Practical Nursing in New York
Many New York residents – often elderly, disabled, or convalescent – rely on Licensed Practical Nurses to meet their healthcare challenges.
Buffalo News recently profiled a couple with Down Syndrome, married 24 years, who had found housing that would allow them to stay together in a traditional home setting despite the challenges of the husband’s early onset dementia (http://buffalonews.com/2018/02/13/sean-kirst-for-valentines-day-a-quiet-but-monumental-love-story). The couple had had various other forms of support along the way. In the accompanying photograph, one sees the wife self-administering insulin while an LPN observes the process.
For some nurses, it’s all in a days’ work. LPNs provide care, and they also genuinely care. The New York State Department of Labor notes that they are found in many places, including nursing homes, clinics, private practices, hospitals, and, yes, private homes.
Becoming an LPN is not a lengthy process. A person must complete an approved New York program (LPN programs in New York) or an acceptable out-of-state or military-based program. The program may be completed in less than a calendar year. Licensure is by examination.
New York places some limitations on the scope of LPNs, not surprising given their lower level of training. New York LPNs don’t assess or do triage. They are prohibited from carrying out various technical tasks such as IV administration of chemotherapy agents. They do carry out duties that support assessment, such as careful observation.
The trend nationwide is for LPNs to represent a smaller portion of the nursing staff mix in hospital settings than they did in years past.
LPN Work Settings and Roles in New York
There have been changes over the years in typical work settings. Partly, this is a result of changes in patient acuity and in what services are available in what settings. The Times Union reported that Samaritan Hospital in Troy had eliminated its inpatient LPN positions (https://www.timesunion.com/business/article/Troy-s-Samaritan-hospital-eliminates-22-LPN-jobs-9132685.php). The chief medical officer noted that many services were now provided in outpatient settings and that hospitals were mainly for the sickest. Limitations in LPN scope meant that it no longer made sense to include them as part of their hospital staff mix. Health system officials stated, though, that LPNs remained in high demand in other areas, including primary care as well as long-term care.
Nursing facilities are among the most common LPN work settings nationwide. Nursing facilities provide post-acute rehabilitative care as well as long-term nursing care. They may boast different types of specialized unit, for example, neurobehavioral intervention. Rochester General Health notes that neurobehavioral intervention is for residents who have dementia and also psychiatric conditions.
Assisted living represent an alternative. New York has changed its laws to allow residents to age in place in assisted living. What this means: more acuity in these settings. Care for high-needs patients requires enhanced licensure.
When certain requirements are met, facilities can retain residents with very low mobility (e.g. chronically chairfast) or in need of more than intermittent or occasional skilled nursing services. New York code differentiates between residents who require less than continual 24 hour care and those that do. However, if all conditions are met, people in either category can remain. Examples of less-than-24-hour skilled care include colostomy care, eye drops, and injections. In some cases, residents contract directly with outside providers for 24-hour care. Lawyers Caroline J. Berdzik and Julia McMillen noted that the changes meant that assisted living organizations would need more nurses on board, both RNs and LPNs (https://www.ahcancal.org/ncal/operations/risk-management/Documents/AssistedLiving.pdf).
Flash forward a few years from the time the law went into effect: Some tasks must fall to an RN — they are the ones whose scope includes assessment — but assisted living facilities are also hiring plenty of LPNs.
The American Health Care Association and National Center for Assisted Living have teamed up to offer a quality development program with three successive levels. The highest, gold, represents rare achievement. Ten New York facilities achieved the silver level in 2017.
Home care agencies represent another viable employment avenue. One can visit the website of NYS Health Profiles to see which organizations serve which areas and also look up quality indicators.
Working with Pediatric Populations
Although it is very common for LPNs to work with geriatric populations, they serve all age groups, including children. Pediatric patients include generally well populations as well as populations with chronic needs.
As winter draws to a close, many organizations look ahead to hire camp nurses. Camp nursing can be a supplement to other nursing work — and to a rich career. The International Nurses Association recently welcomed one New York LPN to Worldwide Leaders in Healthcare (https://www.prnewschannel.com/2018/02/06/highly-respected-licensed-practical-nurse-jodi-tanzman-lpn-will-be-presented-in-the-worldwide-leaders-in-healthcare-2/). She had spent more than two decades as a camp nurse. Other areas of expertise include mother-baby nursing. She currently works at a hospital. Her practical nursing education has also allowed her to serve closer to home; she heads the health committee at her own children’s school.
LPN Career Advancement
Some level of advancement is possible with LPN licensing. However, many positions depend on academic progression. New York has an articulation model whereby qualified practical nurses can matriculate into the second year of an RN program, earning credits for their LPN education (http://www.jtln.org/article/S1557-3087(16)30016-6/pdf).
LPN Salary in New York and Career Outlook
New York Licensed Practical Nurses earned an average hourly wage of $22.68 in 2016. Potentially, this is $47,170 a year.
Those living in the New York City area typically make more than their counterparts in other areas of the state. LPNs in the Nassau County-Suffolk County Metropolitan Division, New York-Jersey City-White Plains Metropolitan Division, and New York-Newark-Jersey City Metropolitan Area average more than $25 an hour. There is still a wide range. 2016 BLS figures had LPNs at the 10th percentile making a little over $20 an hour here while those at the 90th percentile made over $30 – potentially, well over 60K a year.
The practical nursing profession has been projected to see 18% occupational growth in New York across the 2014 to 2024 decade.
Syracuse.com recently spotlighted practical nursing as one of Central New York’s hottest jobs (http://www.syracuse.com/cny-job-hunt/2017/02/hot_job_in_cnys_job_hunt_licen.html).
The Center for Health Workforce Studies provided information about general hiring trends in different types of healthcare facility. The data is not specific to LPNs. Nursing facilities have actually seen a slight decline in overall employment in the very recent past, though this was uneven, with some areas reporting increases. Home care employment in general has seen a steep rise in New York in the 21st century; the trend continued through the most recent reporting period.
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