Depending on where you’re located, a practical nurse might be called a licensed practical nurse (LPN), a licensed vocational nurse (LVN), or a registered practical nurse (RPN). No matter what you call them, practical nurses provide essential services to patients and their fellow health care professionals, working closely with challenging patients and hazardous materials. “If they got rid of the LPN,” warns one practical nurse, “who do you think will have to take on those responsibilities? Everyone else!”
In Texas and California, practical nurses are called licensed vocational nurses, and there are lots of them: 72,030 employed in Texas and 64,000 in California, constituting the two largest practical nursing workforces in the United States, according to the Bureau of Labor Statistics (BLS).
In the remaining 48 states, practical nurses are called LPNs, and in the Canadian province of Ontario they are called RPNs. The titles are the primary difference, as the qualifications and duties for all three are pretty much the same.
For the aspiring nurse, becoming an LPN is the quickest route into the workforce. In as little as one to two years, you can earn a diploma or certificate from an accredited LPN program at a vocational school or community college.
The final step is to pass the National Council Licensure Examination-Practical Nurse (NCLEX-PN).
In contrast, RNs typically spend two to five years in school, either graduating from a four-year college with a bachelor of science in nursing (BSN) or an associate’s degree in nursing (ASN) supplemented by two-to-three years of additional nursing education, according to Nurse Journal.
Job growth for LPNs is expected to increase by 12 percent by 2026, while employment for RNs is projected to increase by 15 percent, meaning that both types of nursing professionals will be in higher demand than many other workers, including high school teachers and lawyers.
To become an LPN, you first need a high school diploma or a GED.
To apply to an accredited education program, you will probably first have to go through a:
Length of study should include three semesters of online and/or on-campus courses. Pursuing your training at a community college should keep your costs low; students at Charlotte Technical College pay about $7,000, including tuition, fees, books, uniform, and various tests.
Attending an accredited certificate/diploma school is important because you can’t earn an LPN license without it. State boards generally list approved programs and may have warnings about unauthorized organizations. Community for Accredited Schools Online lists its top 100 picks here.
Some board-approved LPN programs include:
Upon completion of your studies, you will need to take the NCLEX-PN, the national licensure exam provided by the National Council of State Boards of Nursing (NCSBN), often referred to as “the boards” or “state boards.” The NCLEX-PN is designed to measure whether you can safely perform practical nursing.
To apply, you must submit an application to your state’s nursing regulatory body, which will confirm your eligibility. Second, you must register and pay the $200 fee.
Once you are confirmed as eligible, you will receive an Authorization to Test (ATT) email explaining when and where to take the NCLEX-PN. You have 5 hours to take the computerized PN exam that is mostly multiple choice.
Most LPNs work in long-term care facilities in such roles as supervising nurse assistants (NAs); their opportunities for advancementare likely to be limited. According to the BLS, 38 percent of LPNs work in nursing and residential care facilities. Smaller percentages are employed in hospitals, offices of physicians, home health care services, and government facilities. Average annual earnings range from $42,520 (in physicians’ offices) to $48,050 (at government facilities).
Some LPNs provide acute care on a more short-term basis in faster-paced environments that include emergency rooms or trauma intensive care units. However, between 1984 and 2005, the number of LPNs in hospitals fell by 47 percent while the total number of LPNs in the country grew by 18 percent, according to AFSCME, a public service union.
Depending on the state, practical nurses have varying scopes of practice. In California, for example, the Nursing Practice Act (NPA) prohibits LVNs from starting intravenous fluids (IV) without obtaining specific licensure. In other states, IV therapy is part of the LPN’s initial education or available through certification programs.
The benefit of becoming an LPN is that you can see what sticks as far as your interests and skills. Especially if you’re new to the workforce, exploration can inform you on what type of nurse you’d like to be.
A common assumption is that LPNs really want to be RNs, but that’s not always true. Many practical nurses like their current responsibilities and understand their value to their patients.
Yet others do eventually chose LPN-to-RN bridge programs, not just to advance in their profession but to widen their scope of practice, which varies from state to state and can be confusing.
“The toughest part some of my LPN colleagues have is knowing where the line is drawn in what we can legally do,” writes one happy LPN on her way to becoming an RN.
For working LPNs, bridge courses may take 18 months or longer to finish, with the final result being an associate degree in nursing (ADN).
Example online courses include:
The goal is for graduates to pass the NCLEX-RN for licensure. The curriculum starts where the LPN training ended.
“I found the RN program to be much easier than the LPN because most of it is material that is reinforced, not new,” writes one registered nurse in an online forum. ” … If you can survive the LPN, the RN will be a breeze.”
LPNs may follow the LPN-to-BSN route to earn a bachelor of science in nursing (BSN), which may take three to six years to complete. Study is more rigorous for the BSN programs than the associate degree programs, but higher credentials may set candidates up for better-paying jobs and advanced degrees.
Other possibilities include:
Founded in 1896, the ANA represents the nation’s four million RNs. This large organization should boost your networking opportunities with its career center and conferences. Members receive the monthly American Nurse Today and free quarterly webinars to keep their knowledge current.
NALPN is the national professional organization for LPNs and LVNs and students. Individual membership is $120 and includes invitations to attend national conferences, wonderful for networking. In addition, NALPN offers certificates in IV and gerontology.
Founded March 15, 1978, the NCSBN helps state governments and nursing regulatory bodies (NRBs) collaborate. Not only does the NCSBN administer the NCLEX licensure exams for LPNs and RNs, but the organization also manages the Nurse Licensure Compact (NLC), which allows nurses to practice in one home state in addition to dozens of other NLC states.
When you become a member of NSNA, you receive an annual subscription to Imprint Magazine, study help for the NCLEX, and discounts on liability insurance, office supplies, and uniforms.
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