Licensed practical nurses (LPNs) provide hands-on patient care under the direction of registered nurses and doctors. Their daily work spans everything from checking vital signs and administering medications to wound care, patient education, and updating medical records. With a median pay of $62,340 per year as of 2024, practical nursing is one of the fastest entry points into a healthcare career, requiring about one year of training.
Core Clinical Duties
The bulk of a practical nurse’s day involves direct patient contact. LPNs monitor vital signs like blood pressure, heart rate, and temperature. They administer medications, including oral pills, injections, and in many states, IV medications. They perform wound care, change dressings using sterile technique, insert and manage catheters, and assist patients with basic needs like bathing, eating, and mobility.
LPNs also contribute to patient assessments by collecting data, comparing it to a patient’s previous condition, and determining when and to whom the information should be reported. This is called a “focused assessment,” which differs from the comprehensive assessments registered nurses perform. An LPN might notice a change in a patient’s skin color, a spike in blood pressure, or increased pain, then flag it for the RN or physician to evaluate further.
Documentation is another constant. LPNs update health records throughout their shifts, tracking medication doses, vital sign trends, intake and output, and any changes in a patient’s condition. Accurate records keep the rest of the care team informed and are critical for continuity when shifts change.
What Varies by State
One of the trickiest parts of understanding this role is that LPN responsibilities differ significantly depending on where you work. The biggest variation involves IV therapy. In some states, LPNs with basic IV training can change existing IV fluids and perform site care but cannot start a new IV line. With advanced training, they may insert peripheral IV catheters, administer IV medications, and draw blood from catheters.
Arizona offers a useful example of how granular these rules get. LPNs there with advanced IV training can insert short peripheral IVs, flush central lines, and administer medications through existing lines, but they cannot give blood products, chemotherapy drugs, or medications that require titration (adjusting the dose based on the patient’s response in real time). They also cannot access implanted ports. Other states, like North Dakota, allow LPNs to administer blood products and perform venipuncture for hemodialysis. Before starting a practical nursing job in a new state, you’ll need to check that state’s board of nursing for specific rules.
Patient and Family Communication
Practical nurses serve as a key communication link between patients, families, and the rest of the healthcare team. They explain standard procedures to family members, educate them on how to care for loved ones at home, and relay patient concerns to physicians and RNs. In long-term care settings especially, LPNs often spend more time with patients than any other provider, which puts them in a position to catch subtle changes in mood, cognition, or physical function that might otherwise go unnoticed.
Where Practical Nurses Work
The largest share of LPNs, about 38%, work in nursing homes, extended care facilities, and assisted living communities. Another 17% work in home health care, visiting patients in their residences to provide ongoing treatment and monitoring. Around 10% work in physician offices or outpatient clinics. The remaining positions are spread across hospitals, rehabilitation centers, schools, correctional facilities, and public health agencies.
The setting shapes the work considerably. An LPN in a nursing home might manage medications for a dozen or more residents each shift and monitor chronic conditions like diabetes or heart failure over months or years. An LPN in a doctor’s office might spend the day taking vitals, preparing patients for exams, drawing blood, and handling phone triage. Home health LPNs work more independently, though they still report to a supervising RN, and they often build long-term relationships with individual patients.
How LPNs Fit Into the Nursing Team
Practical nurses sit between certified nursing assistants (CNAs) and registered nurses in terms of training, clinical authority, and pay. CNAs handle the most basic patient care tasks, like helping with hygiene and repositioning. LPNs can do everything a CNA does plus administer medications, perform focused assessments, and carry out clinical procedures like wound care and catheter management. RNs have the broadest scope: they perform comprehensive assessments, create care plans, supervise LPNs and CNAs, and can handle higher-acuity tasks like administering blood transfusions or managing complex IV drips.
LPNs always work under the supervision or direction of an RN, physician, or dentist. In practice, this doesn’t mean someone is watching over your shoulder at all times. It means an RN or doctor delegates tasks, and the LPN carries them out, reporting back with findings and concerns. In settings like home health, the supervising RN may not be physically present but remains available by phone and conducts periodic supervisory visits.
Education and Licensing Requirements
Becoming an LPN requires a high school diploma or equivalent, followed by completion of an accredited practical nursing program. These programs, typically offered at community colleges and technical schools, run about 12 months. Coursework covers anatomy, pharmacology, nutrition, and clinical skills, with supervised clinical rotations in healthcare settings.
After completing the program, you must pass the NCLEX-PN exam to earn your license. If you don’t pass on the first attempt, you can retake the test after 45 days. Each state’s board of nursing sets its own renewal requirements, which usually include continuing education credits.
Pay and Job Outlook
The median annual wage for LPNs was $62,340 in May 2024, which works out to about $29.97 per hour. The lowest 10% earned under $47,960, while the highest 10% earned more than $80,510. Pay varies by setting, region, and experience. LPNs in metropolitan areas and those working evening, night, or weekend shifts typically earn more.
Demand for practical nurses remains steady, driven by an aging population that needs more long-term care, home health services, and chronic disease management. The concentration of LPNs in nursing homes and home health reflects where the need is greatest, and those sectors continue to grow as the baby boomer generation ages.