LPN vs. RN: What's the Difference?
The decision to apply to nursing school is perhaps the most important career decision nurses make, but it is only the first. The second? Deciding whether to become a licensed practical nurse (LPN) or a registered nurse (RN). There are important differences between LPNs and RNs, many of which are tightly regulated by the state in which you practice. It can pay to do your research, and not just in the metaphorical sense. Read on to learn more about the differences -- and similarities -- between these two fields.
Snapshot: LPNs vs. RNs
It can't be stressed enough how much state and employer regulations define both LPNs and RNs, which can make it difficult to make broad statements about either field. There are some general trends that define both types of nurses, however. Among them:
- RNs tend to have more responsibilities and independence in the workplace than LPNs
- RNs must usually complete more training than LPNs
- LPNs are in higher demand than RNs, nationally speaking
- RNs tend to earn more than LPNs
As you can see, which type of nursing career you pursue can define not just your training, but your role, earnings and employment potential throughout the course of your career. Let's explore some of these trends in greater detail.
On the Job: Typical LPN and RN duties
Licensed practical nurses and registered nurses share a common goal: Providing excellent medical care to patients in need. But how they do this -- and how such tasks are regulated -- can vary tremendously from one job or state to the next. Generally speaking, RNs are required to have more training, so tend to operate a bit more independently than LPNs. In fact, according to the Bureau of Labor Statistics (BLS.gov), many LPNs report directly to RNs, who in turn work under the direction of physicians and surgeons.
Common LPN duties, as reported by the Bureau of Labor Statistics:
- Monitoring patients' vitals
- Administering basic patient care, like changing bandages
- Helping patients bathe and dress
- Maintaining patients' health records
- Reporting patients' status to RNs and doctors
Registered nurses tend to perform all of these tasks, plus the following duties:
- Administering medications and treatments
- Establishing and maintaining patients' care plans
- Performing diagnostic tests and analyzing results
- Operating and monitoring medical equipment
- Teaching patients and their families how to manage illnesses and injuries
Keep in mind that every state regulates the duties RNs and LPNs may perform, and what is acceptable in one state may not be in the next. Duties can also vary by employer or specialty. Your state's Board of Nursing can clarify these differences.
Education: LPN vs. RN training requirements
Another way states regulate LPNs and RNs is through training requirements. These requirements can vary tremendously by employer or jurisdiction, but there are some general trends, like the fact that in most cases, RNs must complete more education than LPNs before entering the field.
LPN training requirements. According to the BLS, all states require LPNs to earn a certificate or diploma from an accredited LPN training program. These programs typically require about one year of study and include a supervised clinical component.
RN training requirements. The BLS notes that RNs can typically choose one of three education paths, namely: a diploma from an accredited nursing program, an associate degree in nursing (ADN) or a bachelor's of science degree in nursing (BSN). ADN and diploma programs typically require two to three years of study while BNS programs often require four. As with LPN training programs, RN schools require students to complete supervised clinical experience in addition to laboratory and classroom work.
Specialty and bridge programs. It is not uncommon for LPNs or RNs to eventually invest in more training in hopes of earning more, advancing their careers faster or gaining a competitive edge in a tight job market. Many nursing schools offer so-called bridge programs, which allow practicing nurses to complete only the training they need to advance their educations. Common programs include: LVN to RN programs, ASN to BSN programs and RN to BSN programs.
LPN and RN certification and licensing requirements
It is important to note that all states require RNs and LPNs to be licensed. Licensure requirements can vary by state, but typically require candidates to meet minimum education and experience thresholds, pass a national licensing exam and complete ongoing continuing education courses, or CECs. Once again, your state's board of nursing can clarify licensing requirements for both LPNs and RNs. LPNs and RNs can often pursue additional, more voluntary certifications through various professional groups. These certifications allow nurses to specialize in a particular field (or several) of health care, like pediatrics, oncology or gynecology. Some employers prefer to hire certified nurses.
LPN and RN salary projections: Who earns more?
As noted, RNs are typically required to complete more training than LPNs -- a distinction that usually allows RNs to perform more complicated medical tasks, often with a great deal more independence. This extra responsibility has its advantages, not the least of which is more pay. The BLS reports that as of May, 2015, RNs earned a national mean annual wage of $71,000, which was significantly more than the $43,170 LPNs earned on average that same year. Keep in mind that there are several factors that influence earnings, like education, experience and certification. Location can also drive wages, especially in high-demand and high cost-of-living regions. The BLS provides state- and metro-specific salary data for LPNs and RNs.
Career outlook for LPNs and RNs
Both LPNs and RNs can rejoice in the fact that both professionals are in-demand, nationally speaking, though the former has a bit of an edge. The BLS projects that demand for LPNs will grow by 25 percent between 2012 and 2022 -- much faster than the average for all occupations nationally. The Bureau projects that demand for RNs will grow by 19 percent over that same period -- a tad slower than LPNs, but still faster than the national average. As with earnings, both LPN and RN career projections can vary with a number of factors, like training, experience and location. Some employers also prefer to hire candidates who have invested in voluntary professional certification, further specializing their training.
Licensed Practical Nurse (LPN)
A licensed practical nurse, also known as an LPN, is a member of the health care workforce who assists nurses and doctors in caring for patients.
The primary difference between LPNs and registered nurses (RNs) is the scope of duties and education: Licensed practical nurses typically work under the supervision of doctors or registered nurses and provide basic nursing care, such as monitoring patients, changing wound dressings, and helping patients bathe or dress. LPNs also assist doctors and RNs with disseminating information about care programs to patients and their families.
Practical nursing programs prepare students to provide care in a variety of settings, including hospitals, nursing homes, clinics, and residential-care facilities.
Becoming an LPN typically takes at least one year of full-time study and should culminate in a certificate of achievement or a diploma, reports the Bureau of Labor Statistics (BLS).
What does a licensed practical nurse do?
According to the BLS, more licensed practical nurses work in skilled nursing facilities and extended-care centers than in hospitals. Though the daily tasks of an LPN will depend on the type of facility he or she works in, the following is a list of common duties performed by most LPNs, as reported by the BLS:
- Inserting catheters and dressing wounds
- Checking blood pressure, and other forms of patient monitoring
- Assisting patients with bathing, dressing, or feeding
- Keeping records on a patient's health, and reporting to registered nurses and doctors on a patient's condition
- Helping to education family members on caring for patients at home
Day-to-day tasks will also depend on the state in which the LPN works. In some states, LPN's are allowed to give medication or start intravenous (IV) drips, while in others, LPNs are not licensed to perform these tasks, the BLS reports.
How to become a licensed LPN
To work as an LPN, students must complete a state-approved educational program that culminates in an LPN certificate of achievement or a diploma. Those who wish to enter the field can get a head start by enrolling in core science courses in high school or at a local junior college.
LPN educational programs are usually offered at community colleges or vocational schools, and contain a mix of classroom and laboratory courses and clinical field experience. Some community colleges require students interested in enrolling in their LPN certificate programs to complete two or more semesters of general education studies prior to enrollment.
Training typically includes study in core subjects such as biology, psychology, mathematics, and English composition, since communication with RNs, medical staff, and patients plays such a crucial role in success in the field.
LPN coursework generally includes study in the following areas:
- Foundations of practical nursing
- Nursing care and adult theory
- Nursing care for infants and women
- Practical nursing leadership
- Introductory and advanced clinical lab
The skills required of an LPN are varied. Strong interpersonal and communication skills help LPNs converse productively with patients and other members of the health care team. They must also have keen attention to detail and be able to make fast decisions regarding patient care. Scheduling flexibility may prove important, as many LPNs work long night shifts over weekends and holidays. LPNs help patients get around their rooms, bathe, and dress, so they should be strong enough to assist patients with those tasks.
Admission to the clinical side of LPN training programs can be quite competitive since placement opportunities can lag behind the number of applicants. Students who perform well academically can have an increased advantage of landing a clinical placement over students with weaker grades.
Most schools that offer LPN training have one-year programs for full-time students. Others may offer associate-level degrees that take two years to complete. These are typically for students who eventually want to seek the RN designation.
Students who successfully complete their educational requirements are eligible to take the National Council Licensure Examination practical nursing test (NCLEX), which is required by every state. The test measures a student's competency to work safely as an entry-level nurse.
Before taking the NCLEX, students must get authorization to take the test through their state board of nursing and register for the computer-based exam with test administrator Pearson VUE. Additionally, students are advised to log on to the National Council of State Boards of Nursing Web site (www.ncsbn.org) and review the NCLEX Candidate Bulletin and NCLEX test plans.
Cost for the exam was $200 as of September 2014. According to the the National Council of State Boards of Nursing, approximately 82 percent of first-time test takers passed the exam the first six months of 2014.
The exam is divided into four main categories, with a percentage of weight given to each category:
- Safe and Effective Care Environment (26 to 38 percent)
- Health Promotion and Maintenance (7 to 13 percent)
- Psychosocial Integrity (8 to 14 percent)
- Physiological Integrity (35 to 59 percent)
All test takers must answer a minimum of 85 questions, the council says, while the maximum number of questions is 205 during the five hours allotted to the test.
Successfully passing the NCLEX-PN is the foundation of your entry into the nursing profession. It shows you understand the requirements to administer the appropriate level of care to patients and also to work with senior medical staff as an educated professional. LPNs often take additional schooling to become registered nurses through LPN to RN educational programs, while others advance to supervisory positions, the BLS notes.
LPNs can earn additional professional certifications through groups like the National Association of Practical Nurse Education and Services. These credentials tend to be voluntary, but some employers prefer candidates who have them.
Salary information and career outlook
According to the BLS, there were 695,610 licensed practical nurses working in the U.S. as of May 2014, and they earned a median annual wage of $43,420, or $20.87 an hour. The top 10 percent of LPNs earned $28.22 an hour or more, while the bottom 10 percent took home $15.21 an hour or less.
The top five highest paying states for licensed practical nurses (based on mean annual wage) are:
- Connecticut ($55,170 per year)
- Alaska ($54,380 per year)
- Massachusetts ($53,820 per year)
- New Jersey ($52,950 per year)
- Nevada ($52,760 per year)
The greater New York City and greater Los Angeles areas are the two largest metropolitan employment regions for LPNs, and both pay around $4 an hour higher than the national median salary for the profession. States with the highest employment of LPNs in 2014 include Texas, California, New York, and Florida.
Demand for licensed practical nurses is on the rise; the BLS projects employment in the field to grow by as much as 25 percent nationwide from 2012 through 2022. That's more than double the average growth rate of all other occupations combined. Demand is expected to come from waves of aging baby boomers who need more medical care, as well as from a rise in staffing requirements at outpatient care centers. Additionally, the BLS notes, many senior-level LPNs are expected to retire during that time, creating additional job openings.
- Integrated Bridge to Licensed Practical Nursing Program, LaGuardia Community College, http://www.laguardia.edu/uploadedFiles/T2/pcap/docs/LPN11.3.pdf
- Licensed Practical and Licensed Vocational Nurses, U.S. Bureau of Labor Statistics, Occupational Employment Statistics, May 2014, http://www.bls.gov/oes/current/oes292061.htm
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- NAPNES Advanced Education Certificate Programs, http://www.nursingcerts.com/Default.aspx
- NCLEX-PN Test Plan Examination, National Council of State Boards of Nursing, www.ncsbn.org/2014_PN_TestPlan.pdf
- Number of Candidates Taking NCLEX Examination and Percent Passing, by Type of Candidate, 2014, National Council of State Boards of Nursing, www.ncsbn.org/Table_of_Pass_Rates_2014.pdf
Licensed Practical and Licensed Vocational Nurses, Occupational Outlook Handbook, Bureau of Labor Statistics, January 8, 2014, http://www.bls.gov/ooh/healthcare/licensed-practical-and-licensed-vocational-nurses.htm
Licensed Practical and Licensed Vocational Nurses, Occupational Employment and Wages: May, 2013, Occupational Employment Statistics, Bureau of Labor Statistics, http://www.bls.gov/oes/current/oes292061.htm
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