By Robert Scally, assistant editor
Licensed practical nurses may be one of the least studied segments of the
health care workforce, according to a new study conducted by researchers from
the Center for California Health Workforce Studies at the University of
California, San Francisco.
The study, "Supply, Demand and Use of Licensed Practical Nurses," is the
first comprehensive research on the LPN workforce in 20 years, according to Jean
Ann Seago, Ph.D., RN, and professor of nursing at UCSF, who was one of the lead
researchers on the project. The Health Resources and Services Administration,
part of the U.S. Department of Health and Human Services, funded the study.
In conducting the study, the researchers found that although LPNs began to
organize into professional groups as early as 1941, there is very little
academic literature about the practice, work, demand or efficient use of
licensed practical nurses.
"One of the overall reason for the study was to determine if we could use
LPNs to help with alleviating the nursing shortage," Seago said. "The short
answer is 'no'."
In many settings and especially in hospitals, LPNs are not allowed to
practice to the full extent of the scope of practice laws in respective states,
the study found.
Limiting what LPNs can do in various settings has more to do with rules and
traditions within facilities and geographic regions within the United States
than actual legal restrictions, Seago said. In other instances, such as in
California, a combination of regulations and union rules limits what LPNs can
and cannot do.
Even determining the actual size of the LPN workforce was difficult, since
there was conflicting data from various sources, Seago said.
Data from the 2000 census showed that there were 596,355 people employed as
LPNs. However, this figure differed from data from the Bureau of Labor
Statistics, which showed that there were 702,000 jobs held by LPNs in 2002.
Meanwhile, the National Council of State Boards of Nursing listed 889,027 active
LPN licenses in 2000.
Seago pointed out that since LPNs can have licenses in multiple states, the
number of active licensed LPNs probably overstates the actual size of the LPN
workforce.
The RN workforce vastly outnumbers the LPN workforce. There were nearly 2.7
million RNs in the U.S. in March 2000, according to the National Sample Survey
of Registered Nurses, which was conducted by the Health Resources and Services
Administration.
However, the study found as many similarities between the LPN and the
registered nurse populations than differences (see sidebar for details). Overall
employment trends for both LPNs and RNs are similar with more LPNs employed in
2001 than in 1984; workweeks are approximately the same length; both workforces
are approximately the same age, with the mean LPN age being 43.
As a result of the research, Seago and the team of researchers who worked
with her on the study made a number of recommendations about the utilization of
the LPN workforce (see sidebar).
These recommendations included working to create teams of RNs and LPNs to
appropriately share the patient care workloads; reducing restrictions on the LPN
scope of practice in states where there are restrictive regulations unless there
is substantial evidence of a negative impact on patient care; considering using
LPNs predominately in long-term care settings rather than acute care and
educating the public about the LPN profession both to give recognition to
practicing LPNs and to encourage more people to enter the profession.
To read recommendations from the "Supply, Demand and Use of Licensed Practical Nurses" study, click here.
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