LPNs vs RNs

RN and LPN: two different sets of initials on different name badges – and often two very different roles. Registered nurses (RN) have, at the minimum, a two-year degree or three-year diploma. Many have baccalaureate degrees. RNs have an expanded set of duties and are more frequently employed in hospital settings. They, RNs, are generally expected to do more critical thinking on the job. Find a Registered Nursing program in your state.

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Licensed practical nurses (LPN) have about a year of nursing education, often culminating in a certificate. A minority complete longer programs and walk away with a degree – often an Associate of Applied Science (AAS). Find an LPN or LVN program in your state.

The role of an LPN is, as the name suggests, practical. LPNs are expected to report even minor changes in patient care to a registered nurse or other medical professional. As for what they actually do on the job, often it’s a lot!

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Work Settings

More licensed practical nurses work in long term care than in any other setting. In these settings, they have opportunities to move up in the ranks, often supervising nursing assistants who perform the most basic duties (for example, bathing or changing bed pans). The NLN reported in 2011 that newly licensed LPNs in long term care were almost six times as likely to have administrative responsibilities as their counterparts in hospitals were.

Every state has a Nurse Practice Act that defines the scope of practice for Registered Nurses and for Licensed Practical Nurses.

In hospitals, LPN duties, as well as advancement opportunities, are more limited. You’ll find LPNs taking vitals and sometimes administering medications. You won’t find them caring for premature infants in the neonatal ward. They won’t have as many options for specialization.

Work settings are varied. The BLS reports that 29% of LPNs work in nursing care facilities, 15% in hospitals, 12% in doctor’s offices, and 9% in home health. For RNs, hospitals are the most common setting, with 48% in private general hospitals and 6% in local hospitals. Only 5% work in long term care.

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Demand for LPNs and RNs

Nursing is one of the few fields where there is more demand at the higher levels of practice than the lower ones. Nationwide, there are far more RNs with active licenses than LPNs — 3,236,288 to 816,687. Why? Their skills – and legally allowable duties — are needed.

Both fields are growing, but the registered nursing field is growing a little faster. The BLS has predicted 22% job growth for LPNs between 2010 and 2020. For RNs, the projection is 26%.

Geographic Differences

It is important to be aware that there are different scopes of practice in different states. States have varying policies regarding IV therapy, for example. Some states allow LPNs a range of IV duties, but require additional coursework or certification.

There are also geographic differences in work setting. Many states have workforce centers, and in some states, the board releases detailed information about licensees. Both sources can give a state-specific portrait of the profession. A 2005 Georgia survey found 29.4% of practical nurses employed in nursing homes/ long term care, 28.8% in hospitals, and 14.1% in medical practices (like doctor’s offices). A 2011 South Dakota report found 31% of practical nurses employed in long term care.

The Path to a Nursing License

Is it easier to become a practical nurse? Yes – in terms of the length of the program, difficulty of subject matter, and (in many cases) the cost of the program. Read the article “Becoming an LPN” to gain a greater understanding of the process.

Licensed practical nurses go through a licensing process that is very similar to registered nurses. There is a screening process and often a finger-print based background check. LPNs are accountable to their licensing agency when it comes to demonstrating ethical practice and following the scope of practice.

They also must pass a national exam. The NCLEX is offered at both the RN and PN levels. The NCLEX-PN is considered the easier exam, but differences go beyond difficulty level. Both tests assess knowledge and decision making appropriate to a particular job role. The NCLEX-RN requires more critical thinking; the RN is expected to carry out more assessments and make more decisions on his or her own before seeking the support of a supervisor. Read “Becoming an RN” to better understand the path.

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