LICENSED PRACTICAL / VOCATIONAL NURSE (L.P.N. / L.V.N.)
Most licensed practical nurses (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 collect samples from patients for testing, perform routine laboratory tests, feed them and record food and liquid intake and output. They help patients with bathing, dressing, and personal hygiene, 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 medical assistants and nursing 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 the care provided by nursing aides. In doctors' offices and clinics, 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.
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.
L.P.N.'s may face hazards from caustic chemicals, radiation, and infectious diseases such as AIDS and hepatitis and also are subject to back injuries when moving patients and shock from electrical equipment. They often are subject to stress from heavy workloads. In addition, the patients they care for may be confused, irrational, agitated, or uncooperative.
L.P.N.'s work closely with people while helping them, and 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.
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 1997, approximately 1,100 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.
ADVANCEMENT 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 surgi-centers and emergency medical centers, thanks largely to advances in technology. Advancement for L.P.N.'s is usually tied to additional education and skills. Many L.P.N.'s move into administrative positions, and some earn bachelor's degrees and registered nurse (R.N.) licensure.
Median weekly earnings of full-time salaried licensed practical nurses were $468 in 1996. The middle 50 percent earned between $388 and $563. The lowest 10 percent earned less than $318; the top 10 percent, more than $673.
According to the Buck Survey conducted by the American Health Care Association, staff L.P.N.'s in chain nursing homes had median hourly earnings of $12.00 in 1996. The middle 50 percent earned between $10.60 and $13.50.
Licensed practical nurses held about 699,000 jobs in 1996. Thirty-two percent of L.P.N.'s worked in hospitals, 27 percent worked in nursing homes, and 13 percent in doctors' offices and clinics. Others worked for temporary help agencies, home health care services, or government agencies. Almost one-third worked part time.
Employment of L.P.N.'s is expected to increase faster than the national average for all occupations through the year 2006 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. However, L.P.N.'s seeking positions in hospitals may face competition, as the number of hospital jobs for L.P.N.'s declines. The number of inpatients, with whom most L.P.N.'s work, is not expected to increase much. 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 nationwide job 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.