Becoming an LPN in Washington State
LPNs are vital to the operation of healthcare organizations throughout Washington State. LPNs are true nurses, not aides, but have a level of education below that of registered nurse. An academic degree is not necessarily an expectation, though a prospective LPN will need to graduate from an approved LPN program in Washington and pass an examination. The Washington Center for Nursing lists 12- to 18-months as the norm (https://www.wcnursing.org/nursing-practice/roles-in-nursing/).
LPNs work under direction of RNs or other medical professionals. Supervisors could be any of the following: doctors, dentists, podiatrists, midwives, physician assistants.
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LPN Work Settings and Roles
LPNs administer medication, provide treatments and direct care services, collect data for use in patient assessment, and contribute to patient care planning and evaluation. The Washington Center for nursing lists the following among the work settings: long-term care, home care, outpatient, and hospital.
Some settings are more likely than others. There has been nationwide trend toward decreased use of LPNs in hospital settings even as the need for LPNs in long-term care increases.
2018 finds large Washington healthcare systems – Kaiser Permanente, Swedish Medical Center, CHI Franciscan Health – advertising for LPNs to work as part of their teams. Health systems may utilize LPNs in any of many specialized clinics and centers: cardiovascular, women’s health, diabetes education, occupational health. Family practice is a common one. One well-known organization, though, recently sought LPN staffing for the injection room.
Smaller practices are also hiring. Positions can even combine clinic and perioperative/post-operative duties. One recent posting was for LPN to serve a medical practice that combined ophthalmology, dermatology, and medical spa treatments.
Long-Term Care Employment
Nursing facilities are evolving. Facilities may have different units for different types of service, including long-term care, transitional care, and memory care. Transitional care may be authorized for individuals who are recovering after medical events such as strokes, cardiac events, or surgeries or who have required hospitalization for acute flare-ups of chronic or progressive disease. Memory care is for those with Alzheimer’s and other dementias.
Employment in nursing home settings is in some sense specialized because of the trend toward more specialized units and the trend toward using consistent staff assignments to improve care and deepen relationships. A different type of specialization can occur after LPNs have been on the job for a period of time. Some LPNs, for example, become charge nurses.
Assisted living represents an alternative for residents and staff. Residents may be attracted to the lifestyle. Washington State, meanwhile, views assisted living as a cost effective alternative to nursing home care. Some residents receive Medicaid assistance. Facilities that operate under assisted living and other closely related contracts may administer medication and offer various nursing services, including diabetic management and even ostomy care and tube feedings.
Washington is #3 in the nation with regard to number of assisted living and residential units per 1,000 elderly residents (http://www.longtermscorecard.org/databystate/state?state=WA). The state is also #3 at transitioning long-stay residents back to the community. It is #10 in eliminating burdensome transitions for individuals with moderate or severe dementia who are at the end of their lives.
LPNs are an important part of the picture. Nurses in many parts of the nation have seen an uptick in hiring by assisted living and senior care facilities. LPNs are sometimes considered for high level positions. A 2018 scan of Washington job postings finds job titles such as Resident Care Director, even Director of Clinical Services. One organization cited risk management among the roles and responsibilities.
Memory care is offered in settings other than nursing homes. Some assisted living programs contract with the state to provide services to needy individuals. These Specialized Dementia Care Programs take part in a continuous quality improvement program (https://www.dshs.wa.gov/altsa/home-and-community-services/continuous-quality-improvement-specialized-dementia-care-program).
In the modern age – and particularly in the better facilities— memory care can mean far more than keeping people with dementia safe from harm. Approximately 75 Washington facilities are certified in Music and Memory, a program that utilizes personalized music to enhance cognitive and socio-emotional functioning. King 5 News recently highlighted another way that some communities are improving lives of people with dementia: technology. King 5 describes the iN2L dementia program as something akin to a giant iPad (https://www.king5.com/article/news/local/interactive-technology-helping-improve-memory-care/281-515858929).
Notable Facilities
The American Health Care Association and National Center for Assisted Living have a joint program to foster and reward quality. Achievement levels are progressive. Several Washington facilities achieved silver level in 2017: Prestige Assisted Living at Hazel Dell in Vancouver, Puyallup Nursing & Rehab, and Summer Hill Assisted Living in Oak Harbor. Some AHCA/ NCAL recipients from prior years remain active and could continue the journey.
Summer Hill Assisted Living also won a 2017 workplace award through NRC Health; this honors signifies a facility that is widely recommended by its associates.
Public and Community Health Roles
Community clinics and community psychiatric clinics hire LPNs.
Even in the population health arena, LPNs play some role. The Washington Center for Nursing provided a brief profile of a clinic LPN who has a role in reducing chronic illness through the Healthy Planet Program (https://www.wcnursing.org/nursing-practice/Nursing_Roles_Outside_the_Hospital). She emphasizes that nurses at the LPN level are valued and can make a difference.
Those who want to play an even larger role in improving health (whether at the individual or population level) may eventually choose to continue their educational journey and become registered nurses.
LPN Salary in Washington and Career Outlook
Washington State LPNs enjoyed a mean wage of $25.56 an hour in 2017. There is some variation in wages from one area to the next (though some of the high wage areas also have higher cost of living). The $27.55 per hour reported for the Seattle-Bellevue-Everett area tops the scale. Much of central Washington reports wages ranging from just over $22 to just over $23 an hour; this area includes Yakima and Wenatchee as well as large areas considered nonmetropolitan. The range within metropolitan areas is actually greater. In the Seattle area, LPNs at the 10th percent earn $20.82 while those at the 90th percentile earn $34.84.
Washington has been projected to see 2.9% LPN occupational growth between 2017 to 2019, going from a base of 7,560 up to 7,780. Between 2014 and 2024, growth of nearly 10% has been projected.
The Tacoma-Lakewood metropolitan area has the highest concentration of jobs, according to the most recent BLS data.
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