Education

The educational requirement for LVN/LPN’s is 12 to 18 months. During that time student nurses learn much about human bodies and how they function, and about sickness and what to do about it. A true education changes the way people see the world. With continuing education, learning will become a habit for your whole career. In the words of the song “Colors of the Wind,” from Pocahontas, “You’ll learn things you never knew you never knew.” Obtaining an education and applying it will set a good example for your children.

Opportunity

According to the US Bureau of Labor Statistics, the field of Licensed Practical and Vocational Nursing (LPN/LVN) is likely to grow and provide more opportunities than ever as the US population ages. Baby boomers, born between 1946 and 1964, when men who had served in World War II came back to civilian life and started family, are reaching 65 and older and will continue to need more health care. The number of jobs for LPN/LVNs is expected to be 21 per cent greater in the year 2028 than it was in the year 2008.

Wages

Wages for LVN/LPN’s are higher than what is earned in many occupations that require less education and fewer skills. Licensed vocational or practical nurses can make an average of $42,590.00 per year working in skilled nursing facilities and an average of $37,480.00 per year working in physician’s offices. The coming increase in the need for LVN/LPN’s will be mostly in skilled nursing facilities, which are the settings that offer the highest wages. Parents with LVN/LPN licenses can do more for their spouses and children than they could be working at lower-paying jobs and that can make a difference for generations to come if they are able to pay for good educations for their children.

Advancement

Some licensed practical or vocational nurses can supervise other LVN/LPN’s or nurses’ aides. Some hospitals have programs for licensed nurses to advance to become registered nurses (RN’s). If you return to school to become an RN, you will already be over any fears you might have had about working in hospitals and dealing with patients as a young nurse, and feel confident to jump in and go to work. Many of the procedures you will learn as an RN might be tasks you are already familiar with, but will be ready to learn more about why you do things the way you were taught.

Chance to help others

Actress Bette Davis famously said that old was not for sissies. Suffering from breast cancer and a stroke during her 81 years, she knew what she was talking about. Elderly people face indignities that they did not perhaps expect when they were young and healthy, or even middle-aged and healthy. Licensed nurses, who give direct care in most cases, can aid a patient with Parkinson’s disease who has become “frozen” to walk. With the nurse, the patient is able to reach the restroom, the dining room, or his or her bed, which is necessary but not always possible with a severe disability. Bowel control is a frequent, embarrassing problem among elderly people, and a cheerful nurse can perform a quick, efficient cleanup job and restore the patient to feeling clean and normal again, and then get the prescribed medication to get things back to normal again, or report a difficulty so that the appropriate medication can be prescribed. The patient who is not able to move in bed or in a wheelchair can develop painful pressure sores. Thanks to efficient licensed nurses giving primary care, patients can be moved often enough to prevent too much pressure on any one spot from causing a sore.

When your child or your neighbor’s child is running a fever you’ll know when to start giving an alcohol bath and when to take the child in to see the doctor. When you come upon an accident in the street you will be able to do more than just call for help. When there is a near-drowning accident at a pool party you will be able to perform cardiopulmonary resuscitation and save a life. When someone at a dinner or a restaurant chokes, you will know what to do. What greater satisfaction could there be?

The role of the licensed practical nurse (LPN) on a medical surgical floor is to give direct patient care and document it, under the supervision of the registered nurse (RN). LPNs do most of the same work that RNs do, with the exception of supervision and nursing assessment. Whether the LPN is allowed to perform IV therapy is largely a function of the hospital where he or she works.

Measuring vital signs and recording them is one important job often performed by LPNs. Vital signs include temperature, pulse, respiration, and blood pressure. Seeing the vital signs gives physicians a rapid first impression of how their patients are faring at any given time.

Is the temperature high? Perhaps an infection or cancer is present
Too low?
Are thyroid tests needed?
Is the pulse too high?
Is the thyroid gland putting out too much hormone?
Is the pulse too low?
Is the patient going into heart failure?
Is respiration too fast?
Will the patient needed to be on a ventilator?
Blood pressure too high or too low?
Is the heart struggling to pump enough blood?
Is the patient about to go into shock?

Vital signs are of vital importance!

Providing patients with nourishment and a clean, comfortable environment are also functions that LPNs frequently perform for their patients. Trays of food are carried to patients three times per day and some patients get snacks as well. Nurses are expected to record how much patients eat and in some cases to measure how much fluid patients drink along with how much urine they make. Providing a clean bed with fresh linens and a bed bath with a back rub, tooth brushing, and hair combing are responsibilities that often fall to the LPN.

Passing out medications is often the job of the RN team leader, but many LPNs medicate patients too. When giving medications, all nurses remember the five rights:

1. the right patient
2. the right medication
3. the right dose
4. the right time
5. the right route

The route of most medications is oral, and nurses wheel a cart filled from the pharmacy through the floor, stopping at each bed to give out the correct medications with a glass of water. Some medications must be injected into the muscle or under the skin, and LPN’s are qualified for that type of injection. Ear drops, eye drops, and vaginal or rectal suppositories are occasional routes as well.

Taking care of surgical patients and some medical patients an LPN is likely to have to perform dressing changes, removing bandages and applying new clean dressings.

Caring for elderly patients is often performed in facilities that hire LPNs and the elderly have their own special needs. Preventing pressure sores or bedsores is an important part of care for those who are immobilized. Turning patients every two hours while keeping them clean and dry is one function that conscientious LPNs perform to keep patients from feeling discomfort. Elderly patients in nursing facilities often need to be helped into the day room during the day and back to bed at night, which can be performed by LPNs.

Answering call lights and bells is the responsibility of all nursing personnel, and no one should walk past a light. All nursing personnel at the nurses’ desk should answer bells promptly as they occur. Solving a problem involved in answering a call could be as simple as fluffing up a pillow to make a patient more comfortable, or reporting a complaint of more severe pain to the medication nurse. Occasionally a patient suffers an accident such as a fall and the LVN/LPN must act quickly to get help.

Documenting everything that is done is crucial not only for the staff and physicians to be able to keep track of the patient and what have been done, but, unfortunately, it is a fact of life that documentation is important for medico-legal reasons as well. In a court of law, if a procedure has not been documented, it is considered not having been done. The most effective notes are the SOAP notes, Subjective, Objective, Assessment, and Plan. A subjective complaint might be a headache. An objective observation might be that the patient is sweating. The assessment might be that the patient is sweating from a severe headache. The plan might be to get the medication that has been ordered, or report the complaint immediately to the medication nurse. All in all, the LPN on a medical or surgical floor plays a varied role that leaves little time for boredom.

To become a Licensed Practical Nurse in the State of New York, an applicant for the licensing test must first complete a course of study approved by the State Education Department’s Office of the Professions. NYSED.gov has a list of state approved lpn programs listed by region. You can also find the list here on our website organized by city.

The Central Region includes fifteen accredited programs, the Genesee Valley Region has eleven, the Long Island region includes six programs, the Metropolitan Region has twelve, the Mid-Hudson region includes eight, the Northeast Region has twelve, the Northern Region includes five, and twenty programs are included in the Western Region.

State University of New York

The State University of New York at Delhi is located in the Central Region. The school requires 11 courses for graduation from the LPN program. Nursing courses must be passed with a grade of at least C+ and non-nursing courses must be passed with grades of C or higher.

Nursing courses consist of: Introduction to Nursing and Mental Health, Clinical Calculations, Fundamentals of Nursing, Nursing Clinical I, Introduction to Maternal Child Nursing, Medical-Surgical Nursing I, and Nursing Clinical II. Science and liberal arts courses include: Anatomy and Physiology I and II, Freshman Composition, and Introductory Psychology.

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Suffolk County Community College

Suffolk County Community College on Long Island requires 27 units of nursing education and 10 units of anatomy and physiology, psychology, and composition. Students must keep up a C average in all nursing and science courses. A list of nursing courses includes Foundations for Success in Practical Nursing, Pharmacology Safety and Dosage Calculations, Fundamentals of Nursing for Practical Nurses, Nursing Care of Adult Clients I and II, and Nursing Care of Maternal-Child Clients.

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La Guardia Community College

La Guardia Community College, located in the Metropolitan Region, offers 29 units of nursing leading to LPN certification. Courses include Fundamental Nursing Concepts and Skills, the Science and Art of Nursing I and II, Pharmacology and Nutrition, Medical Surgical Nursing I and II, Mental Health Nursing, Maternal-Child Health Nursing, Pediatric Nursing, Pediatric Nursing, and Management and Leadership.

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Westchester Community College

Westchester Community College is located in Valhalla, in the Mid-Hundson Region. Its non-nursing courses leading to the LPN certificate include Composition and Literature, Anatomy and Physiology, General Psychology, and Introduction to Sociology. Nursing courses include First Aid and cardiopulmonary resuscitation (CPR) and Nursing I, II, III, and IV.

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Maria College

Maria College is located in Albany, in the Northeast Region. Its program includes 29 nursing units and 18 to 19 liberal arts units. A grade of C or better is required in all courses. Anatomy and Physiology and CPR courses must be completed before students are admitted to the nursing program.

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Samaritan Hospital School of Nursing

Samaritan Hospital School of Nursing, in Troy, in the Northeast Region, has courses leading to the LPN certificate as well as being transferable for college credit. Courses include Practical Nursing I, II, II, and IV. Students must be certified in CPR each semester.

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North Country Community College

North Country Community College is located in the Northern Region of New York State. It offers courses in psychology, biology, math, English, and nursing leading to the LPN certificate.

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Trocaire College

Trocaire College in Buffalo fills the needs of students in the Western Region of the state. Its curriculum includes College Seminar, Anatomy and Physiology, English Composition, General Psychology, Principles of Sociology, Medication Essentials I and II, and Practical Nursing I, II, III, and IV.

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The above review barely begins to describe the practical nursing educational opportunities available in New York State. Please find the complete list of approved LPN programs here. Before choosing a school, be sure to check with the New York State Education Department to be sure that it is approved and that its graduates are eligible to sit for the state licensing exam.

Infection control is an important aspect of hospital care. According to the Centers for Disease Control and Prevention in Atlanta, Georgia, about 1 in 20 hospitalized patients contracts an infection in the hospital. Such infections can be deadly. According to Ohio State University, 20,000 patients die in United States hospitals every year due to infections acquired in a hospital.

Bacteria in hospitals have been exposed to antibiotics and have evolved immunity to them. This makes treating them extremely difficult. Methicillin-Resistant Staphylococcus aureus, or MRSA, is well known for causing a variety of serious infections because it is resistant to the family of penicillin antibiotics.

Hospitalized patients are frequently old or frail and their immune systems are not always up to dealing with micro-organisms. Having a urinary catheter makes patients susceptible to urinary tract infections because bacteria are able to enter the bladder through the catheter. Intravenous infusions (IV’s) are also a danger because bacteria can enter broken skin through the needle. Patients on ventilators are at risk for fungal infections and pneumonia because the warm, wet environment provides a place where micro-organisms are able to grow and reproduce. Wounds and burns also offer micro-organisms the chance to enter and cause infection.

Hospitals are highly concerned with the cost of nosocomial infections, or those acquired in clinical settings. According to the South Carolina Department of Health, hospital-acquired infections cost U.S. hospitals $35.7 to $45.0 billion per year. Programs to reduce nosocomial infections have proven to help hold down costs. According to the Centers for Disease Control and Prevention, preventing infections is likely to save hospitals money.

Licensed vocational nurses (LVN’s) and licensed practical nurses (LPN’s) can help their employers to save money and help their patients to get well by keeping away nosocomial infections. To become well-versed in techniques of preventing hospital-acquired infections and to prove to employers that they are well qualified, nurses can become certified in infection control.

The Certification Board of Infection Control and Epidemiolgy (CBIC)  tests nurses and other healthcare workers over their knowledge of infection control and issues a certificate to those who pass. According to the Board, at least one study performed with 203 hospitals in California showed less MRSA infection in hospitals whose infection control programs were led by individuals certified in infection control. The study was published in this month’s issue of The American Journal of Infection Control.

To be eligible to take the test, an LVN/LPN must be currently and currently working in healthcare, with infection control as one of his or her primary responsibilities. Experience required includes collection, analysis and interpretation of information dealing with infection prevention, investigation of possible outbreaks, and at least three of five other activities. The five include planning, carrying out, and evaluation of infection control measures, education of other people about infection prevention and control developing policies and procedures, managing infection prevention and control activities, and serving as a consultant for infection prevention.

The CBIC test consists of 150 questions to be answered in 3 hours or less. Like nurses’ license exams, It can taken at any of 140 electronic  testing centers throughout North America. To apply for the exam, you may apply online at the CBC website or write to CBIC Examination Services,

555 East Wells St., Suite 1100,
Milwaukee, WI 53202

A practice exam is also available.

Courses are available to prepare professionals to sit for the CBIC examination. The University of South Florida has an online program that includes four courses in microbiology, planning infection control procedures, disease prevention techniques, program design, and the subject of surveillance and monitoring.

To be proficient in preventing the spread of infections through a hospital, a good nurse should know which micro-organisms to watch out for. The three basic types of microbes that cause infection are bacteria, viruses, and fungi. Courses in microbiology teach students which ones are dangerous and how to test for them.

Universal precautions are a set of instructions for putting barriers between patients and micro-organisms and between micro-organisms and healthcare workers. Barriers such as gowns, gloves, hats, and masks are used to stop micro-organisms from spreading.

Disease prevention might involve good hand washing, cleaning catheters, changing dressings, and changing catheters in a timely manner. Designing programs might involve having in-service lessons to train every person on staff on universal precautions, and supplying the latest barriers for containing microbes.

Surveillance and monitoring might be keeping track of the number of hospital-acquired infections diagnosed in the hospital, tracking down their source, and watching for further infections after the proper precautions were instituted.

 Infection control is a valuable and challenging skill. Nurses schooled and certified in the subject can make a positive difference.

Like many questions, it depends largely on whom you ask. According to wantedanalytics.com, which keeps track of online advertisements for employees, in May of 2011 there were over 9,720 online ads for LVNs and LPNs, slightly higher than for May of 2010 but less than for May of the previous 2 years, with over 11,340 online ads. The U.S. Bureau of Labor Statistics paints a rosy picture, with a prediction of a robust increase in the need for LVN/LPNs by the year 2018. The Bureau predicts a 21 per cent increase in jobs for 2018 compared with the year 2008. In 2008 there were 753,600 licensed practical or vocational nurses employed in the United States. By 2018 the expected number will climb to 909,200.

The reason for this optimistic theory is that there will be more elderly people in the country by that time. While it is true that, baby boomers (children of soldiers and sailors returning home after World War II) the theory does not take into account the American habit of tinkering with everything.

At least some healthcare facilities have decided that the traditional team of registered nurses (RN’s), vocational or practical nurses, and nurses’ assistants should be replaced by one which does not include LVN/LPNs. Kaiser Permanente replaced its LVN/LPN’s with RN’s four years ago. LVN/LPNs were given the choice of becoming RNs or seeking employment elsewhere. Fortunately, Kaiser paid for LVN/LPNs to become RNs, so the new policy provided nurses with a new opportunity.

Henry Mayo Newhall Memorial Hospital in Santa Clarita, California, announced plans last year to change from the team approach to the primary care RN model, having more RNs giving direct care to fewer patients. By not hiring more LVN/LPN’s, the hospital is phasing them out through attrition.

Many hospitals in Pennsylvania are also phasing out LVN/LPNs. Last year Schuylkill Medical Center in Pottsville, Pennsylvania, announced its plan to phase out 51 LPNs in six months and replace them with RNs and CNAs. LPNs were given the choice of becoming CNAs with a cut in pay or studying to become RNs.

New York’s Glen Falls Hospital announced last year that it would begin phasing out its LPN/LVNs in favor of having RNs performing direct patient care. Of 700 nurses working at the hospital, 125 were LPNs many of whom had been performing a competent job for as long as 40 years. A spokesperson said that the reason for the new policy was that RNs are able to perform more tasks such as nursing assessment, which LVN/LPNs are not trained to do. The hospital was especially anxious to staff its emergency department, pediatrics department, critical care unit, and obstetrics ward with RN’s only.

Perhaps a better question to ask would be, where are LPN/LVNs being phased out, and where are they still welcome? While many acute hospitals are phasing out LPN/LVN’s, facilities that provide long-term care for older patients are expected to have a growing need. Job growth is expected chiefly in skilled nursing facilities, community care facilities, and home healthcare services, according to the U.S. Bureau of Labor Statistics.

As of May 2010, when the latest statistics became available, skilled nursing facilities were the biggest employers of LVN/LPN’s, with 217,020 licensed practical or vocational nurses. The second largest employers were acute medical and surgical hospitals, employing 145,130. The third biggest employers were private physicians, employing 90,090. The next largest employers were home health care services, with 69,470, while community care facilities for the elderly, employed 41,040. Last on the list was psychiatric and substance abuse facilities, employing 9,550.

According to what we have seen, licensed practical and vocational nursing as a profession is not so much being phased out as changing. From a kind of nurse employed frequently in acute care hospitals, including critical care units and emergency rooms, LVNs/LPNs are likely to become an important part of the labor force caring for aging baby boomers in long-term care facilities as well as doctors’ offices, home health care agencies, and psychiatric and drug abuse hospitals facilities. A growing need is likely to be seen in this rapidly changing occupation.