Licensed Practical Nurse (LPN)

Licensed practical nurses (LPNs), care for the sick, injured, convalescent, and disabled under the direction of physicians and registered nurses.

Most LPNs provide basic bedside care. They take vital signs such as temperature, blood pressure, pulse, and respiration. They also treat bedsores, prepare and give injections and enemas, apply dressings, give alcohol rubs and massages, apply ice packs and hot water bottles, and monitor catheters. LPNs observe patients and report adverse reactions to medications or treatments. They collect samples for testing; perform routine laboratory tests, feed patients, and record food and fluid intake and output. They help patients with bathing, dressing, and personal hygiene, keep them comfortable, and care for their emotional needs. In States where the law allows, they may administer prescribed medicines or start intravenous fluids. Some LPNs help deliver, care for, and feed infants. Experienced LPNs may supervise nursing assistants and aides.

LPNs in nursing homes provide routine bedside care, help evaluate residents' needs, develop care plans, and supervise the care provided by nursing aides. In doctors' offices and clinics, they also may make appointments, keep records, and perform other clerical duties. LPNs who work in private homes also may prepare meals and teach family members simple nursing tasks.

Training and Qualifications

All States and the District of Columbia require LPNs to pass a licensing examination after completing a State-approved practical nursing program. A high school diploma, or equivalent, usually is required for entry, although some programs accept candidates without a diploma or are designed as part of a high school curriculum.

In 2000, approximately 1,100 State-approved programs provided practical nursing training. Almost 6 out of 10 students were enrolled in technical or vocational schools, while 3 out of 10 were in community and junior colleges. Others were in high schools, hospitals, and colleges and universities.

Most practical nursing programs last about 1 year and include both classroom study and supervised clinical practice (patient care). Classroom study covers basic nursing concepts and patient-care related subjects, including anatomy, physiology, medical-surgical nursing, pediatrics, obstetrics, psychiatric nursing, administration of drugs, nutrition, and first aid. Clinical practice usually is in a hospital, but sometimes includes other settings.

LPNs should have a caring, sympathetic nature. They should be emotionally stable because work with the sick and injured can be stressful. They also should have keen observational, decision making, and communication skills. As part of a healthcare team, they must be able to follow orders and work under close supervision.

Registered Nurse (RN)

Registered nurses (RNs) work to promote health, prevent disease, and help patients cope with illness. They are advocates and health educators for patients, families, and communities. When providing direct patient care, they observe, assess, and record symptoms, reactions, and progress; assist physicians during treatments and examinations; administer medications; and assist in convalescence and rehabilitation. RNs also develop and manage nursing care plans; instruct patients and their families in proper care; and help individuals and groups take steps to improve or maintain their health. While State laws govern the tasks that RNs may perform, it is usually the work setting that determines their daily job duties.

Training and Qualifications

In all States and the District of Columbia, students must graduate from an approved nursing program and pass a national licensing examination to obtain a nursing license. Nurses may be licensed in more than one State, either by examination, by endorsement of a license issued by another State, or through a multi-State licensing agreement. All States require periodic license renewal, which may involve continuing education.

There are three major educational paths to registered nursing: associate degree in nursing (A.D.N.), bachelor of science degree in nursing (B.S.N.), and diploma. A.D.N. programs, offered by community and junior colleges, take about 2 to 3 years. About half of the 1,700 RN programs in 2000 were at the A.D.N. level. B.S.N. programs, offered by colleges and universities, take 4 or 5 years. More than one-third of all programs in 2000 offered degrees at the bachelor's level. Diploma programs, administered in hospitals, last 2 to 3 years. Only a small number of programs offer diploma-level degrees. Generally, licensed graduates of any of the three program types qualify for entry-level positions as staff nurses.

Individuals considering nursing should carefully weigh the pros and cons of enrolling in a B.S.N. program because, if they do so, their advancement opportunities usually are broader. In fact, some career paths are open only to nurses with bachelor's or advanced degrees. A bachelor's degree is often necessary for administrative positions, and it is a prerequisite for admission to graduate nursing programs in research, consulting, teaching, or a clinical specialization.




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