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A Primer on Nursing’s Alphabet Soup

A Primer on Nursing’s Alphabet Soup

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  • A nurse can be an LPN, RN, LVN or NP.

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For the average consumer, decoding health care can be about as easy as deciphering a bank’s balance sheet.

It’s not just the process of finding the appropriate care provider and maneuvering the insurance maze that makes understanding health care difficult. Members of the healthcare industry seem to speak in what many would describe as code.

Is your health expense OON (out-of-network) or OOP (out-of-pocket)? Are you afflicted with a chronic digestive disorder that doctors call GERD for short, or are you in need of a heart surgery that’s referred to as “cabbage” for its abbreviation CABG?

Even understanding the skills and qualifications of the person caring for you involves a bit of industry alphabet soup. Depending on where you are in the health system, you could be receiving care from an LPN (licensed practical nurse), RN (registered nurse), LVN (licensed vocational nurse) or NP (nurse practitioner).

For anyone who’s thought a nurse is a nurse, the difference between the two most popular licenses — licensed practical nurses and registered nurses — might just be surprising.

Not only is there a marked difference in the level of education between the two, but the responsibilities each can hold vary significantly.

LPNs are often the people who provide basic bedside care. According to the U.S. Department of Labor, the duties of an LPN include: measuring and recording vital signs; preparing and giving injections; monitoring catheters; dressing wounds; bathing and helping keep patients comfortable.

They are educated at the vocational level and have a limited scope of practice, always under the direction of an RN or other physician, says Dan Coble, a registered nurse and acting dean of the College of Nursing at South University — Savannah.

Registered nurses, on the other hand, hold more responsibility. Not only do they treat patients directly, they help perform diagnostic tests and analyze the results, the U.S. Department of Labor says. RNs also operate medical machinery, administer medication, and educate patients and the public about various medical conditions.

“A registered nurse covers a much broader scope of practice,” says Carol Bickford, senior policy fellow with the Department of Nursing Practice and Policy of the American Nurses Association. “They tend to be more of a leader and coordinator of care.”

Registered nurses are educated at the professional level and can practice independently in most states, Coble says.

From the patient perspective, that means that RNs can be found everywhere, Coble says. Indeed, there were about 2.6 million registered nurses in the United States in 2008 compared with only 753,600 LPNs and LVNs, according to statistics from the U.S. Department of Labor.

Because of the broader scope of responsibility, registered nurses are a staple in hospitals. According the government, nearly 60% of registered nurses work in hospitals compared with only about 25% of LPNs.

But those numbers could soon change.

“Due to the economy, many hospitals have reduced their need for nurses at both the LPN and RN level,” Coble said. “But the demand for RNs is expected to return after the economic recovery is complete.”

LPNs are far more likely to be found working outside hospitals – whether in nursing homes (28%), physician offices (12%), home health care, or community care for the elderly, according to the Department of Labor.

“Long-term care facilities are still hiring LPNs, but the number of opportunities is still limited,” Coble says.

For aspiring nurses contemplating one track over another, there are multiple factors to take into consideration.

Registered nurses earn more — the median wage for an RN in May 2008 was $62,450 compared with $39,030 for an LPN, according to the Department of Labor – but they also must spend more time, and therefore money, in pursuit of their education.

Most LPN programs last about a year and are offered by vocational and technical schools or by community colleges, according to the Department of Labor. The program must be state-approved for the student to be eligible for licensure.

To become a registered nurse, you must complete at least a two-year degree and pass the licensing exam, says Bickford of the ANA.

There are three typical educational paths to registered nursing: a bachelor’s of science degree in nursing (BSN), an associate degree in nursing (ADN) and a diploma.

A diploma can be earned at a hospital and take about three years to attain, according to the Department of Labor. It takes anywhere from two to three years to finish an ADN program, which typically is offered by community and junior college. And BSN degrees, which are offered by colleges and universities, usually take about four years to complete.

At South University, the BSN degree is designed for registered nurses who wish to become more proficient in their field and focus on the delivery of patient care. The program is accredited by the Commission on Collegiate Nursing Education.

“There are only a few LPN to BSN programs in the U.S., mainly due to the requirements in baccalaureate level education for general studies and humanities course requirements,” says Coble of South University. Another factor, he added, is the inability to transfer LPN (vocational) courses to the university level.

So what sort of market is there for either specialty?

Given the changing healthcare landscape, it can be difficult to say. “You can hire an LPN for lot cheaper than a RN,” Bickford says.

But healthcare providers must be careful to use LPNs only where such a license makes sense, Coble says.

“LPNs are under pressure to exceed their authority under the State Nurse Practice Acts and to perform tasks and duties that really require an RN,” he says.

At the same time, however, there could be growing demand for RNs to take a greater role in providing some services such as diabetes management. As Coble points out: “Since RNs by State Nurse Practice Acts are licensed to perform assessment and nursing diagnosis, agencies have increased the ratios of RNs in the workforce, mostly in acute care.”

Written by freelance talent for South Source.

© South University