Licensed practical nurses, called licensed vocational nurses in California and Texas, help provide patient care under the supervision of either registered nurses or physicians. There are some differences in LPN supervision and LPN duties by state, but there is general agreement about most of their work.
Licensed practical nurses provide direct patient care and record information. They report back to nurses or physicians. They are the most hands-on part of the team, also the ones who communicate information about a patient to other providers.
LPNs can provide basic nursing care in a hospital setting. In the hospital, they record vital signs, including temperature, blood pressure, pulse, and respiration. They take care of the patient directly, by changing wound or surgical dressings, applying hot and cold compresses, giving massages and alcohol rubs, and administering enemas when necessary. Practical nurses clean and assemble equipment for patient use, including necessary equipment for oxygen therapy, intravenous therapy, and indwelling catheters. LPNs collect samples for lab tests, and do simple tests themselves. Some states allow them to start intravenous lines, some do not. Some states let them give oral and injectable medications, some do not. Practical nurses might help doctors or registered nurses do procedures. In some areas they help deliver and take care of babies. Duties vary not just by state but also depend on where the LPN is working.
They can be on intravenous therapy teams, and learn other special procedures so they can work in critical care settings.
In all cases they keep meticulous records about their patients' condition. They note the amount of fluids taken in and going out, how much food the patient is eating, and the condition of the patient's wound or surgical site. They recognize, record, and report any changes in the patient's condition and any adverse reaction to treatment. They record any medication administered, and how much oxygen is being used.
LPNs also provide patients with assistance in some day-to-day activities of daily living. They can help patients who cannot walk very much with range of motion exercises. They assist patients as they walk and go to the bathroom. They may bathe patients, and help dress them. They may help feed patients.
There are additional tasks hospital LPNs can do, if they get extra training and certification. They can be on intravenous therapy teams, and learn other special procedures so they can work in critical care settings.
In a doctor's office, an LPN may take and record patients' medical histories and report them to the physician. They may help with insurance forms and other paperwork. They will also record vital signs in an office setting. They may do other tasks similar to what they do in the hospital, such as clean and dress wounds. They often help educate patients and their families. They also may make appointments and help keep records.
In nursing homes, LPNs help devise plans for residents based on their needs. Experienced LPNs may supervise nurses' aides. They supervise or deliver most of the care in a nursing home. When working in patients' homes, practical nurses will teach family members how to do some of what the patients need. They might also help prepare appropriate meals, taking the patient's illness and condition into account.
Wherever they work, licensed practical nurses do the things a lot of people think of as nursing. They are often called "angels in comfortable shoes."
