Practical Nursing in Oregon

Licensed Practical Nurses are a critical part of the nursing workforce. So says the Executive Director of the Oregon Center for Nursing (http://oregoncenterfornursing.org).

The LPN scope of practice includes hands-on care, monitoring of patient condition, and some tasks related to patient education. LPNs have more limited assessment-related duties than RNs. They work under direction. In some cases, LPNs follow standing orders of independent providers.

LPNs typically provide nursing services in settings other than hospital acute care. Patients are often elderly, disabled, or chronically ill. LPNs may work with other populations, including those who require only primary care. Some do work in hospital settings, though the percentage has decreased over the years.

Supporting Individuals who are Elderly, Disabled, or Have Long-Term Illnesses

The Oregon Health Care Association reports that Oregon has long been a leader in long-term services and supports. LPNs have an opportunity to be a part of this healthcare arena.

By far the most common settings for practical nurses in Oregon and around the nation are skilled nursing facilities and long-term care facilities. In Oregon in 2014, 31.4% of the practical nursing workforce –nearly a third — worked in these settings.

These facilities serve multiple purposes: short-term rehabilitation and long-term residences. Short-stay residences may be initiated for many reasons, including a recent stroke, surgery, cardiac event, or accident. Just 9.2% of Oregon’s new nursing home stays last 100 days – this places the state #2 in the nation (http://www.longtermscorecard.org/databystate/state?state=OR). On the other hand, most residents who are in nursing facilities for several months are there for the long haul. Oregon is also #2 with regard to transitioning people who have been in care 90 days or longer back to the community; even so, it’s just 12.7%.

Residents are often, but not always, elderly. 33.7% of the total Oregon LPN workforce consider themselves to have a geriatric or long-term care specialty, and employment in these settings is a big part of the reason! 5%, meanwhile, consider their specialty to be rehabilitation.

6.5% of Oregon LPNs provided home health or hospice nursing care. It can be trickier to provide care in these situations because the nurse doesn’t have all the supports accessible on-site.

Some people who need significant support in meeting health needs live in other settings in the community. These settings also employ LPNs. 2.9% of the LPN workforce is in assisted living; another 3.6% in residential care. These two types of facilities are licensed separately but provide many similar services. Some services must be provided by an RN. Others can be provided by a licensed nurse in either category.

Oregon is #1 in the nation with regard to the number of assisted living units when figured on a per-population basis by the total number of elderly residents.

The American Health Care Association and National Center for Assisted Living have a joint quality development program. Three facilities made it to silver level in 2017: Coast Fork Nursing Center in Cottage Grove, Creswell Health & Rehabilitation in Creswell, and West Hills Village in Portland.

NRC Health provides another perspective on excellence: associate satisfaction. Two Oregon assisted living facilities, Adams House in Myrtle Creek and Rackleff Place in Canby, were recognized in the workplace category in2017.

Oregon boasts a number of long-term care resources (http://www.oregon.gov/DHS/PROVIDERS-PARTNERS/LICENSING/CBC/Pages/resources.aspx).

Employment in Medical Offices, Clinics, and Primary Care Settings

Office and clinic settings employ 21.3% of the state’s LPNs.

Clinics and medical offices are often comprised of care teams with healthcare workers who are credentialed at different levels (http://medicaleconomics.modernmedicine.com/medical-economics/news/heres-how-physicians-can-build-best-care-team?page=0,0). Staffing varies by population and model. Veterans and rural populations are among those served.

The Curry Coastal Pilot provided coverage more than once about a new veteran’s clinic in Brookings. In November of 2017, they announced two new teams, each composed of a provider, an RN, an LPN, and a support assistant who could handle scheduling (http://www.currypilot.com/news/localnews/5783098-151/local-news-briefs).

The following is a sampling of positions for which practical nurses were sought in early 2018:

  • Working as part of a Patient Aligned Care Team (PACT) for a veteran’s clinic
  • Providing varied services for a family practice (for example, taking blood pressure and temperature, administering EKGs, assisting the provider with procedures, providing instruction about medication usage, and updating medical records)
  • Providing support for a gastroenterology team (providing focused assessment and routine triage, helping keep the examination room clean and adequately supplied, using standardized tools to determine patient engagement and identify gaps in care, and performing tests that fell within the LPN scope of practice)

Hospitals employ 10.4%. Hospital employment of LPNs is on the decline nationwide.

Becoming an LPN in Oregon

A prospective LPN will need to earn a certificate or diploma through an approved program (LPN programs in Oregon). This takes about a year; examination follows.

Oregon has a practice requirement. Nurses should be aware that just because they are working in a particular setting, duties performed will not necessarily constitute nursing practice.

Career Outlook and Average LPN Salary in Oregon

LPNs are concentrated in the Western part of the state, particularly the Portland metro region.

Forecasting is tricky business. The practical nursing occupation has been projected to increase by 12.9% in Oregon between 2014 and 2024. Other factors come into play, however, such as the state’s capacity to turn out new graduates. The Oregon Center for Nursing has predicted more than enough LPNs in the years to come. 2018, though, does find some organizations offering sign-on bonuses to LPNs. The bottom line? Opportunities tend to change with changing economies, but nurses who have proved themselves in the field tend to have the most opportunities.

Oregon Licensed Practical Nurses earned an average of $24.11 in 2016 – well above the national average. The Bureau of Labor Statistics equates this to $50,160 for 52 40-hour weeks.

The vast majority of Oregon LPNs work 31 to 40 hours a week: 72%. 10% work 41 or more hours a week.

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