Should I Become an LPN or a CNA?

Licensed practical nurse (LPN) and certified nursing assistant (CNA) programs both facilitate quick timelines and prepare graduates to provide entry-level patient care. LPNs provide a higher level of care than a CNA in most settings. They work under the supervision of registered nurses (RNs) and physicians monitoring patients, administering first aid, and updating health records. CNAs provide basic care and help patients with daily living tasks under the direction of LPNs and RNs.

LPNs practice with more independence than CNAs and can perform duties beyond those of CNAs, such as assisting with minor surgeries, monitoring catheters, and administering injections.

The table below highlights the differences and similarities of the two careers. Because LPNs have more responsibility and autonomy than CNAs, it is important to understand the variations in salary, educational requirements, and workplace options.

LPNs hold practical nurse licenses and receive more training and responsibility than CNAs. CNAs must pass a competency exam in most states, but they fill assistant roles and often work under the supervision of LPNs. In addition, LPNs earn higher salaries than CNAs.

Becoming a CNA offers valuable experience in caring for patients’ daily needs and performing basic medical services. CNAs may be able to transfer credits toward their LPN certificates or diplomas, and some schools offer CNA-to-LPN bridge programs. CNAs should plan for at least a year of schooling to become an LPN.

Enrolling in an LPN training program at a vocational school or community college offers the quickest route to earning LPN credentials. Students can complete most programs in 1-2 years. Some schools and programs may offer accelerated tracks, which can cut the timeline to under one year.

The advantages of becoming a CNA include spending weeks or months, instead of years, in school; discovering whether you like nursing without spending a lot of time and money on training; earning money toward further education; and gaining experience working with patients and nursing staff in healthcare settings.

LPNs and CNAs focus on direct patient care, and their duties may overlap to a certain extent. In both positions, these healthcare team members spend much of their time assisting patients with day-to-day needs, such as cleanliness, mobility, and health monitoring. The lists below provide specific differences and similarities between the two jobs.

LPNs’ job duties combine helping patients with daily living and providing basic nursing care.

Typical tasks include:

As part of medical care teams, CNAs work under the direction of RNs and LPNs to provide the following services:

Most CNAs and LPNs find employment in assisted living and retirement communities, home healthcare services, hospitals, and nursing care facilities, but the top-paying industries for both positions include less common employers. Bigger paychecks can be earned in higher education, research and development, and outpatient care centers. CNAs, in particular, can see increases of around $10,000 per year in these work settings, compared to more typical healthcare worksites.

The U.S. Bureau of Labor Statistics (BLS) lists the average annual compensation for LPNs at $50,090, with the lowest 10% of earners making below $35,570 and the top 10% making at least $65,520. The BLS reports an average annual salary of $32,050 for CNAs, with the lowest 10% paid less than $22,750 and the highest 10% making more than $42,110. The average hourly wage figures translate to $24.08 for LPNs and $15.41 for CNAs.

Projected employment outlooks for 2019-2029 indicate that LPNs should see a growth rate of 9% and CNAs can expect an 8% growth rate.

Geography plays a significant role in how much LPNs earn, and the table below lists the five highest-paying states. LPNs fare the best in the Western United States, with the exception of those in Massachusetts. These top-paying states bump up LPN earning potential by at least $9,000 a year.

The highest-employing states include California with an average annual salary of $64,090, Texas with a $48,380 average salary, and New York with a salary of $51,300.

The states in 2020 with the highest annual pay for licensed practical nurses are:

The top-paying states for CNAs bookend the nation on the East Coast and the Pacific. CNAs in these locales can expect to earn average annual salaries of at least $5,000 more than the national average.

California tops the list of states with the highest employment levels of CNAs, with an average annual salary of $39,280, followed by Florida at $28,660 and New York at $40,620.

The states in 2020 with the highest annual pay for certified nursing assistants are:

Entry-level CNA and LPN education and credentialing offer faster routes into the nursing field than traditional nursing schools. Neither CNA training programs nor LPN schools award degrees but instead lead to diplomas or certificates. Rather than spending 2-4 years in undergraduate nursing programs, CNAs can complete their training in a few months, and LPNs can complete their training in about a year. Both CNAs and LPNs need to pass an examination to start working in their respective positions.

CNAs and LPNs go through similar steps to earn their licenses and certifications, but important differences do exist. LPNs receive additional training in nursing procedures, along with preparation for working more autonomously and supervising CNAs and other staff. The sections below outline the expected curriculums, examinations, and licensing procedures that CNAs and LPNs experience.

The first step to becoming an LPN consists of finding and applying to an accredited LPN program at a vocational, technical, or community college. Some high schools and hospitals may also offer training. Applicants need a high school diploma or GED certificate, and some schools may require an entrance exam, such as the Test of Essential Academic Skills.

Admitted students can expect to complete 45-40 credits of coursework in nursing fundamentals, anatomy, biology, and pharmacology, along with lab components and 500-750 clinical hours at a hospital, nursing home, or healthcare facility.

Graduates of LPN programs must take the National Council Licensure Examination (NCLEX-PN), which tests their preparation and readiness to begin work in practical nursing. Once they receive a passing score, candidates qualify for state licensure as an LPN — known as a licensed vocational nurse in California and Texas.

Prospective CNAs can enroll in state-approved training programs through community colleges, hospitals, and organizations like the American Red Cross. High school graduates and GED certificate holders qualify for admission. Some states allow on-the-job CNA training at nursing and assisted living centers and other healthcare facilities. Many hospitals will allow BSN nursing students to work as CNAs after their first year in nursing school. This is a good way for students to get additional patient care experience and network, increasing employment opportunities after graduation.

Students can complete some of their training online, but hands-on experience may also be required to practice such skills as cardiopulmonary resuscitation, first aid, basic nursing care, and using automated defibrillators. In-person or online coursework typically includes anatomy, physiology, and patient care fundamentals and safety.

CNA credentialing procedures vary by state. Most states certify CNAs to begin working once they have completed 75 hours of instruction and clinical experience. CNAs must also pass a competency examination. Certification must be renewed every two years, and states may require completion of continuing education credits.