Practical Nursing in Arkansas
Arkansas LPNs provide services in a wide variety of settings, including nursing homes, clinics and health practitioner offices, home health services, and hospital inpatient wards. In some settings, practical nursing training offers solid preparation for a variety of roles. Individuals who seek employment in other settings will do well to seek higher credentials, whether at the onset, or through academic progression.
The LPN credential is most useful for sub-acute settings. The majority of the state’s LPNs work in long-term or extended care settings (e.g. nursing homes) or in clinic or practitioner office settings. In long-term care, they may progress far without a higher nursing license. Long-term care is also an arena where there are a lot of exciting developments in the state.
While there are a significant number of LPNs in hospital inpatient units, they represent a relatively low portion of the workforce. In these settings, most positions require higher licensing.
Licensed Practical Nurses, as the title suggests, are characterized by practical training and practical duties. They spend about a year completing certificate or diploma programs (LPN programs in Arkansas), at which time readiness is assessed through a licensing examination. The usual pathway is the certificate, though a small percentage of Arkansas LPNs also hold degrees at the associate’s level or higher in other fields. The same exam is utilized throughout the nation, though there is a state-specific element to credentialing and practice.
Arkansas LPNs perform a lot of skilled nursing duties. They work under the directions of doctors, registered nurses, or dentists. They have a role in observing patients but don’t assess or make nursing diagnoses. This does not mean that they can’t have supervisory duties. In long-term care settings, LPNs frequently have charge nurse duties, though there are levels of direction and supervision beyond which they can aspire to.
The Arkansas LPN Workforce
The 2016 Arkansas State Board of Nursing Annual Report provides details about the LPN workforce (http://www.arsbn.org/publications). At that time, 4,129 LPNs reported working in long-term and extended care facilities and 3,396 in office and clinic settings; an example of the latter would be doctor’s offices. 1,495 reported working in inpatient hospital settings and 746 in home health. Less commonly reported settings include schools, community-based residential care, occupational health, and community and public health settings.
LPNs employed in skilled nursing facilities may perform nursing procedures and/ or supervise provision of basic care. Some LPNs are hired as treatment nurses to promote skin integrity and healing of wounds; the pressure ulcers that bedridden patients sometimes present with are considered a form of wound.
Arkansas LPNs may have some IV duties delegated to them if they have had additional training.
Other Options in Long-Term Care and Home Care
The state also provides assisted living for low-income/low resource individuals who are elderly, blind, or have significant physical disability. Residents may receive intermittent skilled nursing services. Here, too, one needs an RN license to take on higher roles like assessment.
Some elderly and disabled people receive home care, respite care or adult day services. Home care may be self-pay or may be covered through governmental programs with varying requirements.
An LPN might, for example, provide care to people of varying age who need respiratory support (trach or ventilator) in their homes.
Exemplary Arkansas Facilities
Medicare Compare, a governmental website, offers star ratings for hospitals, nursing homes, home health agencies and hospices (https://www.medicare.gov/).
Other organizations offer their own recognitions. Some are tied to quality improvement. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) recognized Crossing at Riverside Health and Rehabilitation in Searcy with a silver national quality award in 2017.
Arkansas Successes in Long-Term Care
Arkansas is #3 in the nation at having reduced the rate of long-term residents who are given antipsychotics (http://wreg.com/2018/02/05/tn-arkansas-nursing-homes-lead-nation-in-reducing-antipsychotic-use). There has been much concern at the national level about the medications being used to make it easier for facilities where there is inadequate staffing and inadequate training in managing difficult dementia-associated behaviors.
Arkansas has seen a good deal of activity at the state level in supporting person-centered care models. In person-centered care, the focus is not on accomplishing a list of tasks but on meeting individual needs, including psychosocial ones. Instead of trying to get residents fed and bathed in the most expedient manner possible, there are opportunities for residents to make choices. Staffing patterns reflect the importance of developing caregiver-resident relationships. Sometimes the whole physical design of the campus is re-envisioned to look more like individual households.
LPNs Employed in Clinic and Office Settings
The role of a clinic nurse is quite different. Duties could include taking vital signs, administering vaccines, providing nebulizers or other treatments, providing patient education, and performing EKGs. Duties could also include scheduling appointments and providing some additional care coordination activities (e.g. encouraging a patient to use a patient portal and ensuring lab results and specialist reports are available to the healthcare practitioner by the time of the appointment).
Average LPN Salary in Arkansas and Career Outlook
The following counties each numbered more than 500 LPNs in 2016, according to the Board’s annual report: Benton County, Craighead County, Faulkner County, Gardner County, Sebastian County, Saline County, and Washington County. By contrast, some counties had fewer than 100.
The Arkansas practical nursing occupation has been projected to increase by 11.7% between 2014 and 2024.
Arkansas licensed practical nurses made a mean wage of $17.69 an hour in 2016. This translates to $36,800 for 52 40-hour weeks.
The Arkansas Licensed Practical Nurses’ Association is an additional resource (http://www.arkansaslpna.org/index.html).
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