Licensed practical nurse
From Wikipedia, the free encyclopedia
Licensed practical nurses (LPNs) are also known as licensed vocational nurses (LVNs) in California and Texas and as registered practical nurses (RPNs) in Ontario. They are called enrolled nurses (ENs) in Australia and state enrolled nurses (SENs) in the United Kingdom. LPNs generally have more training than certified nursing assistants, and less training than registered nurses.
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[edit] United States
These individuals usually have twelve months to two years of training in anatomy and physiology, pathophysiology, pharmacology, and practical patient care. They must pass state or national boards (such as NCLEX-PN in the U.S.) and renew their license periodically.
LPNs can perform simple as well as complex medical procedures, but must operate under the supervision of either a registered nurse (RN) or a physician. They can administer most medications, in some states may start IV's and administer IV push medications, monitor patient response to medications, implement wound care, perform vital sign measurements (blood pressure, heart rate, temperature, oxygen saturation, etc), maintain patient records, help with patient-care planning, surgery, Basic Life Support, sterile and isolation procedure, collect samples for lab testing and provide a standard and consistent level of care.
LPNs work in a variety of health care settings. They are often found working under the supervision of physicians in clinics and hospitals, or in private home health care. In long term care facilities, they sometimes supervise nursing assistants and orderlies.
The United States Department of Labor's Bureau of Labor Statistics estimates that there are about 700,000 persons employed as licensed practical and licensed vocational nurses in the U.S.
LPNs must at least be high school graduates. They follow the rules of State Boards of Nursing. Requirements for taking boards usually include a clean criminal record and graduation from an approved practical nursing program.
The first practical/vocational nurse training occurred at the Young Women's Christian Association in New York City in 1892. The first official training was three months long, offered at the Ballard School in New York in 1893. Students studied homemaking as well as learning how to care for patients. Some states did not have licensure for LPN/LVNs until 1955. Current training is usually college-based.[1]
[edit] United Kingdom
The state enrolled nursing qualification can no longer be gained in Britain. Prior to the implementation of Project 2000 which radically altered the face of nurse education in the mid-nineties SEN students used to follow the first twelve months training of the state registered nurses (SRNs, now known as level one nurses), and then had another twelve months of training before sitting SEN exams and becoming registered. Some auxiliary nurses with many years of experience used to be allowed to sit the SEN exams and enter the register without requiring further training. People training to be SRNs who failed their exams at the third attempt were also able to enter the nursing register as a SEN. Although no new SENs are trained in the UK, the Nursing and Midwifery Council (the regulatory body for nurses in the UK) does allow people to be added to the register as level two nurses if they are moving from a similar position from within the European Union.[2]
Formerly, there was a large segregation between the "green" SENs and "blue" SRNs, which were the colour of uniform typically worn. SENs were very much complementary to the nursing team, however did not have the status of SRNs and were ineligible to be promoted, e.g to ward sister. Many SENs sat or re-sat the SRN exams, however a large number did not and were quite content being a SEN. Nowadays, the divide between level one and two nurses is diminishing due to the small number of SENs still in practice. However, many SENs had the same responsibility as level one nurses, especially in a ward environment and were expecting to perform largely the same duties such as taking charge of wards unsupervised at night as well as taking charge of wards on nights and weekends. The demise of the SEN is lamented by many who saw it as a balanced way to staff a ward. However, the divide also meant that potentially, the gap in clinical excellence could be too wide.[3]
Auxiliary nurses (also known as nursing assistants, healthcare assistants, or clinical support workers) are taking on a lot of tasks which have until now been done by the registered nurses - things like taking blood samples, changing dressings, and recording ECGs. Recent announcements consider these staff having their own part on the nursing register. At present they work under the supervision of a registered nurse who is accountable for their actions. Auxiliary nurses on their own part of the register would have huge implications regarding professional responsibility, pay and conditions along with logistical problems.
[edit] Australia
Enrolled nurses in Australia usually spend twelve months training, consisting of fourteen (14) weeks theoretical component at TAFE colleges, followed by practical experience in hospital wards for the remainder of the time. The majority of EN's eventually move on to attend university and become registered nurses, although a substantial number remain as EN's in public and private hospitals, and nursing homes. Trainee enrolled nurses (TEN's) become employees of the hospital for the twelve month training period, meaning that, as well as gaining practical experience on the wards, they are paid for hours worked. This attracts a substantial number of applicants, who may wish to pursue nursing as a career, but are unable to afford to become full-time university students. The enrolled nurse programme also allows people to ascertain whether or not they are suited to nursing, before they make the decision to study it at university level.
The role of enrolled nurses in Australia has greatly increased in recent years, in response to the continuing shortage of registered nurses in the Australian public health care system. In 2004, a medication endorsement certificate was introduced, allowing EN's to administer most oral medications (excluding schedule 8 drugs of addiction) upon completion. Endorsement also permits the administration of some intravenous (IV) medications and fluids (intravenous therapy or IVT), as well as intramuscular (IM) and subcutaneous (SC) injections. Endorsed enrolled nurses (EEN)'s are also permitted to check & give S4D and S8 medications with a registered nurse. Most Enrolled Nurses working in public hospitals are permitted to conduct ECG's, collect pathology specimens, and routinely take a patient load under the direct or indirect supervision of a registered nurse.
Despite the fact that the role of the EN in Australia has been greatly expanded in recent years, opportunities for career progression remain somewhat limited, and for this reason, many choose to go on and study to become registered nurses. In terms of financial renumeration, the earning capacity of an enrolled nurse is capped at five (5) years of service, whereas registered nurses continue to eight (8) years before salary capping is applied.
[edit] See also
[edit] External links
- List of US & Canadian LPN Schools - Directory of accredited LPN programs
[edit] References
- ^ Texas Collaborative for Teaching Excellence.. "Nursing Education: Yesterday".
- ^ Karen Iley (2004). "Occupational changes in nursing: the situation of enrolled nurses" (in English). Journal of Advanced Nursing 45 (4): 360–370. doi:.
- ^ Francis, Becky; John Humphreys (August 1999). "Enrolled nurses and the professionalisation of nursing: a comparison of nurse education and skill-mix in Australia and the UK" (in English). International Journal of Nursing Studies 36 (2): 127–135. doi:.
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