LPN vs RN + Roles & Responsibilities
June 3, 2020 | Staff Writers
In 2016, nearly three million registered nurses (RNs) and more than 700,000 licensed practical nurses (LPNs) were employed in the U.S. alone. Due to an aging baby boomer population and the need for more healthcare professionals in long-term care facilities and outpatient centers, nurses are in high demand. LPN and RN employment rates look to grow by 12-15% between 2016 and 2026, resulting in around 527,000 new nursing jobs.
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Prospective nurses face the choice of pursuing either LPN or RN licensure. This page breaks down the similarities, differences, and education and licensing requirements for each path.
Similarities and Differences
With the LPN vs RN scope of practice in mind, prospective students should note that both nurses meet many of the same fundamental nursing needs. Both types of nurses care for people suffering from illness and injury, providing medical and functional assistance to help them recover as quickly and comfortably as possible. LPNs and RNs alike perform work that often proves mentally and physically demanding, serving patients in pain or dying.
However, RNs and LPNs usually work in different settings, holding distinct job duties and responsibility levels. Candidates for each position must fulfill separate educational and licensing requirements, resulting in different statuses and salaries.
Status, Duties, and Responsibilities
RNs fall under physicians in the healthcare hierarchy. They may diagnose and treat patients, which provides considerable status in the medical field. LPNs work under the supervision of an RN or physician. While LPNs cannot legally diagnose or treat patients, many possess the experience and training required to unofficially assess a patient’s condition. Working as an LPN proves both challenging and rewarding, and these nurses enjoy appreciation and trust for the practical knowledge they bring to patient care.
RNs require intensive training to master a variety of professional responsibilities. As a result, these professions enjoy a more lucrative salary. According to the Bureau of Labor Statistics (BLS), RNs reported earning around $70,0000 annually in 2017, while LPNs make approximately $45,000 each year.
Most LPNs find employment in long-term care facilities. According to the BLS, around 38% of LPNs work in nursing and residential care establishments. As chronic diseases become increasingly prevalent in patient populations, demand for LPNs continues to grow as extended-care facilities struggle to fill nursing positions. These settings often present career advancement opportunities, allowing nurses to pursue supervisory roles.
LPNs who work in hospitals carry out a variety of tasks. They empty bedpans, bathe patients, take vital signs, and, in some cases, administer medication. LPNs’ individual duties depend largely on the state in which they work and any specialty credentials they hold, such as gerontology or intravenous therapy certifications.
RNs often hold supervisory positions, providing bedside patient care and education. Their duties vary considerably depending on their area of specialization. Some RNs with advanced training work in emergency rooms or pediatric hospitals. Others assist doctors in surgery or care for people fighting cancer, diabetes, heart disease, or stroke.
The Largest Employers of LPNs
|Work Setting||Percent Employed||Median Annual Salary|
|Nursing and Residential Care Facilities||38%||$46,280|
|Hospitals; State, Local, and Private||16%||$43,550|
|Offices of Physicians||13%||$41,270|
|Home Healthcare Services||12%||$45,220|
The Largest Employers of RNs
|Work Setting||Percent Employed||Median Annual Salary|
|Hospitals; state, local, and private||61%||$75,900|
|Ambulatory healthcare services||18%||$72,070|
|Nursing and residential care facilities||7%||$66,300|
|Educational services; state, local, and private||3%||$60,300|
Source: Bureau of Labor Statistics
Education and Licensing
RN licensing guidelines require 1-3 more years of education than those for LPN licensure, and RN training programs typically cost more. LPN training consists of both classroom study and hands-on practice performed in a clinical setting. This applied learning component provides the practical skills needed to work in hospitals, long-term care facilities, and other medical establishments. Many community colleges and technical schools offer nursing programs. Some institutions allow students to apply college credits earned through LPN certification programs to a nursing degree at a later time. However, each school maintains different admission requirements and credit policies.
The licensing process begins with a background check during which applicants must provide their fingerprints. LPN candidates must also pass a national exam called the NCLEX-PN and complete a certain number of continuing education credits each year to remain licensed. Continuing education requirements are defined by the state.
RNs can complete either a two-year associate degree in nursing (ADN) or a four-year bachelor of science in nursing (BSN). A BSN presents a variety of career options and qualifies holders for management positions. Many RNs choose to earn a master’s degree, which allows graduates to pursue specialized roles such as clinical nurse, anesthetist, midwife, or nurse practitioner.
RNs must also fulfill national licensing requirements before they can work with the public. After graduating from an approved program, prospective RNs must pass both the written and practical sections of the National Council Licensure Examination. Licensing requirements often differ among states, especially guidelines for specialty nurses. All RNs must earn continuing education credits annually to retain licensure.
Read on for an in-depth look at the similarities and differences between LPN and RN educational paths.
Diploma and Certificate Programs for LPNs
Sometimes known as licensed vocational nurses or LVNs, LPNs must complete at least one year of academic training through a diploma or certificate program. Every state individually sanctions NCLEX-PN examinations, and prospective LPNs must obtain their employer state’s support. While program structure and content differs by school, this section introduces some common course offerings.
Sample Courses for LPN Programs
- Introduction to Healthcare: This course provides an overview of health services professions and the U.S. healthcare system. Students explore healthcare team composition, including professional roles, functions, and responsibilities. In addition to basic workplace safety and disease prevention concepts, coursework introduces legal and ethical guidelines, professional communications, and time management.
- Basic Pharmacology: In this core class, students examine the major drug categories, physiological classifications, and generic nomenclatures. Candidates learn to interpret drug orders, safely administrator medications, reduce side effects, and evaluate efficacy. Pharmacology courses also introduce chemical analysis and health processes.
- Nursing Fundamentals: Providing an overview of nursing history, this course also looks at current healthcare trends, diagnostic procedures, and health initiatives. Students learn to view patients as holistic beings with individual health patterns while also exploring major periods in lifespan development like infancy, early childhood, and late adulthood.
How Long Does It Take to Complete an LPN Program?
Most LPN diploma and certificate programs require 12 months of intensive classroom and clinical work. Students typically complete 40-60 credits of core coursework, mastering fundamental concepts in practical nursing, family nursing, and mental health before developing and presenting a final capstone project.
All practical nurses must undergo clinical simulations and training, and online LPN programs still include an in-person component. While distance learners take classes online, they engage in hands-on learning at designated local health facilities. During laboratory simulations, learners cultivate the critical thinking skills needed to make patient-centered nursing decisions. Some simulations place students in a single challenging scenario, while others require them to care for a patient group over a certain time period.
Clinical training can also affect an LPN program’s duration. This requirement differs by state, with states such as Louisiana requiring 800 hours of clinical experience. Some LPN students spend up to 18 months completing their certificate and diploma programs.
Clinical Component for LPN Students
LPN clinical requirements vary considerably among states. Students in Hawaii need to complete only 12 hours of clinical work, while candidates in Virginia and Colorado must undergo at least 400 hours of training. Texas and California require the most hours, at 840 and 954, respectively. Although many states, including New York, do not set a minimum requirement, students in these states should research common employer requirements and plan their training accordingly.
At most schools, students rotate through different health facilities, including hospitals, specialty clinics, and physician’s offices. LPN candidates work in interdisciplinary teams developing leadership and collaborative skills. They also learn to communicate in professional settings, manage patient information, and facilitate continuous quality improvement.
The ADN Program for RNs
ADN programs offer fundamental training for prospective RNs. Associate-level nurses deliver clinical health services and develop care plans in clinics, schools, and family practices. This section describes ADN program structure and coursework, along with ADN clinical experiences and how they differ from LPN training.
Sample Courses for an ADN Program
- Health and Illness: This core class presents health concepts and practices used to provide diverse populations with patient-centered care. Candidates examine the legal and ethical responsibilities involved with serving different age groups, including adolescents and adults. Coursework also introduces themes in nursing informatics, evidence-based care, and surgical procedures.
- Health Promotion: Students learn to promote healthy dietary and self-care practices at every life stage. They gain the skills needed to aid and inform patients on important issues like reproduction, pregnancy, labor and delivery, postpartum challenges, and newborn childcare. Some courses also cover the health spectrum, including major adaptive and maladaptive behaviors.
- Pathophysiology: In this course, candidates learn to recognize physiological and structural changes attributed to disease, gaining an evidence base to help them assess health deviations. Building on basic anatomy, learners delve into Roy’s Adaptation Model and examine cellular, genetic, and organ changes across the lifespan.
How Long Does It Take to Complete an ADN Program?
Most candidates complete at least 60 semester credits to earn their ADN. This process takes two years in conventional associate programs, although some colleges and universities offer accelerated options that let students earn an associate degree in about 18 months. While these intensive programs require full-time commitment, they often suit working LPNs who can apply prior learning and clinical experience toward degree completion. Active LPNs may also choose to study part time while they remain employed, earning their associate degree in 3-4 years.
Like most remote nursing programs, ADN degrees use a hybrid learning method. Online students take asynchronous classes powered by educational software like Blackboard and Canvas. They travel to campus and designated training sites to engage in nursing care simulations and clinical practice. In addition, some ADN programs offer weeknight and weekend classes on campus, enabling students to craft a schedule that fits their work and family lives.
Clinical Component for ADN Students
Every U.S. state upholds distinct nursing education standards, including the number of clinical training hours ADN candidates must complete before sitting for the NCLEX-RN and earning state licensure. While the National Council of State Boards of Nursing (NCSBN) provides an overview of general clinical requirements, nursing regulations constantly evolve alongside changing healthcare laws and coverage guidelines.
Students should confirm their clinical requirements with an academic adviser to plan an effective course sequence. In general, ADN candidates complete one hour of clinical training for every three hours of classroom or theoretical nursing education. Students may find this ratio helpful if they live in states without an official minimum, like Texas or Arizona.
The BSN Program for RNs
Students who pursue a bachelor’s degree in lieu of an associate degree receive a professional-level introduction to registered nursing. BSN programs offer a comprehensive nursing education that includes core nursing classes, extensive clinical training, and specialization opportunities. This section details the degree structure, classes, and timeline candidates can expect when they enroll in a BSN program.
Concentrations Offered for a BSN Program
The nurse midwifery concentration covers a full spectrum of women’s health issues, including gynecological services, prenatal care, pregnancy and birth, and postpartum health. Students learn to educate clients on family planning and birth control options. Midwifery programs also explore holistic and alternative care traditions. Due to significant nurse midwife shortages, the BLS projects a 21% job growth rate through 2026.
According to BLS, nurse anesthesiologists represent one of the highest-paying nursing professions. These specialists support clients before, during, and after surgery. Candidates pursuing this concentration learn to assess patient needs, health histories, and drug interactions to create individualized care plans. They also gain the pharmacological knowledge and technical skills needed to administer anesthesia and monitor anesthetized patients.
Students who select an orthopedics concentration learn to treat patients with musculoskeletal deviations, including genetic disorders and joint, muscle, connective tissue, and bone injuries. Learners train to conduct physical assessments like x-rays and develop the skills to set and cast breaks and fractures. According to Payscale, certified orthopedic nurses earn, on average, $82,000 a year.
Pediatric endocrinology nurses support children with endocrine conditions such as diabetes. Candidates learn to create care plans for patients with developmental delays, thyroid issues, pituitary problems, and hypoglycemia. Degree training emphasizes disease management through healthy living and medication. Payscale data shows that the average pediatric nurse earns an annual average salary of $58,726.
This concentration trains BSN students to tackle mental health challenges for patients in all life stages. Degree candidates delve into pathophysiology, examining comorbidity rates between psychiatric disorders and physical conditions like obesity and cardiovascular diseases. Other course topics include diagnostic reasoning, population-based primary care, psychotherapy, and pharmacotherapeutics. Payscale reports that average annual salaries for psychiatric RNs approach $60,239.
Sample Courses for a BSN Program
- Health Assessment: Students learn to create comprehensive health assessments for diverse client bases by collecting, identifying, and evaluating patient data with respect to individual needs, developmental level, and current condition. Emphasizing a holistic approach to nursing care, coursework integrates physical, psychological, and spiritual health concepts.
- Nursing Informatics: This class examines computer science and information technology influences on nursing and general health services. Using literacy standards, candidates learn to evaluate digital information and apply data to improve patient care, organizational efficacy, and community health. Lectures also address the ethical issues surrounding patient information and online social networking.
- Gerontological Nursing: Degree candidates analyze the psychological, socio-cultural, and physical effects of human aging within social and familial contexts. Emphasizing health education and promotion, coursework addresses topics like disease prevention, maximum functioning, and overall quality of life enhancement. Students learn to apply evidence-based intervention practices as they care for vulnerable older adults.
How Long Does It Take to Complete a BSN Program?
Most BSN curricula require around four years of study and 120 semester credits, including NCLEX-RN preparation classes during students’ final semester. Like associate candidates, BSN students can slow degree progress to accommodate their work schedules or to accumulate additional clinical hours in specialty areas like anesthesiology and neonatology. Part-time learners obtain their baccalaureate credentials in 5-7 years.
Some postsecondary schools deliver accelerated BSN programs. Candidates pursuing an accelerated degree take eight-week classes year round and earn their credentials in as few as two years. These pathways require students to possess prior work experience and fulfill prerequisite coursework, making them ideal for working LPNs and associate-level RNs.
Course structure also affects the graduation timeline. Many universities offer self-paced online programs that allow students to take as many courses as they want each term. Others use a cohort learning method in which learners take one class at a time, advancing at the same rate as their peers.
Clinical Component for BSN Students
BSN programs design clinical training protocols in accordance with state-defined RN education guidelines. Providing advanced instruction, bachelor’s curricula include more extensive clinical components than diploma, certificate, or associate programs. In general, nursing students engage in one hour of clinical work for every three hours of classroom instruction they complete.
According to NCSBN, 46 U.S. states and territories do not list minimum requirements for BSN clinical training. Delaware, Virginia, and Colorado require 400, 500, and 750 contact hours, respectively. California stipulates at least 28 semester credits of clinical practice, while Hawaii and Oregon asks for 48 semester credits. In Connecticut, 50% of BSN contact hours must consist of simulated, laboratory, observational, or supervised direct patient care.
Can I Complete LPN and RN Programs Online?
LPN and RN candidates without significant career experience and an extensive clinical background must earn their degrees through hybrid learning programs. They take asynchronous classes online and complete clinical work at university-approved training sites. Nursing programs rotate students through multiple clinical settings to provide experience serving different patient populations and collaborating on diverse care teams.
Distance learners typically complete their clinical training in primary care clinics and hospitals. They may also explore public health issues, working in teams to identify and assess community healthcare needs. Online students whose current nursing positions align with programmatic outcomes can satisfy a portion of their clinical requirements through their employer.
Licensure for LPNs and RNs
Students may sit for the NCLEX-PN if they possess a nursing diploma, certificate, or degree from a program accredited by their state’s nursing board. Some states provide alternative routes to LPN/LVN licensure for candidates with international or military nursing experience. LPNs seeking work beyond their licensing state can seek licensure through endorsement.
During the NCLEX registration process, candidates submit formal exam and licensure applications and undergo a background check. Applicants pay an exam fee and any state-mandated charges. Most candidates take the NCLEX in a computer adaptive format, which picks questions based on prior responses and decreases or increases difficulty accordingly.
The five-hour exam includes 85-205 questions. Candidates receive a pass or fail score. The NCLEX contains questions in four categories: safe and effective care environments, health promotion and maintenance, psychosocial integrity, and physiological integrity. To retain licensure, LPNs must complete a state-approved continuing education program, maintain verifiable employment, and submit renewal fees every 2-3 years.
Prospective RNs may take the NCLEX-RN and earn state licensure after earning an ADN or BSN accredited by their state’s nursing board. Some states combine the NCLEX and licensing applications, while others require two separate applications. Upon receiving an authorization email from NCSBN, candidates can pay the exam fee and schedule a testing date.
Like the LPN exam, the NCLEX-RN is a computer adaptive test. However, the RN test consists of 75-265 questions and lasts up to six hours. Questions draw from the same four categories, but they include more advanced care scenarios. Test takers receive a pass or fail notification from their state board of nursing 2-6 weeks after exam day.
RNs renew their licenses every 2-4 years, depending on the state. Renewal conditions include clinical contact hours, employment status, and continuing education. Continuing study guidelines differ among states, and may include specialized training related to opioid addiction, HIV/AIDS, human trafficking, and child abuse.
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