Vocational Nursing

NATURE OF THE WORK
Licensed Vocational Nurses (LVNs) care for people who are sick, injured, convalescent, or disabled under the direction of physicians and registered nurses. The nature of the direction and supervision required varies by State and job setting.

LVNs care for patients in many ways. Often, they provide basic bedside care. Many LVNs measure and record patients’ vital signs such as height, weight, temperature, blood pressure, pulse, and respiration. They also prepare and give injections, enemas, and other medications, monitor catheters and dress wounds. To help keep patients comfortable, they assist with bathing, dressing, and personal hygiene, moving in bed, standing and walking. They might also feed patients who need help eating. Experienced LVNs may supervise nursing assistants and aides.
As part of their work, LVNs collect samples for testing, perform routine laboratory tests, and record food and fluid intake and output. They clean and monitor medical equipment. Sometimes, they help physicians and registered nurses perform tests and procedures. Some LVNs help to deliver, care for, and feed infants.

LVNs also monitor their patients and report adverse reactions to medications or treatments. LVNs gather information from patients, including their health history and how they are currently feeling. They may use this information to complete insurance forms, pre-authorizations, and referrals, and they share information with registered nurses and doctors to help determine the best course of care for a patient. LVNs often teach family members how to care for a relative or teach patients about good health habits.

Most LVNs are generalists and work in all areas of health care. However, some work in a specialized setting, such as a nursing home, a doctor’s office, or in home health care. LVNs in nursing care facilities help to evaluate residents’ needs, and supervise the care provided by nursing aides. In doctors’ offices and clinics, they may be responsible for making appointments, keeping records, and performing other clerical duties. LVNs that work in home health care may prepare meals and teach family members simple nursing tasks.

In some states, LVNs are permitted to administer prescribed medicines, start intravenous fluids, and provide care to ventilator-dependent patients.

WORK ENVIRONMENT
Most licensed vocational nurses in hospitals and nursing care facilities work a 40-hour week, but because patients need round-the-clock care, some work nights, weekends, and holidays.

LICENSE
Passing the NCLEX-VN licensing exam is required in order to become an LVN. The exam is developed and administered by the National Council of State Boards of Nursing. The NCLEX-VN is a computer-based exam and varies in length. The exam covers four major categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity.

OTHER QUALIFICATIONS
LVNs should have a caring, sympathetic nature. They should be emotionally stable because working with the sick and injured can be stressful. They also need to be observant, and to have good decision-making and communication skills. As part of a health-care team, they must be able to fol- low orders and work under close supervision.

ADVANCEMENT
In some employment settings, such as nursing homes, LVNs can advance to become charge nurses who oversee the work of other LVNs and of nursing aides. Some LVNs also choose to become registered nurses through numerous LVN-to-RN training programs.

EMPLOYMENT
Licensed vocational nurses held about 749,000 jobs in 2006. About 26 percent of LVNs worked in hospitals, 26 per- cent in nursing care facilities, and another 12 percent in offices of physicians. Others worked for home health care services; employment services; residential care facilities; community care facilities for the elderly; outpatient care centers; and Federal, State, and Local government agencies.

JOB OUTLOOK
Employment of LVNs is projected to grow faster than average. Overall job prospects are expected to be very good.

EMPLOYMENT CHANGE
Employment of LVNs is expected to grow 14 percent between 2006 and 2016, faster than the average for all occupations, in response to the long-term care needs of an increasing elderly population and the general increase in demand for health care services.

Many procedures once performed only in hospitals are being performed in physicians’ offices and in outpatient care centers such as ambulatory surgical and emergency medical centers, largely because of advances in technology. LVNs care for patients who undergo these and other procedures, so employment of LVNs is projected to decline in traditional hospitals, but is projected to grow faster than average in most settings outside of hospitals. However, some hospitals are assigning a larger share of nursing duties to LVNs.

Employment of LVNs is expected to grow much faster than average in home health care services. Home health care agencies will offer a large number of new jobs for LVNs because of an increasing number of older people with functional disabilities, consumer preference for care in the home, and technological advances that make it possible to bring increasingly complex treatments into the home.

Employment of LVNs in nursing care facilities is expected to grow faster than average, and provide the most new jobs for LVNs, because of the growing number of people who are aged and disabled and in need of long-term care. In addition, LVNs in nursing care facilities will be needed to care for the increasing number of patients who have been discharged from the hospital but who have not recovered enough to return home.

JOB PROSPECTS
Replacement needs will be a major source of job openings, as many workers leave the occupation permanently. Very good job opportunities are expected. Rapid employment growth is projected in most health care industries, with the best job opportunities occurring in nursing care facilities and in home health care services.