Practical Nursing in Maryland

Maryland Licensed Practical Nurses work across healthcare settings carrying out essential nursing duties such as medication administration, tube feedings, assessment, and treatment of skin ulcerations. Unlike their RN counterparts, they most often provide care below the acute level. This can still make for many diverse career options!

According to a 2015 workforce survey, nursing home or extend care settings are the primary workplace for fully 37.5% of Maryland LPNs (http://mbon.maryland.gov/Documents/workforce-data-pn-rn-2015.pdf). This is the largest subset of the LPN workforce, not only in Maryland but around the nation.

Another 17.6% of Maryland LPNs work in home health. 8.3% are stationed in hospitals. This is a setting that is becoming less common for practical nurses in most parts of the nation; Maryland’s figures are not atypical.

Assisted living and ambulatory care are both relatively common work sites for Maryland LPNs, employing 6.9% and 6.8% respectively. Assisted living has been on the rise around the nation in recent years.

School health services employ 4.2% of the state’s practical nurses. As for the others? They are found in a wide variety of settings including community health, public health, and correctional facilities.

More than 20% noted a secondary employment setting. Much larger percentages (13.8% and 29.6%, respectively) report secondary employment in assisted living or home health settings.

LPNs were also asked about their specialty. This question captures more nuance with regard to populations served and areas of expertise developed. LPNs employed in clinics and hospitals serve varied populations. 6.6% of Maryland LPNs consider their specialty to be pediatrics; 2.9% adult health or family health, and 5.4%, primary care. 4.3% have a general medical-surgical specialty; this is a common hospital specialty around the nation. Much smaller numbers report specific medical specialties. Oncology is reported by only .1% of nurses at the LPN level. (At the RN level, though, the rate increases to 2.5%.)

32.9% of LPNs consider their specialty to be gerontology or geriatrics — not surprising given how common it is for LPNs to be employed in settings that serve primarily a senior population. 6.2% report rehabilitation. Increasingly, rehabilitation – re-building physical and functional capacity – is a function of nursing centers. 4.6% of Maryland LPNs, meanwhile, reported mental health, psychiatry, or substance abuse specialties.

Many Maryland practical nurses reported working with special populations or working in specialty areas. 18.7% noted work in the developmental disabilities arena; 7.8%, work in correctional settings. 2.6%,meanwhile, worked as camp nurses. 1.3% selected faith-based care; 1.6%, holistic health.

3.9% were travel nurses. This doesn’t denote a particular population or clinical focus. It means the nurse travels for relatively short stints to serve unmet staffing needs (typically commanding a high wage).

71.2% of those surveyed reported that they were staff nurses in their primary position – this term is often used for nurses who count direct patient care as their main duty. 5.3%, interestingly, selected clinical nurse leader. While nurses at different levels may provide clinical leadership, this is a title used more often around the nation to denote a graduate level clinical role. 4.1% of Maryland LPNs described themselves as nurse managers and 1.4% as case managers. 11.8% indicated they were in health-related roles other than the given choices.

Spotlight on Assisted Living and Home Care

Maryland licenses assisted living at multiple levels: low, moderate, and high. Distinctions are made in part based on the number of activities of daily living that the resident needs assistance with and how much assistance they need. Other health issues also come into play. At Level III, facilities provide or ensure access to comprehensive services.

Maryland assisted living facilities count assistance with medication among their obligations. At the highest level, at least, they are responsible for medication administration.

Sometimes assisted living facilities seek waivers to continue to care for individuals whose needs have moved beyond the level the particular facility is generally authorized to meet.

The Maryland Health Care Commission has provided information about the state’s assisted living facilities (http://mhcc.maryland.gov/consumerinfo/longtermcare/AssistedLiving.aspx). Also available is information about other innovative options, including adult day care.

Home health and other home care services have become common delivery models. These organizations employ nursing staff with a mixture of skill sets and credential levels to provide care within their scope of practice. Home Care Magazine recently profiled Family & Nursing Care, a family-run organization with a 50-year history (https://www.homecaremag.com/providers-provider-profiles/september-2017/major-milestone-private-duty-homecare). The organization has been around since care in home settings was a fairly new concept.

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Becoming a Maryland LPN

Prospective LPNs complete approved programs – generally relatively short ones – before attempting the NCLEX licensing examination. According to the 2016 survey, 78.4% of Maryland LPNs had qualified for their initial nursing license with a certificate, and 18.2% with a diploma. 2.8% had earned associate’s degrees in nursing (LPN programs in Maryland).

Many Maryland LPNs do have other degrees, though not necessarily in nursing. Nearly 10% reported holding a bachelor’s degree in some other field as their highest degree.

LPNs can and do progress to the RN level. Many have earned their RN with a degree at the associate’s level. However, some nurses progress straight to a bachelor’s degree, or BSN. The Board has even approved one online LPN to BSN program (LPN to BSN programs).

Even short, noncredit courses can improve one’s practice. The Board recommends taking a free cultural competency course.

Average LPN Salary in Maryland

Maryland Licensed Practical Nurses earned a mean hourly wage of $24.99 in 2016, according to the Bureau of Labor Statistics. The BLS figures this at $51,980 for 52 40-hour weeks. The median is only very slightly less: $51,640.

According to the 2015 workforce survey, Maryland LPNs earned a median $43,000 from their primary position. Between 18% and 21% of survey respondents fell into each of the following brackets: $30,000 to $40,000, $40,000 to $50,000, $50,000 to $60,000, and over $60,000. The vast majority of those who reported a secondary position made less than $20,000 a year from it.

The median number of hours worked by Maryland LPNs is indeed 40, according to the workforce survey. There was a wide range, with approximately 85% reporting somewhere between 16 and 50. More than 9% reported more than 50 hours.

Maryland has been projected to see 35% LPN occupational growth across the 2014 to 2024 decade.

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