Practical Nursing in Massachusetts

Massachusetts LPNs care for a population that is changing and aging, one that is receiving care in increasingly diverse settings and innovative ways. LPNs often care for older adults. However, some work with children or work across age groups.

Massachusetts LPN Work Settings and Roles

The Massachusetts Department of Health released an LPN overview in 2014 which included data collected at the time of license renewal (https://www.mass.gov/lists/the-massachusetts-health-professions-data-series-rn-lpn). Among the topics addressed: Where were the state’s LPNs working?

42.8% of Massachusetts LPNs cited nursing homes, extended care, or assisted living as their primary work setting; these settings, sometimes referred to as long-term care, are the most common settings nationwide. Another 9.2% of the state’s practical cited home health; home health nurses may work with similar populations but under different circumstances.

11.2% were hospital-based. Physicians’ offices employed another 9.4%. The following settings each employed between 1.5% and 2.5% of the state’s LPNs: community health, school health services, correctional facilities, and community health.

88% of employed LPNs routinely provided direct care. They had varying roles. 53% described their role as staff nurse. The next most common role was charge nurse at 18%. (LPNs are commonly employed as charge nurses in nursing homes.)

The Department of Public Health also asked about practice area. Long-term care was the most frequently cited and by no small amount. The second most common was home health. 6.3% had a rehabilitation focus. Nursing homes themselves notably often have rehabilitation as a main focus. They support recovery after surgeries and medical events such as stroke; they help people who are struggling with chronic conditions like Parkinson’s improve function enough to go back out into the community.

5.4% of the state’s LPN’s had a pediatrics focus. 5.1% reported primary care; this is a practice area that would be common in a doctor’s office setting. The next most common practice areas were mental health/ substance abuse and subacute care; each was reported by 4.6%.

LPN Nursing Home Employment

Early 2018 finds many Massachusetts nursing facilities advertising for practical nurses.

Nursing homes are a varied set. The Centers for Medicare and Medicaid Services rates facilities from one to five stars based on safety inspections, quality indicators, and staffing (https://www.medicare.gov/nursinghomecompare/search.html?).

Four Massachusetts skilled nursing facilities were recognized by NRC Health in 2017 for workplace satisfaction:

  • North Adams Commons Skilled Nursing and Rehabilitation Center
  • East Longmeadow Skilled Nursing
  • Pilgrim Rehabilitation and Skilled Nursing Center in Peabody
  • Mount Greylock Extended Care Facility in Pittsfield

A number of other facilities were recognized for resident satisfaction.

Many nursing homes are changing or going through culture change with the end result being more person-centered care. The Massachusetts Senior Care Association has provided a list of state resources (https://www.maseniorcare.org/culture-change).

LPN Assisted Living Employment

Massachusetts licenses assisted living; some units are licensed to provide special care. In many cases, this means care of individuals with Alzheimer’s or related dementias. Massachusetts assisted living is intended to be something distinctly different than a nursing home living. Massachusetts doesn’t authorize assisted living organizations to carry out skilled nursing services, but, at the same time, it doesn’t mandate that elders leave their homes just because they require them. Skilled nursing services can be provided by a Certified Provider of Ancillary Health Services such as a home health agency; hospice services may also be provided.

An LPN who is hired by an assisted living facility will have a different role than one hired by a nursing home. Assisted living nurses assess resident condition. They also arrange for ancillary services. One recent LPN ad noted that the incumbent would coordinate services through the Visiting Nurses Association; the person would also coordinate therapy services. An assisted living nurse may provide limited medication administration. This can include some duties beyond passing out oral meds, but the nurse won’t administer medication by all the routes that he or she might in a nursing home setting. Supervision of resident care associates is another possible duty. However, a Massachusetts nurse won’t supervise medication administration.

Rising acuity has been a subject of interest and concern on a national level. It’s an issue on which Massachusetts leaders have voiced opinions. Some facilities are part of continuing care communities. Older adults may enter at the independent living level. Here, too, acuity has a way of rising. An experienced LPN may have duties that cross over levels of care. Massachusetts-based Benchmark has noted the value of being proactive at the organizational level.

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Other LPN Employment Opportunities

Clinics, offices, and health systems can provide diverse employment options.

One recent position was for administering hyperbaric oxygen therapy. This particular position might be filled by an LPN or other qualified health worker.

A behavioral health and substance abuse center, meanwhile, sought to fill multiple positions, serving both adult and pediatric populations.

LPN Education for Licensure and Advancement

Licensure is based on education (LPN programs in Massachusetts) and examination.

The Department of Public Health noted in its LPN overview that 96% of the state’s LPNs had qualified for licensure on the basis of certificate or diploma programs. 4% had completed their qualifying education at the associate’s level.

28% of the LPNs already had degrees in other fields. The greatest percentage were at the associate’s level. 1.5% had graduate degrees.

Of course some LPNs can go on to achieve more advanced degrees in nursing. A person can qualify for RN licensure on the basis of a qualifying RN associate’s degree program (LPN to RN programs and LPN to BSN programs).

Career Outlook and Average LPN Salary in Massachusetts

Massachusetts LPNs averaged $26.53 an hour in 2016. Massachusetts is #4 in the nation, coming in just $.26 behind the top paying state, Connecticut.

Massachusetts practical nursing has been projected to see 7% occupational growth across the 2014 to 2024 decade, going from a total employment of 16,460 to one of 17,610.

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