Licensed practical nursing (LPN), also called licensed vocational nursing in some states, has a noble history. It started in the early 1940s as a way to get licensed caregivers into the workforce in a shorter period of time, compared to registered nurses. This was important during and after WWII, when many RNs served in the military, resulting in a nursing shortage in the US.
While they filled a definite need during that time period, the question is often asked whether LPN programs are still relevant and needed today.
In the spirit of full disclosure, I must reveal that I am the Executive Director of a Board of Nursing which licenses LPNs. My instinctual response to this question is a resounding “Yes!” But at the risk of sounding self-serving, I have taken a step back to look more objectively at the issue. I think that the answer actually is “It depends.”
How Many LPNs Are There Today?
According to the Health Resources and Services Administration (HRSA), the number of LPN programs has remained stable in the US since the 1990s. While the number of graduates has declined over this time period, the number of actively licensed LPNs has increased.
Possibilities for this scenario are that these nurses are remaining in practice for a longer period of time. It is also important to note that the number of LPN graduates who pass the NCLEX-PN exam has remained stable. Data collected by the National Council of State Boards of Nursing (NCSBN) from January through March 2010 indicates that LPNs pass the licensure exam at a slightly higher rate than RN graduates on their first attempt.
The supply and demand data for LPNs varies. It depends on the location, area of practice, scope of practice, and whether unlicensed personnel can be utilized in their place at a cheaper cost to the employer.
The Present Role of an LPN
Unlike RNs, the scope of practice for LPNs varies from state to state, sometimes with significant differences. In many states, there are nonspecific guidelines as to what the LPN can and can't do, leaving much up to interpretation by the employer. There is at times a lack of knowledge by the supervising RN as to what should and should not be delegated to the LPN, therefore they may be under or over utilized.
The essential difference between the LPN and the RN is not task-related. LPNs in many states engage in IV therapy, communicate directly with physicians and write verbal and telephone orders, etc. LPNs are trained to be the bedside caregiver, while other forms of nursing education typically focuses on more supervisory functions.
Establishment of a clear articulation between LPN and RN in the educational system could be beneficial to both levels of licensure, especially for those who wish to pursue a higher level of nursing education. LPNs have a wonderful base knowledge upon which RN education can be added.
Many facilities including those in long term care could not function without the LPNs. They are often the backbone of the nursing staff, at times managing the building on evening and night shifts when no RN is on site. HRSA data states that LPNs could be used more fully in acute care settings. This is not to say that an LPN can replace an RN; clearly that would be inappropriate even in times of an RN shortage.
The fact is, however, that many of the tasks that the RNs perform could be done by the LPN in many jurisdictions. This is clearly demonstrated by a research study conducted by NCSBN, which obtained information from newly-licensed LPNs. The tasks that these individuals routinely perform include organizing and prioritizing client care, following up with clients after discharge, and using data from different sources to make clinical decisions.
Standardization of education, practice, and programs for LPNs across the states could benefit the profession. Clearer guidelines could be created, which could potentially result in employers being more comfortable when working with them.
While the number of LPNs in the US is less than RNs, they still have influence. Given the right set of circumstances, they can be more than relevant and needed. They are indispensable.
What are your thoughts on today’s LPN programs? Do you think LPNs still play a vital role in the nursing profession? Leave a comment below!