health care in general expands.

  Employment of L.P.N.'s in hospitals is expected to show only a small increase, largely because the number of inpatients, with whom most work, is not expected to increase much.

• Earnings

  Median weekly earnings of full-time salaried L.P.N's were $450 in 1994. The middle 50 percent earned between $383 and $537. The lowest 10 percent earned less than $316; the top 10 percent, more than $636.

  According to a University of Texas Medical Branch survey of hospitals and medical centers, the median annual salary of L.P.N's, based on a 40-hour week and excluding shift or area differentials, was $23,394 in October 1994. The average minimum salary was $19,122 and the average maximum was $28,234.

  According to the Buck Survey conducted by the American Health Care Association, staff L.P.N.'s in chain nursing homes had median annual earnings of about $23,900 in 1994. The middle 50 percent earned between $21,500 and $27,100.

• Related Occupations

  L.P.N.'s work closely with people while helping them. So do emergency medical technicians, social service aides, human service workers, and teacher aides.

• Sources of Additional Information

  A list of State-approved training programs and information about practical nursing are available from:
  Communications Department, National League for Nursing 350 Hudson St., New York, NY. 10014

  National Association for Practical Nurse Education and Service, Inc., 1400 Spring St., Suite 310 Silver Spring, MD 20910.

  For information on nursing careers in long-term care, write to:
  American Health Care Association, 1201 L St. NW., Washington, DC 20005.

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