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Can LPNs Save Hospitals from the Nursing Shortage?

It was a decade ago when the rallying cry came forth: "We are running out of nurses!" Today, many hospitals face a shortage of nursing staff. It is expected to only get worse over the next 15 years, when baby boomers reach retirement and need more health care. The fact that some of those retiring baby boomers will be nurses themselves makes the situation even more precarious.

However, there are solutions to the nursing shortage. One of the most promising is a group of individuals who have so far been underutilized in health care: Licensed practical nurses or licensed vocational nurses.

How bad is the nursing shortage?

According to the Bureau of Labor Statistics, there were just over 718,000 licensed practical nurses in the United States in May 2012. The job outlook is expected to be excellent, with 22 percent growth in the profession from 2010 to 2020, or an increase of 168,500 nurses.

The job duties of an LPN vary according to state rules and the health care setting. Typical responsibilities include basic bedside care, applying dressings, treating wounds, monitoring vital signs or catheters, administering injections and more basic duties. In some states, LPNs can also provide IV fluids and medications.

A May 2007 report prepared for the United Nurses of America found that even as the numbers of LPNs rose, the number of positions for LPNs in hospitals actually declined. The report found that in the 20 year period between 1984 and 2005, hospital employment of LPNs fell by 47 percent while the actual number of LPNs rose by 18 percent. Some of this can be explained by the vast nursing cuts that occurred during the 1990s, but the shift from "team nursing" to "primary care" likely also played a role.

As the number of LPNs has dropped, registered nurses have become overburdened with patient care, as they are now doing the work of their own position as well as that of an LPN. As a 2012 report from the Department for Professional Employees (DPE) points out, overworked nurses can face higher rates of injury, suffering cardiovascular health, burnout, lower job satisfaction and more. Patients can also face troubling problems: Studies have found that for every extra patient over four that is under a registered nurse's care, the risk of death for hospital patients increases by seven percent.

Can licensed practical nurses ease the nursing shortage?

Many experts believe that licensed practical nursing is the answer to alleviating the nursing shortage. LPNs hired by hospitals could relieve much of the work that is now placed on the shoulders of registered nurses, thus freeing up their time and possibly improving employee retention rates. LPNs who are interested in becoming RNs could also make use of the LPN to RN bridge programs to move into work as registered nurses.

The need for patient ratio control is a serious factor in the nursing shortage. This is borne out by the nursing situation in the state of California, where nurse-to-patient staffing ratios were implemented in 2004. During that year, applications for nursing licenses increased by 60 percent. Four years later, open registered nursing positions in California had fallen by 69 percent.

Wages also matter in the fight to keep the nursing shortage at bay. The DPE report stated that most of the nursing shortage is seen in places like Florida, where the need for nurses is high. However, low wages and tough working conditions could be a reason that LPNs are seeking jobs out of state or choosing to leave the profession altogether.

Nurses are on the front lines of patient care. By offering more jobs for LPNs and encouraging LPNs to enter LPN to RN bridge programs, health care facilities might be able to head off the nursing shortage before it becomes an even more serious issue.

Sources:

"Can the use of LPNs alleviate the nursing shortage? Yes, the authors say, but the issues -- involving recruitment, education, and scope of practice -- are complex," National Institutes of Health, July 2006

"Licensed Practical and Licensed Vocational Nurses," Bureau of Labor Statistics, Occupational Employment Statistics, March 29, 2013

"Licensed Practical and Licensed Vocational Nurses," Bureau of Labor Statistics, Occupational Outlook Handbook, March 29, 2012

"Nursing: A Profile of the Profession," Fact Sheet 2012, dpeaflcio.org, April 2012

"The LPN: A Practical Way to Alleviate the Nursing Shortage," afscme.org

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