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One of the most interesting parts of the nursing profession is the many different points of entry into the profession. Most people are aware that it takes eight or more years to become a doctor or a lawyer. Teachers are now encouraged if not required to have a Master's Degree, meaning about six years of college.
What happens if you enter medical school, but are forced to leave in year five due to illness, family issues, or other problems? What happens if you complete six years of law school, or make it three years into preparation to become a teacher, but do not complete the degree? What you have is a hefty student loan bill, but with an inability to qualify for any jobs in your chosen career path. Likely, you are stuck with the student loan bill and a low paying job. This is where nursing is different.
The path into the nursing profession can be described as a ladder. You can begin at entry level as a Certified Nursing Assistant in a matter of weeks, and have a job that is in high demand. While working as a CNA, you can study to become a Licensed Practical Nurse (LPN) or in California and Texas - a Licensed Vocational Nurse (LVN). You can then work as an LPN while studying to become a Registered Nurse (RN).
After attaining the RN license, a nurse can continue to further his or her education while still earning a good salary. Like steps on a ladder, nurses can continue to move up in their career field, without the need for completing a four-year or longer degree program before getting into the field.
This article focuses on the first rung on the nursing career ladder eligible to use the title of "nurse", the Licensed Practical Nurse (LPN). While this position is also known in some states as a Licensed Vocational Nurse (LVN), most states use the LPN title and that abbreviation will be used for this article.
LPNs have training and authority to carry out more advanced nursing functions than the Certified Nursing Assistant (CNA), but have lower level training, authority, and responsibility than the Registered Nurse (RN). LPNs are supervised by RNs. They have the ability to perform all of the duties of a CNA, and can also do more advanced functions such as administering injections (shots), changing urinary catheters and wound dressings, and supervising CNAs.
Another important function of the LPN is performing a basic assessment of the patient's condition. LPNs are trained to listen to heart, lung and bowel sounds, check basic neurological functions, such as pupil dilation and whether strength is equal in both arms or both legs, check for wounds or pressure ulcers, and perform other tasks to test the general well-being of the patient. In some states, LPNs can do routine assessments, but cannot do the initial assessment when a patient is admitted, as this must be carried out by an RN. LPNs help supervise the work of CNAs, and in some states, may supervise other LPNs.
LPNs can administer medication by mouth, through injections, and depending on state regulations, may be able to start and administer some medications intravenously (IV). Some states allow LPNs to start IVs and start non-medicated fluids, and in some states they may be able to administer some medications but not others. In other states, the LPN has no authority to start or administer IV fluids or medications without a special certification. It is extremely important for the LPN to be aware of the regulations for their state.
Some LPNs work as Certified Nursing Assistants (CNAs) prior to furthering their education and becoming an LPN, while others choose to enter the field of nursing at this level. Generally, about a year of training is required before a student is eligible to sit for the National Council Licensure Exam for Practical Nurses (NCLEX-PN), a test administered by computer at a testing center.
An LPN has a certificate rather than a degree after completing his or her program, and is able to use the title LPN only after passing the NCLEX exam. Unlike Nursing Assistant requirements, which vary from state to state, all 50 states require passing the NCLEX before being able to practice as an LPN.
Practical Nursing programs are commonly found in community colleges and vocational schools. The majority of LPNs work in long term care facilities or nursing homes, but may also work in home health, clinics, or hospitals. In the hospital setting, LPNs are usually delegated to care for the most stable, least medically complicated patients on the unit, or may pass medications while RNs carry out other nursing functions.
Like the job of a CNA, working as an LPN can be physically and emotionally stressful. Lifting and turning patients is physically taxing, and can result in injury if proper body mechanics are not employed. Nurses and CNAs often assist patients with end-of-life care, and may be present during or just after the death of a patient. Dealing with this situation, and consoling the family, is a very emotional experience for many nurses.
Nurses often work 12 hour shifts, and may spend much of that time on their feet. Working overtime, while discouraged by some employers, may be necessary in the case of staff shortages or emergencies. While the rewards of caring for others are great, these conditions cause some nurses to leave the field entirely.
According to the U.S. Bureau of Labor Statistics most recent data, job opportunities for LPNs are projected to grow by 16 percent by 2024, which is a much faster rate of job growth than what is commonly seen in other career fields. As the "Baby Boomer" generation ages, it is estimated that there will be many more patients in hospitals, long term care facilities, and home health programs - thus more nurses will be needed to care for them. The Bureau of Labor Statistics states that the chance of finding employment for a newly graduated LPN is "favorable", especially if the nurse is willing to work in a rural or underserved area.
The most recent data from The U.S. Bureau of Labor Statistics states that the median salary for a Licensed Practical Nurse/Licensed Vocational Nurse is $42,490 per year, or about $20.43 per hour. This amount can vary greatly depending on the setting for employment and the geographical area.
Nurses working in doctor's offices and clinics often make less than those working in long term care facilities. An LPN working for a small rural facility, especially a new graduate, may be closer to $15 per hour, while experienced LPNs or nurses in other areas may have salaries that approach $30 per hour.
By mean annual wage, the 10 highest-paying states for LPNs are:
|Connecticut||$54,690||Delaware||$47,770||District of Columbia||$48,590|
|New Jersey||$52,080||New Mexico||$44,970||New York||$45,030|
|North Carolina||$41,570||North Dakota||$38,930||Ohio||$40,550|
|Puerto Rico||$21,400||Rhode Island||$51,770||South Carolina||$38,680|
Being a Licensed Practical Nurse can be a very rewarding career for those who enjoy working with people and who can withstand the sometimes stressful environment. Many LPNs "work their way through school" as they study to become an RN, which is an advantage of the "Ladder Model" nursing offers. Salary increases and more doors open the further a nurse is willing to carry on with his or her education.