Practical Nursing in Michigan

Michigan’s Licensed Practical Nurses provide nursing care in settings like nursing homes, doctors’ offices, and private homes. The people they care for are often frail, chronically ill, or convalescent. Some LPNs, though, care for people with average health; they assist healthcare providers in providing primary care.

LPN is the lowest nursing license but not the lowest rung on the nursing career ladder. LPNs have more training than CNAs and indeed often provide some level of oversight.

LPNs may achieve high levels of technical competence. One home health employer recently advertised a lengthy list of duties that an LPN might be called upon to perform. The list included trach and ventilator care, catheter insertion, changing of dressings, and some types of oxygen administration. The nurse might also perform various tasks related to basic hygiene and activities of daily living. He or she might assist with physical examination.

Practical Nursing Education in Michigan

State code mandates that Michigan educational programs for practical nursing be at least one year in length, including prerequisites (LPN programs in Michigan). Examination is part of the qualification process.

Michigan nurses have a continuing education requirement. There can be advantages to going beyond the minimum. Although specialty certifications do not have the level of importance that they do at the higher level, some employers do value them. One employer, for example, recently noted Certified Brain Injury Specialist (CBIS) Certification.

LPN Work Settings

The Michigan Public Health Institute publishes an annual report of the nursing workforce (https://www.minurse.org/survey/data.html). MPHI publications indicate that Michigan’s LPNs are found predominately in four work settings: long-term care facilities, assisted living facilities, physician offices, and home health. Small numbers, though, can be found in many places– settings run the gamut of healthcare and include some places we don’t traditionally think of as healthcare settings at all.

LPNs have a far greater likelihood pf being employed in each of these four settings than do RNs. This is also the case with some less common settings such as rural health clinics and correctional facilities. When one considers that there are well over five times as many RNs as LPNs, it is only in the assisted living arena that LPNs significantly outnumber RNs in sheer numbers. There is a slight predominance of LPNs in long-term care facilities. This is the setting that employs the most practical nurses. MPHI estimates the percentage of LPNs working in long-term care at 46.6%.

LPNs are less likely than their more highly trained RN counterparts to be employed in hospital inpatient settings. Hospital inpatient is still the 5th most common setting, though, accounting for 6.8%. The 2015 report, though, reported 11%; the 2013 report, 13%. In 2006, the proportion had been 18.6%.

Almost as many LPNs work in outpatient settings as inpatient ones (if one combines hospital outpatient and nonhospital outpatient jobs). This arena does not show as much decline over the years – but it is an area that is somewhat RN-dominated.

MPHI also reports clinical practice setting; this corresponds more closely to area of focus. By far the most common is geriatrics or elder care. The next most common is case management — this accounts for more than 18%. The third most common is long-term or sub-acute care, followed by rehabilitation. Other common areas of practice include family practice, medical-surgical, pediatrics, case management, and psychiatric/ mental health. Hospice/ palliative care, internal medicine, obstetrics, cardiac care, and patient education are not uncommon practice areas – each represents 1% to 2% of the LPN workforce.

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LPN Practice Areas and Roles

LPNs, by and large, spend their time providing direct care. They monitor vital signs; administer medications, fluids, and nutrients; care for skin ulcerations and other wounds; and carry out other treatment protocols – all the while, offering words of reassurance or explanation. Some, though, have roles other than direct patient care. The most common one is care coordination, reported by 18.7%. Quality improvement is reported by 11%. 8.3% of those outside direct care report acting as admissions nurse. 8.3% also report engaging in triage. 6.2% act as nursing administrators while 5.7% count nursing education among their duties. Other roles include nurse faculty and discharge nurse.

Today’s LPNs work as part of healthcare teams. Most participate in what is considered professional activity, with the most common being clinical discussions and discussions of roles and responsibilities.

Spotlight on Assisted Living

11.1% of the state’s LPNs are employed in assisted living. Assisted living residences are for individuals who have needs below the nursing home level. Residents may be elderly or disabled but do not need 24-hour nursing care. Michigan does not license assisted living per se but many facilities require licensing as homes for the aged or adult foster care homes. There is a separate set of criteria for each. Size is only part of what differentiates the two. Adult foster homes care for no more than 20 residents. However, the Michigan Association for Assisted Living notes that some developments have “twin twenties”; they have more than one facility on their campus that is technically an adult foster home.

Some communities contract with organizations for services. In some cases, this means they do not meet mandatory licensing mandates. They may provide some services and arrange for or connect people to others. Still, they are in a position of responsibility and need knowledgeable staff.

The organizations themselves typically use the terms “assisted living” and “memory care”. These terms are in use around the nation. Another is senior living; these communities may include a continuum of care with on-site skilled nursing facilities.

A common duty is oversight of the medication program. Another is “making rounds”. 2018 finds a number of assisted living facilities advertising for LPNs – and considering them for positions as high as clinical director. An LPN in this role would count coordination of nursing care among his or her duties.

Career Outlook and Average LPN Salary in Michigan

Occupational projections place Michigan LPN occupational growth at 6% for the 2014 to 2024 decade.

Michigan LPNs earned an average of $22.43 per hour in 2016.

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