What is a Licensed Vocational Nurse? What are their duties?

Licensed vocational nurses (LVNs) as they are called in Texas and California, care for the sick, injured, convalescent, and disabled under the direction of physicians (doctors) and registered nurses.

Most LVNs provide basic bedside care. They take vital signs such as temperature, blood pressure, pulse, and respiration. They also treat bedsores, prepare and give injections and enemas, apply dressings, give alcohol rubs and massages, apply ice packs and hot water bottles, and monitor catheters. LVNs observe patients and report adverse reactions to medications or treatments. They collect samples for testing, perform routine laboratory tests, feed patients, and record food and fluid intake and output. They help patients with bathing, dressing, and personal hygiene, keep them comfortable, and care for their emotional needs. In States where the law allows, they may administer prescribed medicines or start intravenous fluids. Some LVNs help deliver, care for, and feed infants. Experienced LVNs may supervise nursing assistants and aides.

LVNs in long term care facilities provide routine bedside care, help evaluate residents' needs, develop care plans, and supervise the care provided by nursing aides. In doctors' offices and clinics, they also may make appointments, keep records, and perform other clerical duties.

What are the working conditions?
Most licensed vocational nurses in hospitals and nursing homes work on average a 40-hour week, but because patients need around-the-clock care, some work nights, weekends, and holidays.

Employment information
Licensed vocational nurses held about 700,000 jobs in 2000. Twenty-nine percent of LVNs worked in nursing homes, 28 percent worked in hospitals, and 14 percent in physicians' offices and clinics. Others worked for home healthcare services, residential care facilities, schools, temporary help agencies, or government agencies; about 1 in 5 worked part time.

What personal qualities should one have?
Although LVNs work under the supervision of a doctor or registered nurse, & must be willing to take directions, they must also be able to work competently without constant instruction from others. In any clinical setting the patient is the most important person. LVNs must truly care about, & find satisfaction in serving, the patient. Because of the critical nature of many common clinical duties, the LVN must enjoy performing precise work, where details can be a matter of life or death. Even if a task is repetitive, an LVN must be able to complete the task accurately every time. LVNs must also be able to maintain this accuracy even in stressful or emergency situations. Many LVN duties require good manual dexterity, & LVNs should enjoy working with their hands. Good communication & interpersonal skills are also essential for an LVN, who must interact with coworkers, patients, & other health care professionals on a daily basis. Finally, all employers want dependable employees, but dependability is especially important for LVNs, since a patient's welfare may depend on their work.

LVNs should have a caring, sympathetic nature. They should be emotionally stable because work with the sick and injured can be stressful. They also should have keen observational and decision making skills.

What are the hours & salaries?
LVNs work the same hours & schedules as doctors and nurses. LVNs should expect to work weekdays & some weekends. Hospitals and clinics are often open & staffed 24 hours a day. LVNs should not expect to work the 9 to 5 weekday schedule common to some occupations. LVNs must be able to handle non - traditional work schedules & the demands they place on family & friends. However, evening, night & weekend schedules may be advantageous for some people, especially those interested in continuing their education.

There is a broad range of starting salaries for LVNs, depending on the type & location of facility (hospital/clinic etc.) where they are employed.

In hospitals, there are usually shift differentials of 10 to 15% paid in addition to base pay for work on evening, night or weekend shifts. Most facilities also provide fringe benefits such as paid sick leave, medical & dental insurance, & retirement plans.

Training, Other Qualifications, & Advancement?
All States require LVNs to pass a licensing examination after completing a State-approved practical nursing program. A high school diploma, or equivalent is required for entry.

In 2000, approximately 1,100 State-approved programs provided vocational nursing training nationwide. Almost 6 out of 10 students were enrolled in technical or vocational schools, while 3 out of 10 were in community and junior colleges. Others were in high schools, hospitals, and colleges and universities.

Most vocational nursing programs last about 1 year and include both classroom study and supervised clinical practice (patient care). Classroom study covers basic nursing concepts and patient-care related subjects, including anatomy, physiology, medical-surgical nursing, pediatrics, obstetrics, psychiatric nursing, administration of drugs, nutrition, and first aid. Clinical practice usually is in a hospital, but sometimes includes other settings.

What is the job outlook?
According to U.S. department of labor statistics, Employment of LVNs is expected to grow about as fast as the average for all occupations through 2010 in response to the long-term care needs of a rapidly growing elderly population and the general growth of healthcare. Replacement needs will be a major source of job openings, as many workers leave the occupation permanently.

Employment of LVNs in nursing homes is expected to grow faster than the average.Long term care facilities will offer the most new jobs for LVNs as the number of aged and disabled persons in need of long-term care rises. In addition to caring for the aged and disabled, Long term care facilities will be called on to care for the increasing number of patients who have been discharged from the hospital but who have not recovered enough to return home.

An increasing proportion of sophisticated procedures, which once were performed only in hospitals, are being performed in physician's offices and clinics, including ambulatory surgicenters and emergency medical centers, due largely to advances in technology. As a result, employment of LVNs is projected to grow much faster than average in these places as healthcare expands outside the traditional hospital setting.

Employment of LVNs is expected to grow much faster than average in home healthcare services. This is in response to a growing number of older persons with functional disabilities, consumer preference for care in the home, and technological advances, which make it possible to bring increasingly complex treatments into the home.