How To Become a Licensed Vocational Nurse

By: Holli Sowerby, EdD, RN

Last Updated: Dec 26, 2018

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.

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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.

Workplace Details

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. 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.

Most LVNs work full time. 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.

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The U.S. Bureau of Labor Statistics states that the annual average salary for LVNs is $44,840. Eighty percent of LVNs earn between $32,510 and $60,420.

Salaries are generally above average in nursing homes and slightly below average in hospitals. Earnings increase commensurate with experience.

The number of employed LVNs, according to the Bureau of Labor Statistics, should increase by 16% between 2014 and 2024, which is much more than the average growth for all 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.

Admission to the vast majority of nursing programs requires a high school diploma.

To begin a career as a licensed vocational nurse, candidates must first complete a certificate program at a career center or community college. 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 Accreditation Commission for Education in Nursing maintains a list of accredited programs on its website.

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The program will last 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.

Licensure is mandatory for LVNs. Upon graduation from an approved 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.

LVNs may pursue advanced training in IV therapy, critical care and other clinical specialties to take advantage of opportunities in large hospitals. To enhance their knowledge, LVNs take continuing education courses or intern under the supervision of a registered nurse or nurse practitioner. Experienced LVNs often move into supervisory roles in which they direct the work of fellow nurses, nursing assistants, orderlies and non-licensed professionals. Some entrepreneurial nurses even leave the clinical setting to start health services companies.

Many LVNs eventually return to school to pursue careers in registered nursing, allied health or medicine. Some colleges offer specialized bridge programs to LVNs who seek certification as registered nurses or nurse practitioners.

In order to work as a licensed vocational nurse, you must complete a training program approved by your state and pass the national licensing exam. Most states list approved schools on their nursing board websites. (Note that some states have a separate board for vocational nursing.)

Vocational nursing programs can also seek voluntary accreditation through the Accreditation Commission for Education in Nursing (ACEN). Accreditation certifies that the school, faculty, and curriculum meet minimum quality standards.

It’s not necessary to attend an accredited program for your LVN certificate, but it can be helpful if you later wish to become an RN or nurse practitioner. For a list of accredited programs in licensed vocational nursing, visit ACEN’s website listing and choose the search term “practical”.

You’ll find licensed vocational nursing programs at many 2-year colleges, career and technical schools, and high schools. Public and private nonprofit schools generally provide better educational value for your money than for-profit schools.

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Admission to an LVN program may require college-level prerequisites in English, math, anatomy and physiology, psychology, biology, and human development. Depending on your past education and experience, these classes could take one to two semesters to complete.

Once admitted to the LVN program, you’ll then take an additional year of nursing classes to complete your training. The course sequence is very similar to the first year of an associate degree in nursing and covers:

LVN students also complete clinical rotations in nursing homes, doctor’s offices, and various hospital departments. This provides an opportunity to practice caring for patients and creating care plans under supervision.

Some states require licensed vocational nurses to undergo additional training and certification before drawing blood or starting IVs. For more info, contact your state board of nursing.

Otherwise, certification beyond your state LVN license is purely voluntary. Additional credentials cost time and money, and not all are well recognized by employers. It’s therefore a good idea to talk to your mentor, employer, or experienced colleagues about which certifications make sense for you.

The National Association of Practical Nurse Education Services (NAPNES) provides certification courses and testing for licensed vocational nurses in the following areas:

• Certification in Long-Term Care (CLTC)
• IV Therapy Certification (IVTC)
• Pharmacology Certification (PC)
• Rehabilitation Practical Nursing Certification (RPNC)

Note that some states require their own IV course for certification.

Specialty certifications designate experience and expertise in a particular area of nursing. All of the following credentials have experience and education requirements. Candidates must also pass a test.

• Certified Dialysis LVN (CD-LVN) – Nephrology Nursing Certification Commission
• Developmental Disabilities Certified (DDC) –Developmental Disabilities Nurses Association
• Certified Managed Care Nurse (CMCN) – American Board of Managed Care Nursing
• Certified Corrections Health Professional (CCHP) – National Commission on Correctional Health Care
• Certified Urology Associate (CUA) – Certification Board for Urologic Nurses and Associates
• Certified Hospice and Palliative Licensed Practical/Vocational Nurse (CHPLN) – Hospice & Palliative Credentialing Center