Should I Become an LPN or CNA?

Those seeking entry-level work in the healthcare field may experience confusion while trying to decide between becoming a certified nursing assistant (CNA) or a licensed practical nurse (LPN). Each of these positions — which entail working under the supervision of a registered nurse (RN) or other physician to see to the general comfort and needs of patients — plays a vital part within a healthcare team.

Though similar on the surface, CNA and LPN careers involve different educational paths and varying job duties in the workplace. Read on to gain a better understanding of LPN and CNA responsibilities, degree requirements, and employment outlooks.

LPN vs. CNA: Status, Duties, and Responsibilities

CNAs

Exact job duties of a CNA vary depending on workplace requirements and patient needs, but CNAs generally fulfill daily tasks that provide for the basic care of patients. CNAs perform both medical and nonmedical tasks, including measuring vital signs; recording patient health concerns; and helping patients bathe, dress, and use the bathroom. Depending on their level of training and the regulations of their home state, CNAs may or may not dispense medication.

When employed by a hospital, CNAs usually spend a majority of their time responding to call lights of patients and completing assigned tasks such as transferring patients. CNAs working in long-term care facilities like nursing homes act as residents’ primary caregivers, seeing to their daily routines and comfort.

In all workplace settings, CNAs work under the supervision of RNs or LPNs. Due to the nonspecialized, entry-level nature of the job, CNAs earn a lower annual median salary than most other healthcare positions — about $27,520.

LPNs

LPNs provide basic medical care to patients in hospitals and other healthcare facilities, including nursing homes. Duties often include monitoring patient vitals; handling basic healthcare tasks; reporting patient status and concerns to RNs or doctors; and helping patients or residents with essential tasks like bathing, dressing, or transferring, as needed.

The extent of medical care an LPN can provide depends upon their training and state regulations. All LPNs can complete basic tasks like changing bandages or inserting catheters, for example; but not all LPNs can administer medication or start IV drips. LPNs work under the supervision of RNs and doctors, and in some states, experienced LPNs may supervise CNAs and other unlicensed medical staff members.

Although LPNs work in entry-level positions, their licensure and more advanced responsibilities equate to a higher average median salary than CNAs — about $45,030.

Work Settings

CNAs

Despite CNA vs LPN vs RN differences in job duties, these healthcare professionals work in similar settings. Every workplace demands a great deal of physical exertion and emotional strength from CNAs in order to move patients and handle stressful situations. The demand for healthcare services never stops, meaning CNA work schedules often include weekends, holidays, and evenings.

Approximately one-third of all CNAs hold employment at skilled nursing care facilities, where full-time salaries fall just under the $27,520 national average for all CNA occupations. CNAs working in hospitals and for the government generally earn higher pay.

The Largest Employers of CNAs

Work Setting Percent Employed Median Annual Salary
Nursing Care Facilities 37% $27,470
Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly 18% $26,700
Specialty (except Psychiatric and Substance Abuse) Hospitals 10% $31,120
General Medical and Surgical Hospitals 7% $30,640
Home Healthcare Services 6% $27,210

Source: BLS

LPNs

When deciding between a career as a CNA, RN, or LPN, your workplace preference won’t make much of a difference, as all healthcare workers can find employment in a variety of facilities. Nearly 40% of LPNs work in skilled nursing and residential care facilities like nursing homes, where they generally earn the highest salaries available in this career.

The job duties of an LPN require frequent physical work like helping patients stand, walk, or move in bed. Additionally, constant contact with injured and sick individuals can take an emotional toll. Most LPNs work full time and often take shifts longer than eight hours, including on weekends, holidays, and nights.

The Largest Employers of LPNs

Work Setting Percent Employed Median Annual Salary
Nursing Care Facilities 13% $47,030
Home Healthcare Services 6% $46,320
Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly 6% $46,710
Offices of Physicians 4% $42,470
Government 4% $44,860

Source: BLS

LPN vs. CNA Salary and Employment Outlook

CNAs

The lowest and highest 10% of CNAs earn annual median salaries of fewer than $20,680 and more than $38,630, respectively. When examining CNA vs LPN salaries, it may seem like an easy decision to choose the career with a higher national average. However, aspiring healthcare professionals must also consider the median salaries of their home state, as CNAs in certain areas earn more than the median of $27,520. See the table below for more state-specific employment details.

Nationally, the demand for skilled healthcare professionals remains high, and entry-level CNA work proves no exception. As the baby boomer population ages, the need for skilled nursing assistants in assisted living and other long-term care facilities continues to increase. The U.S. Bureau of Labor Statistics projects CNA job opportunities to grow by 11% between 2016-2026, a rate faster than a majority of U.S. occupations.

Top-Paying States for Nursing Assistants

State Employment Annual Mean Wage
Alaska 1,850 $37,950
New York 94,980 $35,080
Nevada 6,550 $34,480
District of Columbia 3,160 $34,170
California 98,570 $33,560

Source: BLS

LPNs

To meet the demand for increased care of the aging baby boomer population, the U.S. Bureau of Labor Statistics projects a much faster-than-average 12% job growth in LPN positions between 2016 and 2026. The table below provides a closer look at how an LPN’s location can impact job availability and salary potential. The 10% lowest-earning LPNs make fewer than $32,970, while the 10% highest earners make more than $61,030.

CNA vs LPN vs RN salaries grow exponentially as nurses take on more responsibility, with CNAs earning a median annual salary of $27,520, LPNs earning a median of $45,030, and RNs earning a median of $70,000. Fortunately, a number of advancement opportunities exist for working LPNs who choose to pursue an RN career, including online LPN-to-RN bridge programs, which prepare students for the increased responsibilities of registered nursing.

Top-Paying States for LPNs

State Employment Annual Mean Wage
Rhode Island 1,040 $57,800
Massachusetts 16,680 $57,800
Connecticut 7,750 $57,210
Alaska 520 $56,580
Nevada 2,630 $55,340

Source: BLS

Education and Licensing

RN vs LPN vs CNA job requirements involve varying amounts of education and certification. While RNs must obtain at least an associate degree in nursing, CNAs and LPNs can generally pursue employment upon obtaining a high school diploma and completing a state approved, non-degree education program. Commonly offered by community colleges and technical schools, and less often by high schools, hospitals, and nursing facilities, these certification and diploma programs take approximately one year to complete.

LPNs must successfully pass a licensure exam from the National Council of State Boards of Nursing in order to work as an LPN in any U.S. state. CNAs do not generally need any additional licensure to pursue employment, but they can obtain additional credentials if desired. For example, a certified medication assistant credentialM allows CNAs to dispense medication.

In the sections below, discover more detail about LPN vs CNA education requirements, including common courses and clinical component information.

Nursing Assistant Programs

This section outlines common requirements of nursing assistant programs for aspiring CNAs. Note that precise details may vary from one program to another.

Sample Courses for Nursing Assistant Programs

  • Introduction to Healthcare: Healthcare introduction courses typically provide a broad survey of the U.S. healthcare system. Topic selection varies, but students can generally expect to develop an understanding of the history and evolution of American healthcare, to examine economic impacts of the healthcare industry, and to explore current trends in healthcare.
  • Nursing Assistant I: During the primary courses of a nursing assistant program, students learn how to perform basic nursing tasks in hospitals, long-term care facilities, and home environments, all under the supervision of an RN. Students learn fundamentals including vital sign measurement, patients’ rights and safety, and basic nutrition.
  • Nursing Assistant II: A second nursing assistant course builds upon a student’s fundamental learning and provides classroom exposure, hands-on laboratory training, and clinical experiences in more advanced areas. Course concepts cover vital CNA procedures including sterilization techniques, wound care, catheterization, irrigation, and respiratory procedures. Students fulfill learning requirements and prepare for their certification exam.

How Long Does It Take to Complete a Nursing Assistant Program?

Nursing assistant program typically takes between 4-12 months to complete, depending on factors like program scheduling, required clinical hours, and potential general education prerequisites.

Clinical Component for Nursing Assistant Students

The length of time students spend completing onsite clinical experiences varies depending on their program and the state in which they live. The minimum federal standard requires at least 16 hours of hands-on clinical training for nursing assistant programs. Around half of all U.S. states expand on this minimum, requiring students to complete as many as 100 hours of training before becoming eligible for certification.

During a clinical experience, students work in hospitals or health care facilities under the direct supervision and mentorship of an RN. Students may also shadow CNAs. Common hands-on tasks include infection control procedures, feeding patients, and patient transfers.

Diploma and Certificate Programs for LPNs

Below you can learn more about what it takes to prepare yourself for LPN licensure, including courses and clinical experiences. The representative information below may vary depending on the school and program selected.

Sample Courses for LPN Programs

  • Fundamentals of Practical Nursing: Typically the first taken in an LPN program, this introductory course utilizes a combination of lectures and hands-on lab work. Course content exposes students to basic nursing processes, develops student understanding of nursing theory, and emphasizes cultural awareness and critical thinking in the context of healthcare.
  • Mental Health Nursing: A mental health nursing course introduces aspiring LPNs to concepts relating to emotional, mental, and behavioral disorders through a combination of lectures and clinical practicum work. Students also study theory relating to mental health, mental illness, and psychosocial nursing, securing the knowledge and skills needed to provide nursing care to mentally ill patients.
  • Pharmacology for Nurses: Pharmacology — or the study of uses, effects, and action of drugs — remains an important area of focus for nursing students. A fundamental pharmacology course introduces field concepts while emphasizing client safety, client education and information literacy, compliance with therapy, and cultural awareness across the lifespan.

How Long Does It Take to Complete an LPN Program?

Completing an LPN diploma or certificate program generally requires 1-2 years of study. Factors impacting student completion time include program structure and type of enrollment (part- or full-time). LPN programs require roughly 46 credits of nursing coursework and practicums. Students who need to complete general education requirements may take up to 72 credits of coursework before becoming eligible for graduation.

Due to the sequential nature of an LPN program curriculum, students are limited in how quickly they can progress through each component. For this reason, LPN programs rarely offer accelerated enrollment options.

Clinical Component for LPN Students

The number of clinical hours required for an LPN program varies depending on state law. However, students should expect to complete anywhere from 700-1,000 hours of onsite clinical experiences before graduation. Typically staggered throughout the duration of the program, LPN clinical hours begin with fundamentals — communication, basic nursing procedures, assessment skills — and progress to more advanced work, including medication administration, nursing care for patients with chronic illness, and nursing care for patients in acute care settings.

Students typically complete their practicums in a variety of outpatient and inpatient settings, including hospitals, long-term care facilities, and nursing homes.