Practical Nursing in Montana

Montana’s Licensed Practical Nurses provide patient care in diverse settings — in a geographical sense as well as a professional one. LPNs work under the supervision of registered nurses or other healthcare professionals (for example, doctors, physicians, or physician assistants).The LPN scope of practice includes using standardized procedures to care for people who are sick or incapacitated and administering medications and other prescribed treatments. Although LPNs are supervised healthcare workers, their role can extend as far as charge nurse if they are employed by a long-term care or intermediate care facility.

One can become an LPN with a Certificate of Applied Science in Nursing from an approved program, though associate level education is becoming common (LPN programs in Montana); licensure is also dependent on passing the NCLEX-PN.

LPN credentialing is good preparation for employment in a variety of healthcare organizations, from nursing homes to clinics, though advancement opportunities are limited for those who do not advance their education. In Montana, as in other states, prospective nurses who have their heart set on hospital employment will do well to seek education beyond the LPN level.

A Snapshot of the Montana LPN Workforce

The Montana Department of Labor & Industry published a nursing status workforce report in 2016; results were based on a 2015 national survey (https://lmi.mt.gov/Portals/135/Publications/LMI-Pubs/Labor%20Market%20Publications/NursingReport2016.pdf). There were some differences between trends statewide and nationwide. Ambulatory settings provide same-day services. In Montana, employment in ambulatory care settings very slightly topped employment in nursing homes and extended care settings. (More often, it’s nursing homes and extended care settings that come out on top.) Nonetheless employment in these two categories was relatively equal: 22% vs 21%. Assisted living, a closely related work setting, was treated as a separate category; these facilities employed 4%.

Hospital was the primary work setting for 14% of Montana LPNs – this is a little higher than it is in many states. Home health, meanwhile, employed 7% — this is an area that tends to be big nationwide. As for the remaining LPNs, they are found in organizations throughout the community. Community health settings employ 6%; public health, 3%. School health is the primary work setting for 2% of Montana LPNs; correctional facilities, another 2%. There are many settings possible; 19% fall into the “other” category.

Varied options remain. A 2018 Montana LPN job search calls up a number of positions in long-term care at both the staff nurse and charge nurse level. Various clinics and practices are advertising as are home care and private duty organizations. Among the other settings for which practical nurse have recently been sought: a dialysis center, a correctional institution, a youth residential treatment facility, and the mother-baby unit of a hospital. LPNs are among those considered for roles as diverse as clinical liaison, community health worker, and community educator.

Spotlight on Long Term Care and Assisted Living

Modern nursing facilities provide short-term rehabilitative and post-acute services as well as traditional long-term care. Residents may be receiving intensive therapies as well as nursing treatments such as IVs, tube feedings, and support with medically necessary equipment.

Assisted living provides services for residents with varying levels of acuity. The Montana Senior & Long Term Care Division notes that residents range from those who only need personal care assistance to those who need care at almost the level of a nursing home (http://dphhs.mt.gov/sltc/homelivingoptions#147881271-i-need-to-move-from-my-place-but-i-dont-need-a-nursing-home). Facilities are licensed as Category A, B, or C. Among the duties of LPNs who work with residents beyond the personal care level: medication administration.

One will often find facilities offering separate memory care services. Assisted living residences sometimes also accommodate short-stay residences who are convalescing or who have at-home caregivers who require occasional respite.

The American Health Care Association and National Center for Assisted Living recognize quality through three progressive levels of commitment and achievement. Three Montana facilities achieved silver level through AHCA/ NCAL in 2017. The list includes two assisted living communities, the Villa Assisted Living at Valle Vista in Lewistown and Westpark Village in Billings. It also includes one community that boasts a skilled nursing and rehabilitation center, the Cedar Wood Healthcare Community in Red Lodge.

Westpark Village was also recognized by NRC Health in 2017 as being in the upper echelon for both associate and resident satisfaction.

One will find elders with dementia residing in both assisted living and skilled nursing facilities. Fortunately, there is a lot going on in the world of dementia care at both the state and national levels. The State Dementia Coalition noted the following among Montana’s recent efforts and accomplishments: creation of a Google Group (Montana Nursing Homes Working Together), provision of in-services and online resources, coaching calls, stakeholder meetings, and training and encouragement for use of the Music and Memory program (https://www.nhqualitycampaign.org/files/State_Dementia_Care_Coalition_Best-Practice_Strategies.pdf).

Career Outlook and Average LPN Salary in Montana

Montana Licensed Practical Nurses earned a mean wage of $19.68 an hour in 2016 — $40,920 a year, when figured as 52 40-hour weeks. The median was nearly the same: $19.75.

The 2015 status report breaks Montana LPN salary down by category. For those employed in the capacity of staff nurse – the most common role – the average salary was $36,000; the average number of hours, 40 per week. Nurse managers made an average of $43,860 a year and also worked an average of 40 hours. LPNs in some leadership roles received even greater compensation.

12% LPN occupational growth has been projected for Montana over the course of the 2014 to 2024 decade.

The status report noted that only 2.9% of the state’s LPNs fell into the unemployed but actively looking category – a rate lower than the national average (but not quite as low as the Montana RN ‘unemployed but looking’ rate).

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