Nursing Roles: What LPNs Can and Can’t Do

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If you’re considering diving into healthcare but need help figuring out where to start, becoming a Licensed Practical Nurse (LPN) is a great first step. LPN responsibilities range from hands-on bedside care to providing essential support to doctors and registered nurses (RNs). Becoming an LPN is quicker than becoming an RN, offering a fast-paced, rewarding career while building a solid foundation for future growth in healthcare.

You may have heard LPNs called Licensed Vocational Nurses (LVNs)—they’re essentially the same role, just called by a different name in California and Texas. For the purpose of this article, Vivian Health will use the term LPN inclusively as we delve into their responsibilities, what sets this role apart from others, the path to becoming an LPN and an overview of job demand and salary.

LPN Responsibilities

The LPN role is highly versatile and adaptable, with their scope of practice steadily expanding over time. The National Council of State Boards of Nursing outlines that the LPN scope of practice, under the supervision of an RN or physician, includes the following standards:

• Assisting in planning care for stable or predictable patients
• Helping to identify patient needs and priorities with the RN, APRN or physician
• Monitoring patients and contributing to the development, modification and implementation of patient-centered care plans
• Implementing nursing interventions and prescribed medical regimens safely and timely.
• Accurately documenting care provided
• Collaborating and communicating patient information to ensure quality and continuity of care
• Advocating for patient rights, diversity and dignity
• Promoting a safe and healthy environment for patients and staff
• Maintaining professional boundaries
• Participating in quality improvement efforts to enhance patient outcomes
• Assigning and delegating nursing activities to assistive personnel based on their competence and skills
• Participating in nursing care, health maintenance, patient teaching, counseling and rehabilitation

LPNs meet patients’ day-to-day needs while providing direct care. The role requires clinical LPN skills and compassion, balancing patient interactions with technical duties. Some specific LPN responsibilities may include:

• Monitoring vital signs
• Administering medications
• Basic wound care
• Assisting with personal hygiene
• Taking patient histories
• Collecting samples
• Assisting with procedures
• Charting and documentation
• Educating patients and families
• Supporting RNs and doctors

This information reflects the scope of practice for LPNs as of October 10, 2024, but it’s important to note that the scope is continually evolving. It’s your professional responsibility to stay informed about your state’s specific regulations and limitations. Vivian Health has made every effort to gather accurate information from state boards, but we encourage you to verify with your local board to ensure compliance with the most up-to-date standards.

LPN Limitations and Restrictions

LPN responsibilities can change depending on the state and the type of healthcare facility. For example, in some states, LPNs may be able to administer intravenous (IV) medications, while other states limit this task to RNs. Similarly, the type of healthcare facility plays a role. LPNs working in long-term care facilities might focus more on personal care and wound management. Alternatively, LPNs in hospital settings may assist with more acute medical issues and perform more advanced procedures.

Because every facility and state can have different scopes of practice, understanding local regulations ensures LPNs know what they can do where they live and work. Some LPN limitations and restrictions in certain states include:

• Prescribing Medications: LPNs can’t prescribe medications in any state. 

• Diagnosing Medical Conditions: LPNs aren’t authorized to diagnose medical conditions anywhere in the U.S. This task is exclusively for doctors, nurse practitioners and physician assistants.

• Developing Care Plans: While LPNs often assist in gathering patient information, they don’t have the authority to create initial care plans independently. In some states, LPNs may contribute to care plans under the supervision of an RN.

• Administering IV Medications: An LPN’s ability to administer IV medications varies widely. For example, LPNs in Florida can administer IV medications with certification, but California restricts LPNs from starting IVs or administering IV push medications without RN supervision.

• Managing Complex or Critical Patients: LPNs generally can’t independently manage patients with complex or unstable conditions. 

• Initiating Blood Transfusions: LPNs aren’t permitted to initiate blood transfusions in many states, including New York and Texas. They can assist in monitoring patients during the process but can’t begin the transfusion.

• Performing Advanced Assessments: LPNs can assess basic vital signs and patient conditions but can’t independently perform comprehensive patient assessments or interpret clinical data. RNs or higher-level healthcare professionals must perform advanced assessments.

• Administering Certain Controlled Substances: In Oregon and Nevada, LPNs can only administer certain controlled substances and only under the direct supervision or presence of an RN or physician.

• Supervising Other Healthcare Workers: LPNs can’t supervise RNs in any state, but they may oversee nursing aides or other support staff in some settings.

What’s the Difference Between CNAs, LPNs and RNs?

Understanding the distinctions between various nursing roles is essential for aspiring healthcare professionals. LPNs, Certified Nursing Assistants (CNAs) and RNs each play vital roles within the healthcare system, but their scopes of practice and responsibilities differ significantly. The following table outlines the key differences and similarities in the scopes of practice for CNAs, LPNs and RNs, highlighting how LPNs fall between CNAs and RNs.

	CNA	LPN	RN
Education & Training	Short training program 4 to 12 weeks Pass a certification exam	Complete a 12 to 18-month program, often through vocational schools or community colleges  Pass the NCLEX-PN exam to obtain state licensure	Complete an Associate of Science in Nursing (ASN), which takes about 2 years, or a Bachelor of Science in Nursing (BSN), which takes about 4 years  Pass the NCLEX-RN exam for state licensure
Scope of Practice	Responsible for basic patient care, including bathing, dressing, feeding and assisting with mobility  Responsible for taking vitals and reporting changes in patient conditions to nurses Can’t perform clinical tasks like administering medication or handling complex procedures	Responsibilities include monitoring vital signs, administering medications, performing wound care and assisting with patient procedures like catheter insertion Limited in administering IV and certain high-risk medications and can’t independently create care plans or perform complex assessments based on each state’s regulations  No charge nurse responsibilities	Broadest scope of practice  Can perform all LPN duties and manage more complex patient care (developing care plans, performing detailed patient assessments, administering IV medications and initiating critical care interventions) Take on leadership roles and care for unstable patients with more severe conditions
Supervision	Work under the direct supervision of LPNs or RNs	Work under the supervision of RNs or physicians but may oversee CNAs	Work more autonomously than LPNs, though they often collaborate with LPNs, CNAs and doctors  Can supervise LPNs and are accountable for patients’ overall care

Related: LPN vs. CNA: What’s the Difference and Which Is Right for Your Career?

Collaboration Between LPNs and RNs

In healthcare settings, LPNs and RNs collaborate closely. LPNs are responsible for patients with less complex needs who typically require routine care, allowing them to work independently and report to RNs when necessary.

RNs oversee the broader, more critical aspects of patient care and are responsible for patients with complex conditions. They assess patients, develop care plans and manage more intensive treatments. While LPNs can manage their own group of patients, they frequently communicate with RNs about any significant changes in patient status or concerns that fall outside their scope of practice.

The teamwork between LPNs and RNs improves the efficiency of care delivery, ensuring that all patients receive the appropriate level of attention based on their needs.

Educational Pathways and Career Advancement for LPNs

LPN education and training is typically shorter and more affordable than other nursing programs, allowing for quick entry into the workforce. An LPN role provides a strong foundation in patient care, making it a sustainable career path to stay in or an excellent stepping stone for further nursing education.

To become an LPN, you complete a structured educational curriculum available through in-person or online programs. This pathway includes several essential steps that equip aspiring LPNs with the knowledge and skills needed for their roles in patient care. Here’s a closer look at the key steps involved in this educational process:

1. Earn a High School Diploma or GED
2. Complete an LPN Program: Most programs take about 12 to 18 months to complete and include classroom instruction and clinical training. An accelerated LPN program allows for quicker education. Core subjects typically cover anatomy, nursing fundamentals, pharmacology and patient care.
3. Acquire Clinical Experience: Students must complete supervised clinical hours in various healthcare settings, gaining hands-on experience under the guidance of experienced nurses.
4. Pass the NCLEX-PN Examination
5. Obtain State Licensure: Apply for licensure in the state where you intend to practice. Licensing may involve background checks and meeting other state-specific requirements.
6. Fulfill Continuing Education: Many states require LPNs to complete continuing education units (CEUs) to maintain their licensure. CEUs ensure that LPNs stay updated with the latest nursing practices and standards.

LPN Career Advancement

Starting in healthcare as an LPN offers a strong foundation for a fulfilling healthcare career, with numerous professional development and specialization paths.

LPNs can advance their careers by pursuing further education, such as an LPN-to-RN bridge program, allowing them to become RNs and expand their scope of practice. These programs allow LPNs to build on their education and clinical experience, typically taking 1 to 2 years to complete and leading to an ASN or a BSN. After completing the program, aspiring RNs must pass the NCLEX-RN exam to obtain their RN license.

Related: How Accelerated LPN Programs Can Fast-Track Your Nursing Career

LPN Specialities

LPNs can pursue various certifications and specialties to enhance their expertise and career opportunities. These specialties enable LPNs to expand their knowledge and skills in targeted patient care areas. Some specialties include:

• Certification in Long Term Care
  • Offered by the National Association of Practical Nurses Education and Services and requires 6 months of experience working with chronically ill patients 
• Certified Wound Treatment Associate 
  • From the Wound, Ostomy and Continence Nursing Certification Board and requires 2 years of experience as an LPN 
• Certified Hospice and Palliative Licensed Nurse 
  • Offered through the Hospice and Palliative Credentialing Center and requires between 500 and 1,000 hours of relevant experience 

Related: 10 Highest Paying LPN Specialities

LPN Salary and Demand 

The Bureau of Labor Statistics projects LPNs will experience an average job demand growth of approximately 3% over the decade between 2023 and 2033. As of October 10, 2024, Vivian Health had over 3,400 open positions for LPNs on its jobs marketplace, including staff roles, local contracts, travel contracts and per diem opportunities, with new listings added hourly.

LPN salaries can vary widely based on location, experience and the type of facility. According to salary data from Vivian Health on October 10, 2024, the average staff LPN hourly rate nationwide was $29.33, with higher pay in states experiencing nursing shortages or for LPNs with additional certifications. Some of the higher-paying states during this time included the following hourly rates: 

• Washington: $43
• California: $38 
• Virginia: $38
• Pennsylvania: $37
• Missouri: $34 
• New Jersey: $34

Provide Essential Care as an LPN 

LPNs are vital to the healthcare system, delivering crucial patient care and supporting the broader medical team. Their work ensures patients receive quality care while forming a crucial link between RNs, doctors and patients. As LPN responsibilities and regulations change and healthcare demands shift, LPNs should always stay current with shifting state regulations and consider expanding their knowledge through further education to enhance their healthcare careers. Whether by advancing to an RN or pursuing specialized certifications, LPNs have numerous pathways to move up the career ladder and continue making a significant difference in patient care.

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