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Practical Nursing in Alabama

Alabama’s Licensed Practical Nurses provide nursing care to people who have chronic or acute illnesses or are living with disability. They also assist with routine health care and play a role in health promotion.

The largest portion of LPNs, in Alabama and elsewhere, work with people who need sub-acute care over an extended period of time. Patients are often elderly or convalescent. However, some patient populations look very different. In Alabama, a portion of the nurses employed in school settings hold licenses at the practical level.

LPN is the most basic nurse license. However, it is above the level of nursing assistant or patient technician. For some, it represents a step above the entry level. LPNs work under registered nurses or physicians. In some settings, they also have supervisory duties; it is not uncommon for those in long-term care facilities to direct the activities of nursing assistants.

LPN Training

Prospective LPNs complete approved programs LPN programs in Alabama and pass the NCLEX licensing examination at the practical nursing or ‘PN’ level. State licensing is granted by the Alabama Board of Nursing.

The duties an LPN carries out are a reflection of licensing but also of other factors, such as experience level and complexity of patient needs (as determined by physician or RN).

Some LPNs receive additional training to do IV push medications and rapid sequence intubation in acute care settings; this requires Board approval. Duties in other settings that are beyond the level of basic educational preparation also require Board approval.

LPN Work Settings

The Alabama Health Action Coalition lists, as LPN career options, long-term care facilities, doctor's offices and clinics, home health, and some hospitals.

The Alabama Health Action Coalition provided a 2015 report of the LPN workforce, based on re-licensure data from the previous cycle (http://www.al-hac.org/newsroom). By far the most common settings are those in the nursing home/ extended care/ assisted living category; they were reported by fully 5,204 of the state’s LPNs. The next most common were hospital settings, reported by 1,568 LPNs. The following are other common workplaces, along with the number of LPNs reporting each as his or her primary work setting:

  • Home health: 990
  • School health services: 766
  • Ambulatory care: 546
  • Community health: 519
  • Correctional facilities: 488
  • Public health: 279

A substantial portion of the data is reported as unknown or “other”.

The specialties reported to a large degree corresponded with work setting. The largest subset reported nursing home; a smaller subset selected the separate assisted living category. Some reported more specific specialties such as women's health, which could reflect a hospital unit or type of clinic. Medical- surgical is a very common hospital specialty; accounting for nearly 5% of Alabama's LPNs (this despite the 17.8% of specialties reported as “unknown”). More than 5% cited psychiatric, mental health, or substance abuse. 2.2% listed their specialty as rehabilitation.

LPN's Roles

Most Alabama LPNs are staff nurses. The next most common role is medication nurse; the third most common, nurse manager. More than 1% of the state’s LPNs reported nurse medical record reviewer as their primary role.

A 2018 job search turned up a number of positions in long-term care facilities and rehabilitation centers, including some at the charge nurse level. Some were specialized (for example, a treatment LPN who would be primarily concerned with preventing and treating pressure ulcers and other ulcers).

LPNs were sought for a variety of other roles. The following is a sampling:

  • A medication nurse at a medication-assisted opioid treatment center who would observe patients after medication administration, perform blood draws, and collect specimens
  • A medication nurse at a psychiatric facility whose duties would also include nursing care, personal care, admission-related duties, and direction of CNAs
  • An LPN/ clinical manager who would help the doctor, provide patient care, keep the examining rooms in good condition, and assist with lab work
  • A practical nurse at a U.S. Air Force medical treatment center whose duties would include assisting with medical procedures, performing procedures such as catheterization or EKGs, and teaching patients and family members to do health tests
  • A nurse coordinator for a youth treatment facility, with duties to include carrying out basic physical examinations, scheduling medical appointments, and administering medication
  • A resident services director at a cottage-style assisted living community (either LPN or RN) who would be able to carry out various coordination and oversight activities, including some geared toward socialization and recreation

Opportunities for Advancement

LPNs may pursue additional education to progress to higher levels of nursing licensure in Alabama. A student will need an associate or bachelor's degree to progress to the level of an RN in Alabama. Bridge courses are in place to help with the transition. There will be some additional science coursework as well as courses in nursing.

The Alabama Health Action Coalition lists an average base wage of about $7.50 an hour more for an ADN nurse than an LPN, based on having carried out a sampling of open positions (http://www.al-hac.org/newsroom); bachelor’s level (BSN) positions can potentially pay far more. There is no limit to the level of degree a nurse can ultimately earn, and LPNs have progressed as far as advanced practice (though statistically nurses are less likely to earn very high degrees if they start at a low level).

Career Outlook and Average LPN Salary in Alabama

Practical nursing employment is concentrated in certain parts of the state. Jefferson County employed the most LPNs (numbering 1,534), followed by Mobile County with 874. Tuscaloosa, Madison, and Montgomery were runners up.

Alabama has been projected to see 14.2% LPN occupational growth between 2014 and 2024.

The Bureau of Labor Statistics reports an average hourly figure of $17.45; this is based on 2016 wages.

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