How To Become a Licensed Vocational Nurse
Licensed vocational nurses (LVNs, also called licensed practical nurses or LPNs in some states) provide compassionate, hands-on care to people of all ages, from newborns to senior citizens. For many vocational nurses, the most rewarding part of the job is the close, meaningful contact they have each day with patients. As front-line providers, LVNs offer physical and emotional support and often form close bonds with the people they care for.
Working under the supervision of a physician or registered nurse, LVNs deliver much of the bedside care that hospital patients receive, from wound dressings to simple laboratory procedures. Much of the workday is spent assisting people with daily tasks like moving, dressing and bathing. Vocational nurses also answer questions from patients and family members and relay concerns to the health care team. LVNs who work in community settings conduct health screenings and educate schools, workplaces and the public about preventative care.
LVNs are team players who work closely with other health care professionals to plan, deliver and evaluate patient care. Many eventually return to school to pursue careers in registered nursing, allied health or medicine.
Until recently, most LVNs worked in inpatient settings such as hospitals, extended care facilities, nursing homes and rehabilitation centers. However, new advances in medicine and technology mean that many complex procedures can now be performed on an outpatient basis. This has created demand for licensed practical nurses in physician offices and outpatient surgery centers. In addition, many LVNs work in non-traditional settings such as the military, community programs, industrial and occupational health centers, schools, correctional facilities and home health care agencies.
Most LVNs are employed in clean, well-lit clinical settings, though some travel to patients’ homes, schools and workplaces. The job demands physical strength as nurses spend long periods standing and walking and often need to physically assist or lift patients. Like other health care workers, LVNs have daily exposure to infectious diseases, body fluids, needles and chemicals. They must be very careful to follow safety procedures and use protective clothing like gloves and masks when appropriate.
Seventy-five percent of LVNs worked full time in 2010. Shifts at inpatient facilities often last eight or more hours and include nights, weekends and holidays. Nurses in outpatient settings usually work daytime shifts but cover some evenings and weekends for the convenience of patients.
To begin a career as a licensed vocational nurse, candidates must first complete a certificate program at a career center or community college. Training lasts about one year and covers nursing, biology and pharmacology. Students also work under supervision in hospitals and other clinical settings to sharpen their practical and interpersonal skills.
When enrolling in an LVN program, it is important to choose an accredited institution that meets state requirements. Contact the state board of nursing for a list of approved programs. The National League for Nursing maintains a list of accredited programs on its website.
While admission to most nursing programs requires a high school diploma, a growing number of school districts are offering LVN training in grades 9 to 12. Many graduates go directly into the workforce or continue on to college to study nursing, medicine or pharmacy.
LVNs may pursue advanced training in IV therapy, critical care and other clinical specialties. To enhance their knowledge, they take continuing education courses or intern under the supervision of a registered nurse or nurse practitioner.
Licensing and/or Certification
Licensure is mandatory for LVNs. Upon graduation from an approved training program, candidates may apply to the state board of nursing. Once deemed eligible for licensure, they must next pass the National Council Licensure Examination (NCLEX-PN), a rigorous, computer-based assessment covering safety, health promotion and physical and psychological care for patients.
In addition, LVNs can pursue voluntary certification in foot care, gerontology and IV therapy through the National Federation of Licensed Practical Nurses (NFLPN). To earn a specialist credential, they must show evidence of training, obtain a letter of endorsement from a supervisor and pass an exam. The foot care certification requires an eight-hour internship with a registered nurse specialist.
The Nephrology Nursing Certification Commission now offers a Certified Dialysis LVN (CD-LVN) credential for experienced vocational nurses. Requirements include two years of full-time employment and 15 hours of continuing education in dialysis care. Candidates must also pass an exam.
Necessary Skills and Qualities
Licensed vocational nurses should be compassionate, empathetic people with a genuine desire to ease the suffering of others. Patience and emotional stability will help them to work effectively with difficult patients and those who are frightened or in pain.
Because they act as a key link between patients and other members of the health care team, LVNs need to have excellent communication skills. In particular, they must be able to clearly and accurately describe changes in a patient’s condition. They should also enjoy working collaboratively with colleagues and professionals from other disciplines.
Patients need to get the right care at the right time, so LVNs need to attend closely to schedules and details. This is especially important when dispensing medications.
Opportunities for Advancement
Experienced LVNs often move into supervisory roles in which they direct the work of fellow nurses, nursing assistants, orderlies and non-licensed professionals. Those working in large hospitals often have the opportunity to specialize in a clinical area such as IV treatment or critical care. Some entrepreneurial nurses even leave the clinical setting to start health services companies.
Many licensed vocational nurses go back to school to complete a bachelor’s or graduate degree in the health care field. Some colleges offer specialized bridge programs to LVNs who seek certification as registered nurses or nurse practitioners.
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The U.S. Bureau of Labor Statistics states that the annual average salary for LVNs was $42,910 in May 2013. Eighty percent of LVNs earned between $31,300 and $58,020.
Salaries were generally above average in nursing homes and slightly below average in hospitals. Earnings increased commensurate with experience.
The number of employed LVNs, according to the Bureau of Labor Statistics, should increase by 25% between 2012 and 2022, which is much more than the average growth for most occupations. There are many reasons for this growth. For one, the aging of our population is increasing the demand for nursing home and rehabilitation care services. LVNs can therefore expect many new opportunities in long-term care facilities and in agencies that assist people who have experienced stroke or Alzheimer’s disease.
Another factor driving the demand for LPNs is the growing shift toward outpatient care. More physician offices and surgery centers are hiring licensed vocational nurses to assist with procedures and care for patients during brief stays. In addition, a large number of LVNs are expected to retire in the coming decade. Demand will be greatest for licensed and experienced professionals. The NFLPN maintains a job board for LVNs on its website.