Top 8 Challenges for an LPN
Patients rely on licensed practical nurses (LPNs) for emotional support and assistance with daily activities. LPNs help patients with tasks like bathing, dressing changes, and walking. Registered nurses (RNs) depend on LPNs to implement care plans and record patient medical histories in various healthcare settings, including nursing homes, hospitals, doctors’ offices, and rehabilitation centers.
However, LPNs have a narrower scope of practice compared to RNs due to state regulations and workplace rules. While becoming an LPN requires less time than becoming an RN, the entry-level education requirements can limit LPNs and licensed vocational nurses (LVNs).
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This guide for LPNs highlights the challenges they face, including demanding work environments, limited opportunities for advancement, salary constraints, and shortages in the nursing workforce.
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1. Experience vs. Education
LPNs generally have less education compared to RNs. However, this doesn’t mean LPNs lack experience, as many have worked in nursing for decades. They often specialize in areas like respiratory and physical therapy. State regulations and workplace policies, including those set by the Nurse Practice Act, can restrict the roles of LPNs.
LPNs may have fewer chances for career growth without further training. This can lead to situations where LPNs with extensive experience are managed by less experienced RNs, which can be frustrating.
While LPNs may have decades of experience, hospitals and employers might still limit their roles, favoring education over experience. LPNs require a certificate, diploma, or associate degree, while RNs often hold a bachelor of science in nursing (BSN) degree. Professional nursing organizations, like the American Association of Critical-Care Nurses, recommend that RNs have at least a four-year degree.
2. Limited Job Outlook
The projected job growth rate for LPNs is 9%, which matches the average growth rate across all industries, according to the U.S. Bureau of Labor Statistics (BLS). While there’s potential for about 60,700 new LPN jobs each year, career advancement within the LPN field is limited without further education.
The roles and responsibilities of LPNs compared to RNs can vary based on the setting and location. LPNs may perform tasks like administering medication and starting intravenous drips, which are typically reserved for RNs in certain states. By engaging in duties typically done by registered nurses, LPNs can prepare for the clinical requirements needed to become an RN.
3. Demanding Working Conditions
LPNs often work long shifts at inconvenient hours, including nights, weekends, and holidays. Private practice employment can offer relief from these demanding hours, but such opportunities are rare for LPNs. Pursuing a higher degree is another way to potentially avoid these challenging work schedules.
Physical demands take a toll on LPNs, as many develop back and joint problems due to frequent bending, lifting, and prolonged standing.
Additionally, LPNs frequently handle hazardous materials and care for patients with infectious diseases. Hospitals can be breeding grounds for infections, exposing LPNs to risks like methicillin-resistant Staphylococcus aureus (MRSA). Equipment such as X-ray machines also poses risks, along with other hazardous substances like sterilizing agents and chemotherapy drugs.
4. Capped Wage Outlook
State regulations often establish wage and benefit caps for nurses, including LPNs. Even experienced LPNs may face limited salary negotiation, leading to stagnant wages despite gaining skills and training.
Salaries for LPNs vary based on education and specialization. The median annual salary for LPNs is $48,820 according to the BLS.
LPNs with certificates or diplomas earn an average annual salary of $43,000 (June 2020 data), while those with associate degrees make around $45,000 annually. Specialized areas like occupational health and rehabilitation can offer higher-paying LPN positions, with average annual salaries reaching $50,000.
5. Problems With Delegation
LPNs work under the delegation of RNs, which can lead to challenges. LPNs are often restricted from performing routine tasks and critical functions without explicit permission. This regulatory environment can put LPNs at risk of violating rules and regulations.
As an LPN, you are not authorized to diagnose, assess, or evaluate patients. These responsibilities are typically carried out by RNs or doctors, who then delegate tasks to LPNs. This arrangement can sometimes make managing your workload challenging.
While RNs usually have standard delegations for LPNs, there might be instances where you feel uncertain about tasks assigned to you.
6. Challenging Patients
LPNs are frequently at the forefront of primary care, interacting closely with patients. They often work in residential settings, where they encounter challenging patients.
Patients might exhibit fear and react negatively towards staff, and their families may not fully comprehend the situation, leading to inappropriate behavior towards LPNs. While often stemming from misunderstandings, these interactions can be difficult to manage.
In the past, nurses would tolerate physical abuse from patients as an occupational hazard. However, healthcare facilities have implemented zero tolerance policies and identification methods for abusive patients.
Professional healthcare organizations have advocated for laws protecting healthcare workers and prosecuting offenders to safeguard LPNs from such situations.
7. Staffing Shortages
The COVID-19 pandemic exacerbated nursing shortages in the US as nurses retired early. Employers struggled to retain nurses due to burnout caused by longer shifts, heavier workloads, and less time with patients.
Budget cuts have further strained healthcare staff, forcing nurses to handle larger workloads. This situation jeopardizes both LPNs and their patients, leading to increased medical errors, workplace injuries, and compromised health data.
Demand for LPNs may rise with the aging baby boomer population and the growing need for treatment outside hospitals, especially for chronic conditions like diabetes. The BLS predicts that LPN employment will reach 751,900 by 2030, up from 688,100 in 2020.
8. Dealing With Death
LPNs provide care to sick and dying patients, including offering support to grieving families and providing advice on bereavement resources. Nurses also experience grief after losing patients.
Understanding the stages of grief remains crucial in nursing and is covered in the National Council Licensure Examination.
LPNs can enhance their careers by pursuing higher education and specialized training. Earning a BSN and a master’s in nursing degree can elevate LPNs to a more knowledgeable nursing category and make them eligible for the NCLEX-RN exam. Specialized areas like occupational health, rehabilitation, palliative care, and gerontology also offer higher-paying LPN roles, with average salaries ranging from $47,500 to $50,000.
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