Welcome to a Career in Practical Nursing
Start Planning Your Practical Nursing Career as a Licensed Practical Nurse (LPN) Today
PracticalNursing.org is the ultimate guide to everything you need to know about starting your career as a Licensed Practical Nurse. We offer information on all aspects of becoming and working as an LPN / LVN, including:
- Average LPN Salaries
- Completing Education and Licensure Requirements
- Finding the Right LPN Program
- LPN Job Duties
- Financial Aid Resources for Veterans & Military Service Members
LPNs have rewarding, challenging, and well-paying careers that offer excellent opportunities for growth and advancement. With the resources provided by PracticalNursing.org, you can begin your journey towards earning an LPN certificate and license today in the practical nursing industry.
What is a Licensed Practical Nurse?
Licensed Practical Nurses (LPNs), also known in some states as Licensed Vocational Nurses (LVNs - CA & TX), are nurses who provide standard emergency and preventative healthcare to patients who are sick, injured, or just need routine health checkups. LPNs are supervised by registered nurses and doctors and perform their work alongside a team of healthcare providers.
To obtain state certification, LPN's must complete accredited LPN programs, which generally take around one year to complete. LPN programs are offered at many community colleges, technical schools, and even hospitals throughout the United States and Canada.
After LPN students complete their coursework, they must pass the National Council Licensure Examination, or NCLEX-PN. If they pass, they can pursue specialized certificates in certain areas of healthcare, including gerontology, IV therapy, long-term care, pharmacology, and more. LPN's aren't just supposed to work at nursing homes.
What are an LPN's Duties?
LPN duties often vary depending on the state where they work. Some state regulations allow LPN's to provide medication to patients, while others allow LPNs to administer intravenous drips.
In general, LPN's are responsible for assisting registered nurses and doctors by providing basic medical care to their patients. Some of the typical job duties performed by LPN's include:
- Changing bandages, catheters, and IVs
- Checking vital signs like blood pressure and pulse rates
- Feeding patients who are unable to feed themselves
- Keeping detailed records of patients’ overall health
- Reporting any changes in patients’ health to doctors and nurses
These are just a few of the standard duties performed by LPN's, and their day-to-day routines may vary depending on the needs of the hospitals, physician’s offices, or nursing homes where they work.
Additional duties LPN include:
- Greeting Patients and Recording Their Information
LPN's are often the first point of contact that a hospital, doctor’s office, or other healthcare clinic has with patients. After patients are called back to be seen by a doctor, LPN's record their medical history, known allergies, height, weight, internal body temperature, blood pressure, pulse, and breathing rate. These signs give doctors and registered nurses a good indication of patients’ overall health before any additional tests are administered.
- Collecting Samples
One of the most important day-to-day responsibilities for LPN's is to collect patient samples for routine laboratory testing, such as urine, feces, saliva, and other bodily fluids. In addition, some LPN's are trained to draw blood to test for certain diseases and infections.
- Monitoring Patients’ Health
Registered nurses and doctors may need to see several dozen patients in a single day.
Because of those demands, LPN's are asked to monitor their patients’ health throughout the course of their shift. Close monitoring is especially important after major surgeries, accidents, and when patients have received new medications. LPN's are trained to quickly identify adverse reactions or complications and notify doctors and registered nurses immediately.
- Counseling Patients and their Families
LPN's are often tasked with providing a human touch to routine healthcare. They often teach patients and their family members how to administer medication, which symptoms to be aware of after the patient goes home, which activities to avoid, and how to adopt and maintain a healthy lifestyle. Read more about what LPN's do.
Where Do LPNs Work?
The U.S. Bureau of Labor Statistics estimates that LPNs were employed in roughly 738,400 jobs in 2012. These nurses worked in a variety of settings, including:
- Elementary schools, middle schools, and high schools
- Home health care organizations
- Nursing homes and nursing care facilities
- Physicians’ offices and other private practices
- State, federal, and private hospitals
In addition, LPN's can find work in other settings by working as missionaries, serving in the military, or working as consultants for healthcare companies. Other nurses use their patient care knowledge and familiarity of healthcare settings by working as medical coders, billers, transcriptionists, and customer service representatives. Evaluate the many potential practical nursing careers.
How Do I Become an LPN?
If you want to become a licensed practical nurse, you must first complete one year of coursework in an accredited LPN/LVN programs Most states have dozens of accredited colleges, technical schools, and hospitals that offer LPN/LVN programs.
For example, California has more than 170 state-approved LVN programs, while Texas has over 100 established programs at community colleges, technical centers, and private nursing schools. New York has the BOCES programs which are a abundant and state ran. No matter where you live, you should carefully research and weigh the pros and cons of each school in your state to decide which program is right for you.
After satisfying the LPN program coursework and grade requirements laid out by your state’s Board of Nursing, you will be eligible to take the NCLEX-PN, or the National Council Licensure Examination. This exam is mandatory for all LPN/LVN's in the U.S. and can be scheduled through the National Council of State Boards of Nursing for $200.
The NCLEX-PN exam covers four distinct disciplines of nursing:
- Safe and Effective Care Environments
- Health Promotion and Maintenance
- Psychosocial Integrity
- Physiological Integrity
Some LPN programs offer study groups and practice exams, which can help you become more familiar with the format and subject matter that will be on the test. We offer a large expertly written NCLEX-PN practice test with effective question rationales.
After completing the NCLEX-PN, you will receive your examination results in the mail with a detailed description of how you performed in each section depending on the outcome of the exam. Read up on the types of questions asked, registration process, overall NCLEX-PN exam statistics and more. If you passed the examination, you can immediately begin searching for a job as a certified licensed practical nurse.
How Do I Find an LPN Program That’s Right for Me?
One of the toughest and most important decisions you’ll make when you decide to become an LPN is where to attend school. The decision is especially daunting in states with large numbers of accredited programs, such as New York, Florida, and Ohio.
Not all LPN programs are created equal, and some may be a better fit for you than others. When you’re weighing your practical nursing options, it’s important to take a few factors into consideration:
- What is the program’s NCLEX-PN pass rate?
- Is the LPN program accredited by the state?
- Does the program offer online classes?
- How much does the program cost?
- Where is the LPN program located?
- How much hands-on experience do you get?
- Do you feel comfortable with the instructors and students?
The answers to these questions will help you decide which LPN program to attend. If a highly-regarded program isn't available in your area, it may be worthwhile to move closer to one that has the best NCLEX-PN pass rates and reputation. The more you learn about nursing while completing your LPN classes, the better prepared you’ll be for your examination and your future career as a licensed practical nurse.
Cities with Most Available LPN / LVN Program Options
- New York, NY
- Los Angeles, CA (LVN)
- Chicago, IL
- Houston, TX (LVN)
- Philadelphia, PA
- Phoenix, AZ
- San Antonio, TX (LVN)
- San Diego, CA (LVN)
- Dallas, TX (LVN)
- San Francisco, CA (LVN)
How Much Do LPN's Make?
The median salaries of licensed practical nurses varies from state to state. States with the highest median salaries for LPNs/LVNs are:
- Alaska: $52,600 per year
- Rhode Island: $52,500 per year
- Massachusetts: $52,200 per year
- New Jersey: $51,100 per year
- Nevada: $51,500 per year
- California: 51,100 per year
- Maryland: 49,400 per year
The states with the lowest median salaries for LPNs/LVNs include:
- Arkansas: $35,000 per year
- Alabama: $34,700 per year
- Mississippi: $34,600 per year
- South Dakota: $34,200 per year
- West Virginia: $33,600 per year
If you complete your LPN program and licensure in one state but want to move to another state for higher pay or better job opportunities, you’ll have to become licensed in the new state.
How Are LPNs Different From Other Nurses?
Licensed practical nurses differ in many ways from other nurses, but their day-to-day duties often consist of similar work. Some of the major differences between LPN's and other nurses include:
Licensed Vocational Nurses (LVNs):
- This is strictly terminology that separates the differences between LVN and LPN titles. LVN terminology is used solely in California & Texas. See below for further explanation.
Certified Nursing Assistants (CNAs):
- Like LPN's, CNA's earn their certificates with one year of coursework and provide basic care for patients. However, they are not considered licensed nurses. CNA's perform their duties under the close supervision of LPN's and RN's.
Registered Nurses (RNs):
- RN's can complete their coursework and become licensed in two years. Their basic duties are similar to LPNs, although they often receive higher pay, are allowed to perform tests and certain procedures, and are responsible for supervising CNA's and LPN's. Read about the LPN to RN transition process.
Nurse Practitioners (NPs):
- After completing their BSN and MSN degrees, aspiring NPs must pass additional licensing examinations to become fully certified. Licensed NPs have much more freedom than other nurses and are often allowed to write prescriptions and work independently without the supervision of physicians.
LPNs who wish to further their careers and gain increased responsibility and pay can enroll in bridge programs. These programs allow for faster transition and certification in new nursing roles. Bridge programs include transitions from CNA to LPN, LPN to ADN, LPN to RN, LPN to RN Online, and LPN to BSN. Several online program options for current LPN's are available.
What's the Difference Between an LPN and LVN?
The simple answer to this commonly asked question is, well, simply the name.
For example, the Licensed Practical Nurse (LPN) in Arizona who wishes to relocated to Texas or California, obtains his or her license in either state and is now called a Licensed Vocational Nurse (LVN). There is no difference in job duties, education, or scope of practice, as mandated by each state, and Texas and California are the only states using the title LVN.
LPN / LVN History & Background
To gain clarity, let’s explore the history of the LPN/LVN in the United States.
Long before there were nursing schools, scope of practice standards and laws, the role of caregiver or nurse was delegated by family and mythical tradition. Even today the “healer” within a family or community still ministers to sick family members or neighbors whether officially licensed as a nurse or not. However, from a historical perspective nuns, monks, and local common women, were designated to minister to the poor and sick. The dark ages saw this trend of mercy from friends or family, but during the Middle Ages Catholic monasteries took on the role of nursing the ill and infirm. With the reformation the church’s role diminished and female prostitutes, thieves, and criminals were compelled into nursing or face prison indefinitely. Often these women had no training as nurses in healing the sick and would often rob, extort, or aid in hasting the death of their charges to further benefit from the spoils left behind. Besides atonement for their deviant lifestyles, there was a more sinister reason behind consignment of these unrepeatable women. In the alarming and staggering death of a plague-ravished population it was thought that if these women were to die it would be no great loss to society. Thus, nursing was viewed as a disgraceful occupation performed by vagrant and scandalous women (Egenes, 2009).
By the 18th century, nursing once again started to evolve into a benevolent profession performed through missions, churches, and hospital deaconesses (nuns) dedicated to caring for the poor and sick. Nonetheless, the common or disreputable woman nurse remained part of the resources of nursing care available for much of the population. Still considered to be a lowly profession, by the 19th century Florence Nightingale would emerge from the aristocracy as the pioneer in reforming nursing from a shameful profession to the beginnings of a science based practice. Before Florence, deaconesses or nurses received minimal education in the practice of nursing. Up to this time, most nursing was learned through oral traditions and folk remedies. These practices often killed rather than healed the illness, but were attributed to spiritual maladies rather than the physical manifestations of illness. Through the pioneering work of Nightingale and others that emerged during this time, nursing began to revolutionize theoretical and clinical practices that became the corner stone of formalized nursing training education (Egenes, 2009).
Much has been attributed to Florence Nightingale and rightly so, but there are numerous women including sisters of the Catholic Church that contributed to the advances of nursing as an educated and trained profession. Although nursing has changed significantly since the time of Nightingale, the need for nurses has shaped the evolution and appreciation for the indispensable role they have played especially in times of war and epidemic outbreaks.
The Emergence of Practical Nursing & War
In the mid-1800s after the Crimea war, the aristocracy of Nightingale’s influence established the first funded school of practical nursing in London. Within ten years the U.S. Civil War began and the need for nurses became dire. The designated nurses that served wounded Civil war soldiers were usually volunteer wives and mothers, or again, Catholic nuns Since Nightingale’s educational model had not been established in America as of yet, none of the volunteer nurses had any formal nursing training. Like the Crimean war, the American Civil war brought the reality for the need to train nurses building on the experience of caring for battle-related injuries and illnesses. Thus, during the latter portion of the 19th century into the beginning of the 20th century, the post-Civil war population and intensified immigration perpetuated the spread of disease in the overcrowded cities propagated by an environment of emerging industrialization. Nursing care was conducted only during daylight hours by unskilled migrant family members or once again by prostitutes, convicts, and substance abusing women.
The appalling conditions of public facilities for the sick staffed by untrained and substandard caregivers caught the attention of concerned charities and citizens. Accordingly the reputation of the success of Nightingale’s London school of nursing that began under her influence piqued the interest of the concerned to establish the first American nursing education programs in New England and Philadelphia. Within a few years hospital training programs for practical nursing sprang up throughout the East coast. However, hospitals in exchange for educating these individuals took advantage of the cheap, compliant student nurse labor force. Students were expected to work twelve to twenty hours in excess of their studies. Upon graduation the practical nurse gained an autonomous and lucrative self-employment working in households ministering to the sick and performing household chores. Very few were maintained in the hospital and even less became trained for specialties such as surgical assistants (Crihfield & Grace, 2011).
The Nurses’ Associated Alumnae of the United States and Canada was created in 1896 and later would be known as the American Nurses Association (ANA, 2015). The reason for developing the organizations was to establish the first licensure standards and nurse practice laws. Simultaneously, the Volunteer Hospital Corp was developed in 1898 to support the Spanish-American War. Finding the significance of education and training the Volunteer Hospital Corp insisted on accepting only licensed nurses trained from one of the innovative accredited nursing schools (Vancouver Island University Practical Nursing Program Guide, n.d.).
By the 20th century scientific discoveries in understanding disease causing organisms and development of modern technological treatments led to the gradual change from educating nurses in the hospital-training model to formal education within institutes of higher learning. The Army Nurse Corp and Navy Nurse Corp were created in 1901 and 1908, as helpful permanent establishments that improved standardized education of practical nurses. Expanding into the troubles of public health, nurses once again began visiting the sick in their homes through the creation of public health nursing organizations. The educated practical nurse was the exemplary hands-on caregiver working in clinics, health departments, industries, and to some extent hospitals. The designation between the registered nurse and the licensed practical nurse was not yet established, nursing in general was autonomous as most of the medical practices. Nurses set their own contracts and rates for the work they offered and the organizations they started.
One of these organizations was the American Red Cross (2015). The American Red Cross was stylized by Clara Barton in 1881 after the Switzerland International Red Cross model that began in 1863. As a fledgling organization the American Red Cross offered disaster relief for many years until 1900 when it became a nationally sanctioned congressional charter. The reputation and assistance the American Red Cross demonstrated became recognized by the Geneva Convention to fulfill the requirements represented by nursing during war time. As a recognized organization, educated practical nurses were recruited to serve in World War I (WWI), educated by the American Red Cross, the US Army Corps, and Navy Nurse Corps.
Efforts to supply the need for nurses during wartime was never fully achieved and the need for educated practical nurses remained in demand even after WWI, when the outbreak of Spanish Influenza spread around the world. Again the American Red Cross, supported the innovative development of the Vassar Training Camp for Nurses in New York. The Vassar Training Camp was devised as a method to “fast track” the training and supply of practical nurses. The three month program for college educated women included room and board, tuition, and laundry services. During times of war and the ensuing pandemic of Spanish Influenza emphasized the value of the educated nurse philosophy to cure and care for sick and injured (Mills, 2009).
The training program through Vassar was very successful in educating and meeting the needs for trained nurses until 1933 when the Great depression closed Vassar’s and several other nursing educational programs. Like most of the population nurses found it difficult to find employment. However, under the Civil Works Service and the Federal Emergency Relief Administration funding for bedside nursing care was paid at a set rate. The funding provided in-home nursing services to the unemployed, as well as public health education and preventive measures. This was the beginning of end of nursing as an autonomous health care service and soon would be structured as an employee-related position (Mills, 2009).
The autonomy that many educated practical nurses achieved prior to WWI continued to gradually disintegrate as the desperate need for nurses again ramped up at the beginning of World War II. As WWII absorbed the available workforce, hospitals and other industries desperate for workers (including nurses), began to offer incentive programs to attract a dwindling labor force. Instead of setting their own fees and salaries nurses were given a wage based on the same structure still used today and endorsed by physicians that valued, but maintained nursing as a subordinate practice to medicine. Nursing organizations along with the American Red Cross recruited nurses through the development of the Nursing Council of National Defense and the United States Cadet Nurse Corps program. A lack of supply and a great demand again called for educational programs that would crank out nurses in accelerated programs. In exchange for serving in the military or as a civilian nurse, student nurses were provided uniforms, tuition, monthly stipends, books, and housing during a thirty hour or less monthly training course. However, nurses serving during the time of war began earning a reputation of positive respect from the general public in spite of the wages that were often lower than the average hotel maid or seamstress. In 1941, the National Association for Practical Nursing Education and Service (NAPNES, 2015) was established and by 1945 became the first accrediting agency for practical nurse training programs (Dictionary of American History, 2003).
The licensing of trained nurses and national boards of nurse examiners did not emerge until 1951 and 1952 under the supervision of physicians. By 1955 all states had developed standards of educational training, regulations, and laws for both the licensed practical nurse and the registered nurse. Nursing exams were standardized based on state-to-state development but not nationally. Yet, many of the post-WWII nurses were expected to quit working once they married and began domestic life as wives and mothers. It would not be until the radical 1960s that nurses would once again emerge into the workforce as working wives and mothers bargaining for better wages. The autonomous structure of the self-employed nurse was now a thing of the past and hospitals were reluctant to improve work conditions or increase wages. Even the ANA did not advocate for nurses since it had implemented a “no-strike” policy that eventually was rescinded in 1966.
The need for caregivers/nurses has been salient feature since there has been human illness. Throughout the centuries changing environments, populations, endemics, and war have influenced the perception, practice, education, and image of nurses. The licensing and establishing standards of care has improved nursing but imposed other limits to shortages and adequate training. Desperation has altered the focus of each of these principles in lieu of supply and demand. In our contemporary familiar society most Americans understand that nursing has undergone a short supply of nurses. During the mid-1980s and most recently at the end of 20th into the 21st century, there are many reasons for these trends that do not involve societal norms for family commitments as in the past. Changing healthcare structures, the aging baby-boom population, expensive technological advances, and aging experienced nursing are just some of the reasons behind the continued predicted shortage of nurses in the coming years.
As always the practical nurse has been the compensating solution to shortages in the past and according to the American Federation of State, County, and Municipal Employees (AFSCME, 2015) union, is poised to become the solution for the nursing demands predicted for the future. Through organizations such as the ANA the standards and suggested entry of practice have always been recommended at higher levels of education, but ignore the practical vision of the demand. Adhering to these nursing organizations recommendations, has reduced the LPN presence in hospitals nationwide. Not only has this created an environment for burn-out among overworked RNs in acute care settings, but it has also created a wedge in the team spirit of nursing. Although the scope of practice for RNs and LPNs remains somewhat different the value of the LPN as a qualified cost-effective health care team member has been minimized in hospitals. The AFSCME recommends that LPNs be employed in the hospital setting and managers become educated on the LPN scope of practice. They also recommend that hospitals support the education of LPNs through standardization of the scopes of practice for all nurses. Considering the historical need of nurses, their contributions, and the opportunities available to the nurses of today.
I would agree that the traditional practical nurse (LPN) continue to be the standard bearer of nursing’s legacy. - Lucinda Lasater
References for LPN History (Non-Internet)
Crihfield, C. & Grace, T. (2011). The history of college health nursing. Journal of American College Health, 59(6).
Egenes, K. (2009). History of nursing. In Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow, Gayle, R. & Halstead, J (Eds). Sudbury, MA: Jones & Bartlett.
What is the Job Outlook for LPN's in the Future?
Like most jobs in the healthcare field, the job outlook for LPN's is excellent though there are healthcare systems around the country seeking to move forward with minimum standards of RN credentials to work in hospitals. As the population ages and reaches retirement age, they will need more frequent healthcare, including checkups and emergency care. In fact, every state in the U.S. is expected to see major increases in the number of LPN positions through the year 2020, with some increasing by 20 percent every year. Read more about LPN jobs and find current job listings.
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We are nurses helping future nurses. PracticalNursing.org was built to guide those interested in pursuing the exciting career in healthcare. Licensed practical nurses (LPN) are the stepping stone into a successful nursing career. Our trusted nursing experts are informed educators, experienced in their crafts, and advocates for healthcare professionals.