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 home health may also prepare meals and teach family members simple nursing tasks.
Nursing homes will offer the most new jobs for L.P.N.'s.
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.
Hospital-based L.P.N.'s 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.
L.P.N.'s employed in nursing homes often face heavy workloads. In addition, the people they take care of may be confused, irrational, agitated, or uncooperative.
In private homes, L.P.N.'s usually work 8 to 12 hours a day and go home at night. Private duty nurses can often set their own work hours.
Licensed practical nurses held about 659,000 jobs in 1992. About a quarter worked part time. Two out of 5 L.P.N.'s worked in hospitals, almost one-quarter worked in nursing homes, and a tenth in doctors' offices and clinics. Others worked for temporary help agencies, home health care services, or government agencies.
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 1991, approximately 1,200 State-approved programs provided practical nursing training. Trade, technical, or vocational schools offered almost half of these programs, while community and junior colleges provided more than a third. Some were offered 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 prospects for L.P.N's are expected to be excellent, as employment grows much faster than it has in the past. Because of this growth, the number of new graduates needed will be well above the number graduated in recent years. As in most other occupations, replacement needs will be the main source of job openings.
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.
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 may 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.
Very rapid growth is also expected in such residential care facilities as board and care homes, old age homes, and group homes for the mentally retarded, as well as in home health care services.
Employment of L.P.N.'s in hospitals is not expected to increase much, largely because the number of inpatients, with whom most work, is not expected to increase much.
Employment is projected to grow very rapidly in physicians' offices and clinics, including health maintenance organizations.
Median annual earnings of full-time, salaried L.P.N.'s were $21,476 in 1992. The middle 50 percent earned between $18,148 and $25,948. The lowest 10 percent earned less than $15,392; the top 10 percent, more than $31,668.
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 $22,360 in October 1992. The average minimum salary was $18,384 and the average maximum was $26,551.
According to the Buck Survey conducted by the American Health Care Association, L.P.N.'s in chain nursing homes had median annual earnings of approximately $21,900 in January, 1993. The middle 50 percent earned between $19,800 and $24,900 a year.
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.
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Reprinted with Permission of U. S. Department of Labor