What do LVNs do and who are they? Have you ever heard about Licensed Vocational Nurses (LVNs) and wondered who they were or what they do and why they have a different name from registered nurses? Well, this article seeks to answer those questions and more…
What is LVNs?
LVNs is an acronym for Licensed Vocational Nurses, they are also called licensed practical nurses (LPNS) in Canada and some states in the US. LVNS are nurses who take care of patients and help them with their daily tasks, and perform some medical procedures under the supervision of doctors and Registered nurses.
Forty eight states in the United States and most of the provinces in Canada use the title LPN to refer to LVNs, only California and Texas use the acronym LVN. Although these nurses do basically the same as “regular” nurses, there are some subtle differences between an LVN and a registered nurse, and I’d get to that in a bit.
Where do LVNs work?
LVNS can work in federal, state, and private hospitals, schools, nursing care homes, physician’s offices, community health facilities, assisted living facilities, home health care organizations, hospices, Universities, correctional facilities, psychiatric hospitals, military facilities, health agencies, company clinics, and any other facility that provides patient care.
Other nurses may use their knowledge of healthcare and nursing in employment as medical coders, billers, transcriptionists, and customer service representatives for Health Management Organizations (HMOs).
What do LVNs do?
What LVNS do, to a large extent, depends on the state or province where the LVN practices. Some states restrict the duties and responsibilities of an LVN, while other states such as Oklahoma and Texas permit the LVNs to do almost anything within the scope of nursing. In these states, the LVN has the same skill set and performs the same set of procedures as a registered nurse. In California and New York, it’s a different ball game entirely for LVNs, they are limited in the skill sets they are allowed to possess and the scope of their responsibilities.
Generally, each state board of nursing determines the scope of nursing practice for the LVN, however, the organization where an LVN works may further narrow the scope. So it is advisable for an LVN to know the limitations of nursing care in each facility or organization they work in.
Typically, all LVNS do the following:
- Monitor patients’ vital signs including their blood pressure, pulse rate, respiratory rate, and temperature
- They help administer basic nursing care procedures such as inserting and changing urinary catheters.
- Making and changing wound dressings for injured patients either on an outpatient basis or for trauma patients in the ward.
- Provide comfort for inpatients such as bathing and dressing them up
- Write reports on patient’s health status and progress and present it to registered nurses and doctors
- Keep health records of patients
- Discuss patient’s health status with them and get feedback from them.
- Care of critically ill patients with mechanical ventilators.
- Insert and care for patients that need nasogastric tubes.
- Feed patients through nasogastric or gastrostomy tubes.
- Take care of ostomies.
- Take patients’ samples for tests
- Give enemas
- Administering patients’ medications
- Start Intravenous fluids
- Perform CPRs in cases of emergencies.
- Some LVNs assist delivery of babies
- Carry out follow up plans of doctors and registered nurses.
- Perform some laboratory investigations
- Fill out paperwork such as insurance forms, pre-authorizations, and referrals.
Although LVNs work under the supervision of doctors and registered nurses, they also supervise unlicensed medical staff, nursing assistants, and less experienced LVNs. Furthermore, LVNs could become so experienced as to get promoted to administrative posts such as wellness directors, wound care clinicians, case managers, and assistant directors of nursing.
Specialty Areas LVNs can work in
There are a number of nursing specialty areas under which an LVN can work to gain experience and increase their work opportunities. An LPN can work in as many areas as possible.
Pediatrics – This area of nursing care specializes in the care of sick patients from newborn to the age of 18.
Labor and Delivery – This area of nursing involves care of pregnant women, including educating them on diet and lifestyle changes during the prenatal period, administering medications prescribed by doctors, and provision of immunization to prevent certain disease such as the flu and tetanus.
This area of nursing also involves care of women during the delivery and several weeks after delivery, as well as care of the well newborn.
Neonatal – Nurses who specialize in this area work in Neonatal Intensive Care Units (NICU) where they take care of seriously ill new-borns and premature babies.
Oncology – Oncology nursing involves care of patients with cancer. These patients require the services of LVNs a lot, because a lot of times they may be terminally ill and require a lot of pain medications, palliative nursing care, and counselling to boost their quality of life. Additionally, LVNs in Oncology administer chemotherapy, assist and carry out certain procedures cancer patients will need.
Cardiac ICU– Nurses who work in the Cardiac Intensive Care Unit provide nursing care for patients who have undergone cardiac surgery or who suffer serious cardiac diseases such as a heart attack, heart failure, or arrhythmias.
Emergency Room– Emergency room nurses are also one of the busiest sets of nurses. These take care of patients who develop acute illnesses or injuries, medical or surgical, before transferring to the inpatient wards or ICU.
Rehabilitation Nurse – This set of nurses provide nursing care for patients who are receiving physical, speech, and occupational therapy after injuries or diseases that hampered on their ability to their muscles and joints, speak, or function at work respectively. They work in concert with the respective therapists.
Gerontology Nurse – These nurses provide care for the aged who are ill, boosting their quality of life and providing palliative nursing care for terminally ill elderly people
Neuro ICU – Nurses in the Neuro ICU take care of patients who have suffered head injury, those in coma, and those who have undergone brain surgery. They monitor these patients’ vital signs, record patients’ progress, and help with bathing and feeding of patients who are severely brain injured.
Trauma ICU – This is a very busy specialty area and nurses working here take care of patients who have been involved in accidents including domestic accidents, road traffic accidents, disasters, and occupational accidents.
Burn Unit – Patients who have suffered any degree of burns from any source: chemical, electrical, or thermal are taken care of by nurses in the Burns unit. These nurses help dress the burn wound, administer Intravenous fluids and antibiotics, pain medications, and provide counselling for the patients and their relatives.
Educational training and requirements to become an LVN
You need to receive some formal education and training to become an LVN. LVNS complete about 1-2 years of training and pass a licensure examination to be licensed as vocational nurses. The vocational nursing training programs are usually offered by vocational schools and community colleges and students receive both theoretical or classroom knowledge as well as clinical or practical aspects of the profession. Furthermore, students may choose to undergo additional training in specialty areas serving as an added certification.
Subjects offered as part of the vocational nursing program include biology, anatomy, physiology, pharmacology, paediatrics, obstetrics, dietetics, and general patient care, each as it relates to nursing. For programs which are completed within 2 years, additional subjects such as English language, mathematics, and the humanities are taught.
After completing the program in a state-approved centre and have met other requirements for licensure, the students sit for the National Council Licensure Examination in Practical Nursing (NCLEX-PN) to become a licensed vocational nurse. This Exam should not be confused with the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The licensure exam is conducted by the National Council of State Boards of Nursing (NCSBN) and is a computer-based test. Some states also require that LVNs complete continuing education courses at stipulated intervals.
Licensed Vocational Nurses’ Salary and Job Outlook
Reports from the U.S Bureau of Labour Statistics show that licensed vocational nurses earned a median annual salary of $43,170 in 2015. That year, the highest paid ten percent of the licensed vocational nurses earned at least $59,510 annually while the least-paid ten percent earned $32,040 annually.
The table below shows the annual salaries for LVNs since 2017.
|Year||Average Annual Salary|
Source: Bureau of Labor Statistics, Occupational Employment Statistics, Annual Occupation Profiles. Accessed May 2014.
In 2014, the BLS predicted that the growth of employment of licensed vocational nurses will rise by 16% between 2014 and 2024. This rate is, however, faster than average. The Bureau also projected a 25% increase in job growth for LVNs, faster than the 19% and 11% growth rates projected for RNs and all positions respectively.
According to the BLS, areas with the highest LVNs employed are highlighted in the table below.
|Metro Area||Number of LPNs/LVNs Employed|
|New York-White Plains-Wayne, NY-NJ||20,480|
|Los Angeles-Long Beach-Glendale, CA||20,010|
Source: Bureau of Labor Statistics, Occupational Employment Statistics. Accessed May 2014
Generally, the need for LVNs will significantly increase as predicted, because the average age and size of the US patient population is set to rise over the next 10 years. Due to this high demand of LVNS, their work opportunities are abundant across the United States, however, this vary between states. Some states in the US. pay more and employ more LVNs than others, mostly, depending on the population size.
Skills Required for an LVN
As an LVN, you will be in contact with patients a lot and you need a lot of empathy and emotional stability. LVNs are often the ones mostly in contact with patient’s relative and are often looked up to for comfort. LVNs have to maintain a calm and confident disposition, yet empathetic towards the needs of the patient.
Additionally, candidates who wish to become LVNs would need to be able to work under stressful conditions, as they may be required to take care of critically ill patients, and if they work in a medical centre, the number of patients they may be required to attend to may be huge.
Differences between an LVN and an RN
Generally, Licensed vocational nurses do similar things as registered nurses, however, there are a couple of differences between both types of nurses. These differences are related to educational requirements, length of training, scope of nursing practice, earnings, and skill sets.
Typically, registered nurses have a wider scope of practice, longer and more detailed training programs, and they perform certain medical procedures the licensed vocational nurses are not trained to do. In addition, while registered nurses perform their duties independently in many areas, licensed vocational nurses work under the supervision of doctors and registered nurses. Generally, although not always the case, licensed vocational nurses earn less than their registered counterparts.
In addition to supervising licensed vocational nurses, registered nurses have the following additional responsibilities and duties
- Set up plans for patients’ medical care and contribute to existing line of management
- Consult with doctors and other health professionals with regards to a patient’s care.
- Operate and monitor medical equipment
- Assist in performing some diagnostic procedures and evaluating the results.
Can One Switch from being an LVN to an RN?
There are two possible routes through which an LVN can become an RN. One route involves taking an LVN-to-RN course at a local college, after which you earn an Associate of Applied Science in Registered Nursing (ASN).
The alternative route involves enrolling for a bridge program which involves a four-year degree program to earn a Bachelor in Nursing (BSN) degree. Both routes lead up to the National Council Licensure Examination (NCLEX) for Registered Nurses for graduates to apply for licensure and registration as registered nurses with the state board of nursing.
Nursing is no doubt a very interesting and rewarding field, and LVNs and RNs are all nurses alike, and you will agree with me that helping a patient lead a healthier life is more than just a job, and LVNs and RNs contribute in no small way in making that possible. If being an LVN is your dream, go for it! And I hope I have empowered you with as much information as you’d need to get there.