Which nursing role should you choose first – LPN or RN? Read on to discover the differences in role, including education requirements and scope of practice.
Guest Author: Lindsey Nolen
I’m pleased to welcome Lindsey Nolen from CareersinHealthCare.com as a guest author. Ms. Nolen is an experienced journalist specializing in health and healthcare. This article provides good information for those of you who might still be vacillating about which nursing track to pursue first.
Because I believe that nurses should be educated at the highest level possible, I will put in my two cents and encourage you to pursue advanced nursing degrees as soon as you can once you get your first degree.
If you decide on the LPN/LVN route, please make a plan to pursue the RN.
If you decide on the Associate degree RN route, I’m going to encourage you to go on for your Baccalaureate nursing degree (i.e., BSN). (Not many Diploma schools are still operating.)
If you decide on the Baccalaureate RN route, I’m going to encourage you to go on for an advanced nursing degree (i.e., your MSN, DNP, or PhD) after you get a few years of experience.
This article was first published on December 8, 2018, on the CareersinHealthcare site at https://www.careersinhealthcare.com/lpn-vs-rn/ and I was given permission to reproduce it here.
For more details about Lindsey and her work scroll to the end of this post.
Within hospitals and other healthcare facilities, patients may receive care from either a Registered Nurse (RN) or a Licensed Practical Nurse (LPN) sometimes from both types of nurses. Although both professions are careers in nursing, the two roles differ from each other in several areas. The educational requirements of an LPN versus an RN are different and result in different scopes of practice. Here are the facts:
LPN Requirements
“To become an LPN, you must have your GED or high school diploma, be accepted into an LPN program and take the Test of Essential Academic Skills (TEAS) test. This is an entrance exam for nursing programs used to determine the ability of potential students,” Jocelyn Grube, an LPN practicing at a skilled nursing facility in Pennsylvania, explained. “Each school has specific score requirements to be accepted into the program.”
Before enrolling in an LPN course, learners must ensure that their selected program meets their state’s LPN licensing and training requirements. A list of approved in-state programs can be found on each respective state’s Board of Nursing website. Often requirements to be state-approved involve programs ensuring that their instructors are also licensed. They also must be comprised of an extensive curriculum, combining classroom learning which clinical laboratory experience. (Oh, by the way, a Licensed Vocational Nurse (LVN) and LPN are the same types of nurse, just with a different title – California and Texas use the title LVN and LPN is the title used in the rest of the country.)
After completion of a program, Licensed Practical Nurses must also pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN). Even after passing LPNs will be subjected to a potential employer’s screening process which often includes a fingerprint-based background check prior to being hired.
LPN Responsibilities
During a typical day at work, a Licensed Practice Nurse can expect to administer medication to patients, including oral and sublingual, subcutaneous, intramuscular, and intradermal injections, eye drops, ear drops, and topical treatments. They may also administer breathing treatments, clean wounds, perform dressing changes, monitor IV and injection sites, and make sure all patient needs are addressed. Grube added that she will oversee up to six CNAs at a time to ensure that they are completing their own responsibilities.
“I rely heavily on my Certified Nursing Assistant (CNA) to alert me to anything that may seem ‘off’ with my patients,” Grube explained. “I communicate regularly with Family Physicians, Nurse Practitioners, and family members regarding a patient’s needs or concerns.”
She added that her days also consist of participating in careplan meetings and stand-up reports, which has representatives from every department involved in the patient’s care at the facility. These representatives include Social Workers, Recreational Therapists, Occupational Therapists, Speech-Language Pathologists, Dietitians, and Physical Therapists.
“I am further responsible for completing all necessary documentation required, including what care I provided that day and any changes that shift,” Grube shared. “I then report this information to my RN supervisor and the oncoming shift Nurse.”
RN Requirements
Obtaining the proper education is your first step toward becoming a Registered Nurse. To enter a nursing career as an RN, students must first graduate from an accredited program to receive either a nursing diploma, associate degree, or bachelor’s degree in nursing.
“How I went about selecting my RN program was based on a few different things: I wanted to go to a program that had a successful first-time pass-rate, a heavy alumni-connection to benefit me during my employment search, and a strong overall learning environment,” Ashley Gilman RN, a Registered Nurse practicing in Pennsylvania, explained.
Once this educational requirement has been fulfilled, prospective RNs must pass the NCLEX-RN examination which usually takes about six hours and is comprised of more than 100 questions. The final step prior to gaining employment is to obtain a license in the state which the professional intends to practice in.
“Nursing overall is difficult because the field requires a different way of thinking,” Gilman stressed. “You will hear many Nurses say that during an exam there may be more than one answer, but you need to pick the best answer. So, the exams can definitely be tricky! However, once you understand the basis of the nursing exam questions, it becomes easier.”
RN Responsibilities
In a career in healthcare as a Registered Nurse, these professionals treat patients with illnesses, injuries, and medical conditions, and are able to perform all of the same skills as a Licensed Practical Nurse and more. Registered Nurses can also support Physicians in providing treatment to patients suffering from various medical conditions. They also monitor patients, educate patients on best practices, work to develop long-term relationships with patients, and help coordinate doctors’ and surgery appointments.
Unlike LPNs, RNs can also administer IVs, perform BLS (Basic Life Support), ACLS (Advanced Cardiac Life Support) and Pediatric Advanced Life Support (PALS), and admit or discharge patients safely and as appropriate. They may also insert and manage intravenous catheters and intraurethral catheters. Furthermore, those Registered Nurses with advanced education may be tasked with performing case management and patient diagnosis.
Furthermore, “as a Registered Nurse, one of the main responsibilities is knowing your patient, what is their ‘normal’, and being able to realize clinical changes that are happening that stray from their baseline. Advocating for your patient and letting someone know that something isn’t normal is also really important,” Gilman shared.
“Other responsibilities include turning patients in the ICU to redistribute pressure to prevent a bed sore, feeding patients, counting their intake and output I&Os, and doing whatever we need to make them comfy which varies from patient to patient,” Gilman noted. “Despite a common misconception, dispensing medication is a small part of what a Registered Nurse does during the day.”
What really separates the role of an RN from that of an LPN is the expectation of a Registered Nurse to supervise Licensed Practical Nurses, Certified Nursing Assistants, and Aides. By law, Registered Nurses are required to oversee LPNs. In a supervisory position, Registered Nurses must maintain accurate records and ensure that all protocols and planned treatment methodologies are completed as required.
They must also ensure that their staff LPNs and CNAs are aware of their daily responsibilities and instruction and that they are fully equipped to carry out their expected tasks and rounds. Overall, RNs are responsible for all LPN duties as well as RN duties.
The Differences
Whereas Registered Nurses must attend school for two or three years to receive an associate’s degree, LPN programs last only 12 to 18 months. As the title implies, Licensed Practical Nurses are tasked with the “practical work,” while Registered Nurses are able to provide more in-depth assistance due to their associate’s or bachelor’s degree in nursing and license. For these reasons, being an RN also comes with an increased wage.
“Becoming a Registered Nurse undoubtedly requires longer schooling than to become a Licensed Practical Nurse,” Gilman assured. “For this reason, a Registered Nurse has more duties than an LPN and is generally expected to be able to handle situations requiring greater critical thinking skills.”
A Registered Nurse tends to complete more assessments and treatments which require greater critical thinking and responsibility than an LPN. This is because Registered Nurses have more extensive knowledge stemming from more rigorous educational requirements. Many LVNs go on to obtain an RN qualification. There are many schools that offer an RN bridge program which typically takes about a year.
“Income is always something else that will differ. The more schooling in nursing you receive, the higher the income and the greater your responsibilities. I enjoy the practical work in skilled nursing,” Grube said. “Note that in other areas of nursing, such as acute care or intensive care, you have the ability to be even more hands-on and to have more interaction with patients.”
Note that entrance requirements for RNs and LPNs school vary significantly by state and by school, however, in general, LPN applicants need a high school diploma or GED with a 2.0 GPA and sometimes, basic anatomy/physiology courses. LPN programs typically last one year. RN students may need a higher GPA average (2.5) and separate college-level courses in anatomy, physiology, and chemistry.
Most RN programs end in either an associate or bachelor’s degree with their own general education requirements and will take 2 to 4 years to complete. Although you may be able to find an LPN class with minimal entrance requirements, many of the LPN programs with more entrance requirements are gearing their students to advance their nursing career by easing a future transition from LPN to RN.
Guest Author Bio:
Lindsey Nolen is an experienced journalist specializing in health and healthcare. She received her bachelor’s degree from North Carolina State University in 2015 and has subsequently written for publications including ADVANCE Healthcare Magazines, CareersinHealthcare.com, The Philadelphia Business Journal, The Jacksonville Business Journal, and more. Lindsey can be reached at LindseySNolen@gmail.com.
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