Becoming an LPN in North Dakota
People who serve as LPNs in North Dakota are filling important roles in healthcare facilities throughout the state. 2018 finds employers postings jobs in nursing homes, clinics, and other healthcare settings.
Potentially, there is a lot an LPN can do. Allowable duties are determined by scope of practice and also by individual competency. LPNs may supervise nursing staff with the same or lower levels of credentialing, administer medication, carry out IV-related duties, and provide health education according to established protocol.
North Dakota places some limits on technical duties. An LPN doesn’t administer chemotherapy, for example. State code also places limits on level of autonomy. RNs are responsible for creating the initial plan of care for individual patients, but LPNs may contribute to it and modify it.
In some settings, LPNs may work with less immediate supervision and support than others. One example: the Critical Access Hospitals (CAHs) hospitals that very rural areas rely on. They have very low numbers of acute care beds, and many patients are transferred elsewhere for care. Staffing requirements are different in these facilities.
Becoming an LPN and Advancing
North Dakota LPNs may pursue their training at the certificate or associate’s degree level (https://www.ndbon.org/Education/Academic/Programs.asp). State administrative code sets general standards for practical nursing program approval and additional standards for approval of LPN programs in ND at the associate’s level. Among the additional content at the associate’s level is IV-related theory and clinical experience, data collection, management, and computer literacy.
Some individuals become LPNs as part of the pathway toward registered nurse (https://www.thedickinsonpress.com/lifestyle/4332397-dsu-nursing-program-celebrates-50-years). For others, licensing as an LPN is an end goal.
Some organizations are struggling to fill positions, both LPN and RN. State organizations collect data about the nursing workforce. From recent reports, a portrait of need emerges.
The Governor’s Nursing Workforce Task Force reported in 2017 that there had been 1,807 LPN job postings over a 12-month period – somewhat more than those for the previous reporting period. The 2016 LPN vacancy rate was estimated at 4.97%. This was not as high as the RN vacancy rate. Given the expected increase in – and aging of – the North Dakota population over the next 15 or so years, the task force believed it would be a “formidable challenge” to meet the needs for nurses at both the LPN and RN levels.
North Dakota actually has a higher than average number of LPNs when figured on a per-capita basis, but the task force notes that averages do not reflect the needs of a health care delivery system with high percentages of elderly and rural residents. Practical nursing is considered “bright outlook” based on expected 2014 to 2024 growth rates.
The North Dakota Nursing Facility Workforce Survey Chartbook: 2016 was produced by the Center for Rural Health in collaboration with the North Dakota Long Term Care Association; it provides an overview of the challenges nursing facilities have faced trying to meet their staffing needs.
In nursing home settings, the vacancy rate for LPNs was estimated at 10.5%. Isolated small rural facilities had the highest vacancy rate at 16.9%. Urban facilities had the lowest rate; even here, though, it was 6.3%. When considered from a geographic standpoint, the vacancy rate was highest in the Northwest part of the state, followed by the Northeast.
Many facilities reported that LPN positions were somewhat difficult or very difficult to fill. The #1 cited reason was availability and qualifications of potential LPNs. The second was location. Pay was a somewhat distant third. Wages and benefits emerged as a more significant factor in retention. 37.7% reported it as the most important factor (or at least noted it among their reasons, if they gave more than one). Competition from hospitals located in the vicinity of the facility, meanwhile, was reported by 13.1%. There were significant differences in urban and rural responces.
The percentage of contract LPNs was 12.6% in rural settings and 5.4% in non-rural ones; a portion of contract labor usage, too, is probably due to difficulty filling positions.
What were nursing facilities doing to retain the workers they had hired? They most often cited strategy involved pay, benefits, and other incentives. Next on the list: a good work environment. Some facilities cited educational benefits or flexible scheduling.
The Grand Forks Herald has reported that hospital systems are using recruiting services to meet the challenges of recruiting high-caliber RNs and LPNs (https://www.grandforksherald.com/business/healthcare/4422018-recruiting-company-aims-help-nd-hospitals-find-nurses-tight-job-market).
Nationally Recognized Facilities
Various organizations weigh in on nursing facility quality or provide reviews. The American Health Care Association and National Center for Assisted Living recognize facilities through three progressive levels of quality improvement. One North Dakota facility, Sheyenne Care Center in Valley City, was recognized at the silver level in 2017. Four North Dakota facilities had active recognitions at the bronze level as of early 2018: Tufte Manor, Valley Eldercare Center, Wheatland Terrace, and Woodside Village, all located in Grand Forks.
North Dakota LPN Salaries
North Dakota Licensed Practical nurses earned an average of $21.68 an hour in 2017. 80% made between $16.77 and $27.66. (10% were below this range; another 10%, above.)
The North Dakota Center for Nursing can connect interested individuals with mentors (https://www.ndcenterfornursing.org/nurse-mentors). The published list includes primarily nurses who hold higher level of credentialing, but there are some LPNs. The North Dakota Center for Nursing is also a source of scholarship information (https://www.ndcenterfornursing.org/scholarships).
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