Should I Become an LPN or a CNA?
| Maura Deering
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.
Licensed Practical Nurse
- Roles: Monitor patient health, administer basic medical care, discuss care plans with patients, maintain health records, report to RNs and physicians
- Education: 1-2 year certificate or diploma program that includes clinical experience
- Salary: $48,820 median annual pay
- Workplaces: Nursing and residential care facilities, hospitals, physicians' offices, home healthcare
Certified Nursing Assistant
- Roles: Help patients bathe and dress, clean and reposition patients, record and report health concerns to nurses, monitor vital signs, serve and assist with meals
- Education: State-approved, 4- to 12-week training program that includes supervised clinical work
- Salary: $30,830 median annual pay
- Workplaces: Nursing care facilities, hospitals, retirement and assisted living communities, home healthcare
Frequently Asked Questions
Is an LPN higher than a CNA?
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.
How long does it take to become an LPN after CNA?
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.
What is the fastest way 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.
Should I become a CNA before an LPN?
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.
LPN vs. CNA: Job Duties
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.
LPN Job Duties
LPNs' job duties combine helping patients with daily living and providing basic nursing care.
Typical tasks include:
- Assisting patients with bathing, dressing, and eating
- Changing bandages, inserting catheters, and administering enemas
- Checking blood pressure and monitoring other vital signs
- Collecting samples and conducting routine lab testing
- Maintaining patient records
- Providing reports to nurses and doctors about patients' status
- Supervising CNAs and orderlies
- Talking to patients about their care and listening to their concerns
CNA Job Duties
As part of medical care teams, CNAs work under the direction of RNs and LPNs to provide the following services:
- Answering patients' call buttons
- Assisting patients with changing their positions
- Helping patients get in and out of bed and transferring them to and from wheelchairs
- Helping patients with bathroom visits, bathing, and dressing
- Serving meals and helping patients eat and drink
- Taking and monitoring vital signs
- Updating nurses about patients' issues and concerns
Top-Paying Work Settings
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.
|Top-Paying Industries for CNAs||Average Salary|
|Colleges, Universities, and Professional Schools||$44,870|
|Federal Executive Branch||$41,210|
|Scientific Research and Development Services||$39,630|
|Outpatient Care Centers||$38,420|
|Top-Paying Industries for LPNs||Average Salary|
|Outpatient Care Centers||$56,320|
|Scientific Research and Development Services||$54,490|
LPN vs. CNA Salary and Employment Outlook
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.
|Licensed Practical Nurse||Certified Nursing Assistant|
|Average Salary: $50,090||Average Salary: $32,050|
|Average Hourly Wage: $24.08||Average Hourly Wage: $15.41|
|Projected Job Growth: 9%||Projected Job Growth: 8%|
Top-Paying States for LPNs
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:
|Licensed Practical Nurse||Average Salary|
Top-Paying States for CNAs
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:
|Top-Paying States for Certified Nursing Assistants||Average Salary|
Education and Licensing
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.
How to Become an LPN
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.
How to Become a CNA
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.
Brandy Gleason, MSN, MHA, BC-NC, is a nursing professional with nearly 20 years of varied nursing experience. Gleason currently teaches as an assistant professor of nursing within a prelicensure nursing program and coaches graduate students. Her passion and area of research centers around coaching nurses and nursing students to build resilience and avoid burnout.
Gleason is a paid member of our Healthcare Review Partner Network. Learn more about our review partners here.
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