Do you know the difference between a LVN and a LPN? It’s fine if you don’t. Most people don’t. It’s all about where you practice nursing in the USA. According to Wikipedia, a licensed practical nurse (LPN) in much of the United States and most Canadian provinces is a nurse who cares for people who are sick, injured, convalescent, or disabled. LPNs work under the direction of registered nurses or physicians. In the United States however, California and Texas refer to them as a licensed vocational nurse (LVN).
Wow! That’s it? Yeah, it’s that simple. Maybe you are a CNA and already knew that? You are ahead of the class. Here at CDI in Los Angeles, we provide an accelerated LVN program for students who want to learn.
In California, licensed vocational nurses (LVNs) empty bedpans, commodes and clean and change incontinent adults. Licensed vocational nurses read vital signs such as pulse, temperature, blood pressure and respiration. They administer injections and enemas, monitor catheters and give massages or alcohol rubs. They may apply dressings, hot water bottles and ice packs. They help patients bathe and dress, treat bedsores and change soiled bed sheets. LVNs feed patients and record their food consumption, while monitoring the fluids they take in and excrete.
According to the 2010–2011 Occupational Outlook Handbook published by the Department of Labor’s Bureau of Labor Statistics, licensed practical nurses care for patients in many ways:
Often, they provide basic bedside care. Many LPNs measure and record patients’ vital signs such as weight, height, temperature, blood pressure, pulse, and respiratory rate. A licensed practical nurse (LPN) in much of the United States and most Canadian provinces is a nurse who cares for people who are sick, injured, convalescent, or disabled. LPNs work under the direction of registered nurses or physicians. They also prepare and give injections and enemas, monitor and also perform placement of catheters, dress wounds, and give alcohol rubs and massages. To help keep patients comfortable, they assist with bathing, dressing, and personal hygiene, moving in bed, standing, and walking. They might also feed patients who need help eating. Experienced LPNs may supervise nursing assistants and aides, and other LPNs.
As part of their work, LPNs collect samples for testing, perform routine laboratory tests, and record food and fluid intake and output. They clean and monitor medical equipment. Sometimes, they help physicians and registered nurses perform tests and procedures. Some LPNs help to deliver, care for, and feed infants.
LPNs also monitor their patients and report adverse reactions to medications or treatments. LPNs gather information from patients, including their health history and how they are currently feeling. They may use this information to complete insurance forms, pre-authorizations, and referrals, and they share information with registered nurses and doctors to help determine the best course of care for a patient. LPNs often teach family members how to care for a relative or teach patients about good health habits.
According to the Occupational Outlook Handbook, while most LPNs are generalists and will work in any area of health care, some LPNs work in specialized settings, such as nursing homes, doctor’s offices, or in home care. In some American states, LPNs are permitted to administer prescribed medicines, start intravenous fluids, and provide care to ventilator-dependent patients. While about 18 percent of LPNs/LVNs in the United States worked part-time in 2008, most work a 40-hour week. The Occupational Outlook Handbook states that LPNs may have to work nights, weekends, and holidays; often stand for long periods and help patients move in bed, stand, or walk; and may face occupational hazards which include exposure to caustic chemicals, radiation, and infectious diseases; back injuries from moving patients; workplace stress; and sometimes confused, agitated, or uncooperative patients.”
In some settings, LPNs/LVNs have opportunities for advancement, including the possibility of becoming credentialed in a certain area (such as IV therapy, gerontology, long-term care and pharmacology) or of becoming a charge nurse, responsible for overseeing the work of other LPNs and various unlicensed assistive personnel, such as nursing assistants. Some LPNs/LVNs choose to undergo further education and become registered nurses. LPN-to-RN training programs (“bridge programs”) exist for this purpose. These include further classroom study to obtain at least an Associate of Science in Nursing (ASN) and clinical practice followed by another exam, the National Council Licensure Examination-Registered Nurse (NCLEX-RN).
The origins of the practical/vocational nurse can be traced back to the practice of self-taught individuals who worked in home care in the past, assisting with basic care (ADLs such as bathing) and light housekeeping duties (such as cooking). Licensing standards for practical nurses came later than those for professional nurses; by 1945, 19 states and one territory had licensure laws, but only one state law covered practical nursing. By 1955, however, every state had licensing laws for practical nurses. Practical nurses who had been functioning as such at the time new standards were adopted usually granted a license by waiver, and exempt from new training requirements.
The first formal training program for practical nurses was developed at the Young Women’s Christian Association (YWCA) in New York City in 1892. The following year this became the Ballard School of Practical Nursing (after Lucinda Ballard, an early benefactor) and was a three-month-long course of study concerned with the care of infants, children and the elderly and disabled. The curriculum included instruction in cooking and nutrition as well as basic science and nursing. The school closed in 1949 after the YWCA was reorganized. Other early practical nursing education program include the Thompson Practical Nursing School, established in 1907 in Brattleboro, Vermont, (still in operation today) and the Household Nursing School (later the Shepard-Gill School of Practical Nursing), established in 1918 in Boston. In 1930, there were still just 11 schools of practical nursing, but between 1948 and 1954, 260 more opened. The Association of Practical Nurse Schools (APNS) as founded in 1942, and the next year the name of the organization was changed to National Association for Practical Nurse Education and Service (NAPNAS), and the first planned curriculum for practical nurses as developed.