Practical Nursing in Louisiana

LPNs occupy a rung on the nursing career ladder above nursing assistant but below registered nurse. Louisiana LPNs are less likely than RNs to be employed in acute care settings. They are more likely than RNs to work with patients with chronic sub-acute needs. One will, however, find them in many settings – and one will find a number of positions open to those with good track records.

Overall, there are far fewer LPNs than RNs and slightly fewer LPNs than nursing assistants. The smallest subset of nurses is those that make it all the way to advanced practice.

Scope of practice is determined at the state level. Louisiana LPNs work under direction of RNs or healthcare professionals; the latter group could include doctors, optometrists, or even psychologists.

The Louisiana State Board of Practical Nurse Examiners cites the following among the duties commonly performed by LPNs, while at the same time noting that there is no comprehensive list of the things they may be asked to do:

  • Perform physical assessments
  • Load and monitor PCA machines
  • Administer oxygen
  • Care for patients with some types of catheter
  • Carry out some operating room duties

Ultimately, what a Louisiana LPN can be asked to do is largely about competence. The Board does issue practice opinions (http://www.lsbpne.com/practice_opinions.phtml).

There are many guiding voices, some national. Duties will vary by setting, and level of responsibility often will as well. One skilled nursing facility, advertising recently for LPNs, noted that they had many of the same duties as nursing assistants, but also performed more advanced duties such as monitoring oxygen, giving injections, and treating bed sores. An experienced LPN might have the responsibility of creating care plans.

Louisiana LPNs provide direct nursing care. They may also delegate. This is a common occurrence in nursing home settings.

LPN Work Settings and Roles

The Louisiana Center for Nursing published a report in 2015 based on a 2014 survey (http://lcn.lsbn.state.la.us/NursingWorkforce.aspx). It was the second such survey; the first had been carried out four years earlier.

The report described the staff mix at different types of nursing organization (i.e. the percentage of nursing assistants, licensed practical nurses, registered nurses and advanced practice registered nurses).

It was at rural health centers and federally qualified health centers (FQHCs) that the proportion of LPNs was the highest. Here there were more LPNs than nursing staff at any other level, though these facilities employed relatively few nurses overall (particularly the FQHCs). The staff mixed consisted largely of advanced practices nurses and LPNs. (One can assume that the advanced practice nurses were, by and large, acting as healthcare providers.)

LPNs made up a little over 11% of the nursing staff mix in hospital settings – relatively low. On the other hand, they made up almost 30% in both skilled nursing facilities and home health settings. In nursing facilities, the majority of the staff were nursing assistants, not true nurses. Skilled nursing, notably, is the biggest employer of LPNs nationwide. In home health, a slight majority of the staff were RNs. It is more demanding to provide care in this more autonomous environment.

The Louisiana Center for Nursing also looked at vacancies and turnover. There were significantly more LPN separations in nursing facilities than hospital settings.

Varied Employment Options

In March 2018, a scan of LPN job postings revealed diverse options:

They were sought for various practices and clinics within Louisiana, including dermatology, family practice, urgent care, and cardiology.

Assisted living facilities sought them to administer medication, assist residents with activities of daily living, and coordinate services provided by other healthcare professionals.

Some positions were open to healthcare workers with various credentials. A recent example: Field Based Community Healthcare Worker.

Spotlight on Dementia Care

Nursing home life is changing. One area where there has been a lot of attention in Louisiana — and some recognition at the national level — is reduction in use of antipsychotic medication. Nursing homes may care for patients with varying mental health issues. They often have a large population with dementia. There have been recent advances in understanding dementia-related behavior and supporting patients’ core needs. Still, facilities continue to use antipsychotics to manage agitation and facilitate healthcare delivery. Louisiana has brought the percentage way down in recent years. Part of this comes down to state mandates. Facilities with high rates were contacted and asked to come up with a plan. But success is also about organizations – and individuals — sharing ideas.

Louisiana Enhancing Aging with Dignity through Empowerment and Respect (LEADER) holds an annual summit that is open to nurses and nursing assistants as well as administrators and others. Training sessions are applicable to professionals in a variety of settings, including assisted living and adult day care. Among the topics at the 2016 LEADER summit was using music as an alternative to medication to manage the challenges of dementia.

In 2017, the International Symposium on Human Factors and Ergonomics in Health Care found its way to New Orleans, and dementia was again the spotlight. Participants learned how Ambient Activities Technologies could change care; a turn of an old-fashioned knob could call up family photos, music and other personally relevant content such as movie clips and games.

Becoming a Louisiana LPN

Louisiana LPNs are regulated by the Louisiana State Board of Practical Nurse Examiners. Although Louisiana has a separate board for LPNs and RNs, LPN training (LPN programs in Louisiana) and RN training (RN programs in Louisiana) are still tightly connected. A person can complete a qualifying certificate program and take the NCLEX-PN examination for practical nursing licensure. The LPN can, if he or she chooses, later opt for an LPN to RN degree program and examination at the RN level.

Career Outlook and Average LPN Salary in Louisiana

Louisiana LPNs averaged $18.31 an hour in 2016.

Louisiana practical nursing has been projected to see 10% occupational growth over the 2014 to 2024 decade.

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