Licensed Practical Nurse
Encyclopedia
Licensed practical nurse (LPN) is the term used in much of the United States
and most Canadian provinces to refer to a nurse who cares for "people who are sick, injured, convalescent, or disabled under the direction of registered nurse
s and physician
s. The term licensed vocational nurses (LVN) is used in the U.S. state
s of California
and Texas
.
Equivalent professions outside the United States are "registered practical nurse" (RPNs) in the Canadian province
of Ontario
, "enrolled nurses" (ENs) in Australia
and New Zealand
, and "state enrolled nurses" (SENs) in the United Kingdom
.
published by the United States Department of Labor's
Bureau of Labor Statistics
, licensed practical nurses care for patients in many ways:
According to the Occupational Outlook Handbook, while most LPNs are generalists and will work in any area of health care
, some LPNs work in specialized settings, such as nursing home
s, doctor's offices, or in home care
. In some U.S. states, LPNs are permitted to administer prescribed medicines
, start intravenous fluids
, and provide care to ventilator
-dependent patients. While about 18 percent of LPNs/LVNs in the U.S. worked part-time in 2008, most work a 40-hour week
. The Occupational Outlook Handbook states that LPNs may have to work nights, weekends, and holidays; often stand for long periods and help patients move in bed, stand, or walk; and may face occupational hazards
which include exposure to caustic chemicals, radiation
, and infectious disease
s; back injuries
from moving patients; workplace stress
; and sometimes confused, agitated, or uncooperative patients."
In May 2008, the median annual wages of LPNs/LVNs in the United States was $39,030, with the middle 50 percent earning between $33,360 and $46,710, the lowest 10 percent earning less than $28,260, and the highest 10 percent earning more than $53,580. Median annual wages differed by setting:
According to the Occupational Outlook Handbook, in 2008 there were some 753,600 jobs held by LPNs/LVNs in the United States, with about 25 percent working in hospitals, 28 percent in nursing care facilities, and 12 percent in physicians' offices. Other LPNs/LVN worked for home health care services; employment services; residential care facilities; community care facilities; outpatient care centers; and federal
, state, and local government
agencies. In the United States, employment of LPNs is projected to grow by 21 percent between 2008 and 2018, much faster than average. The growth is expected to be driven by the "long-term care needs of an increasing elderly population and the general increase in demand for healthcare services."
In the United States
, training programs to become a LPN/LVN last about one year and are offered by vocational/technical schools
and by community college
s. The Occupational Outlook Handbook states that in order to be eligible for licensure
, LPNs must complete a state-approved training program. A high school diploma
or equivalent usually is required for acceptance into a training program, but some programs accept candidates without a diploma and some programs are part of a high school
curriculum. According to the Occupational Outlook Handbook states that most programs include both classroom study (covering basic nursing
concepts and subjects related to patient care, including anatomy
, physiology
, medical-surgical nursing, pediatrics
, obstetrics
nursing, pharmacology
, nutrition
, and first aid
) and supervised clinical practice (usually in a hospital setting, but sometimes elsewhere).
The National Council Licensure Examination-Practical Nurse
(NCLEX-PN), a computer-based national licensing exam developed and administered by the National Council of State Boards of Nursing, is the exam required to obtain licensure as a LPN/LVN. In many states, LPNs/LVNs are required to obtain continuing education
credits throughout their career.
, long-term care and pharmacology) or of becoming a charge nurse
, responsible for oversee the work of other LPNs and various unlicensed assistive personnel
, such as nursing assistants. Some LPNs/LVNs choose to undergo further education and become registered nurse
s. LPN-to-RN training programs ("bridge programs") exist for this purpose. These include further classroom study to obtain at least an Associate of Science in Nursing
(ASN) and clinical practice followed by another exam, the National Council Licensure Examination-Registered Nurse
(NCLEX-RN).
The origins of the practical/vocational nurse can be traced back to the practice of self-taught individuals who worked in home care in the past, assisting with basic care (such as bathing) and light housekeeping duties (such as cooking). Licensing standards for practical nurses came later than those for professional nurses; by 1945, 19 states and one territory had licensure laws, but only one state law covered practical nursing. By 1955, however, every state had licensing laws for practical nurses. Practical nurses who had been functioning as such at the time new standards were adopted usually granted a license by waiver, and exempt from new training requirements.
The first formal training program for practical nurses was developed at the Young Women's Christian Association
(YWCA) in New York City
in 1892. The following year this became the Ballard School of Practical Nursing (after Lucinda Ballard, an early benefactor) and was a three-month-long course of study concerned with the care of infants, children and the elderly and disabled. The curriculum included instruction in cooking and nutrition as well as basic science and nursing. The school closed in 1949 after the YWCA was reorganized. Other early practical nursing education program include the Thompson Practical Nursing School, established in 1907 in Brattleboro, Vermont
(still in operation today) and the Household Nursing School (later the Shepard-Gill School of Practical Nursing), established in 1918 in Boston
. In 1930, there were still just 11 schools of practical nursing, but between 1948 and 1954, 260 more opened. The Association of Practical Nurse Schools (APNS) as founded in 1942, and the next year the name of the organization was changed to the National Association was changed to National Association for Practical Nurse Education and Service (NAPNAS), and the first planned curriculum for practical nurses as developed.
in the mid 1990s, SEN students used to follow the first twelve months training of the state registered nurses
(SRNs, now known as level one nurses), and then had another twelve months of training before sitting SEN exams and becoming registered. Some auxiliary nurses with many years of experience used to be allowed to sit the SEN exams and enter the register without requiring further training. People training to be SRNs who failed their exams at the third attempt were also able to enter the nursing register as a SEN. No new SENs are trained in the UK, the Nursing and Midwifery Council
(the regulatory body for nurses in the UK) previously used to allow people to be added to the register as level two nurses if they are moving from a similar position from within the European Union, however this has now stopped. Level two nurses from the EU wishing to gain entry to the Register in the UK must be willing to train as a first level (staff) nurse. This is by two different means: starting their training from scratch as a pre-registration student nurse, or by joining an existing cohort of student nurses starting their second year of training, and completing years 2 and 3 with them
Formerly, there was a large segregation between the "green" SENs and "blue" SRNs, which were the colour of uniform typically worn. SENs were very much complementary to the nursing team, however did not have the status of SRNs and were ineligible to be promoted, e.g. to ward sister. Many SENs sat or re-sat the SRN exams, however a large number did not and were quite content being a SEN. Nowadays, the divide between level one and two nurses is diminishing due to the small number of SENs still in practice. The demise of the SEN is lamented by many who saw it as a balanced way to staff a ward. However, the divide also meant that potentially, the gap in clinical excellence could be too wide.
Auxiliary nurses draw blood samples, change bandages, and record ECGs. At present, they work under the direct supervision of a registered nurse
.
usually spend twelve months training, consisting of fourteen (14) weeks theoretical component at TAFE colleges, followed by practical experience in hospital wards for the remainder of the time. The majority of ENs eventually move on to attend university
and become registered nurses, although a substantial number remain as ENs in public and private hospitals, and nursing homes. Trainee enrolled nurses (TENs) become employees of the hospital for the twelve month training period, meaning that, as well as gaining practical experience on the wards, they are paid for hours worked. This attracts a substantial number of applicants, who may wish to pursue nursing as a career, but are unable to afford to become full-time university students. As of 2009, however, the government has stopped working with the NSW Department of Health, and those wishing to become enrolled nurses are not being paid. The enrolled nurse programme also allows people to ascertain whether or not they are suited to nursing before they make the decision to study it at university level.
The role of enrolled nurses in Australia
has greatly increased in recent years in response to the continuing shortage of registered nurses in the Australian public health care system. In 2004, a medication endorsement certificate was introduced, allowing ENs to administer some oral medication (excluding schedule 8
drugs of addiction) upon completion. Endorsement also permits the administration of some intravenous (IV) medications and fluids (intravenous therapy or IVT), as well as intramuscular (IM) and subcutaneous (SC) injections. Endorsed enrolled nurses (EENs) are also permitted to check & give S4D and S8 medications with a registered nurse. Most enrolled nurses working in public hospitals are permitted to conduct ECGs, collect pathology
specimens, and routinely take a patient load under the direct supervision of a registered nurse
.
Despite the fact that the role of the EN in Australia has been greatly expanded in recent years, opportunities for career progression remain somewhat limited, and for this reason, many choose to go on and study to become registered nurse
s. In terms of financial remuneration
, the earning capacity of an enrolled nurse is capped at five (5) years of service, whereas registered nurses continue to eight (8) years before salary capping is applied.
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
and most Canadian provinces to refer to a nurse who cares for "people who are sick, injured, convalescent, or disabled under the direction of registered nurse
Registered nurse
A registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
s and physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
s. The term licensed vocational nurses (LVN) is used in the U.S. state
U.S. state
A U.S. state is any one of the 50 federated states of the United States of America that share sovereignty with the federal government. Because of this shared sovereignty, an American is a citizen both of the federal entity and of his or her state of domicile. Four states use the official title of...
s of California
California
California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...
and Texas
Texas
Texas is the second largest U.S. state by both area and population, and the largest state by area in the contiguous United States.The name, based on the Caddo word "Tejas" meaning "friends" or "allies", was applied by the Spanish to the Caddo themselves and to the region of their settlement in...
.
Equivalent professions outside the United States are "registered practical nurse" (RPNs) in the Canadian province
Provinces and territories of Canada
The provinces and territories of Canada combine to make up the world's second-largest country by area. There are ten provinces and three territories...
of Ontario
Ontario
Ontario is a province of Canada, located in east-central Canada. It is Canada's most populous province and second largest in total area. It is home to the nation's most populous city, Toronto, and the nation's capital, Ottawa....
, "enrolled nurses" (ENs) in Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
and New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
, and "state enrolled nurses" (SENs) in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
.
Licensed practical nurses in the United States
According to the 2010-2011 Occupational Outlook HandbookOccupational Outlook Handbook
The Occupational Outlook Handbook is a publication of the United States Department of Labor's Bureau of Labor Statistics that includes information about the nature of work, working conditions, training and education, earnings, and job outlook for hundreds of different occupations. The Handbook is...
published by the United States Department of Labor's
United States Department of Labor
The United States Department of Labor is a Cabinet department of the United States government responsible for occupational safety, wage and hour standards, unemployment insurance benefits, re-employment services, and some economic statistics. Many U.S. states also have such departments. The...
Bureau of Labor Statistics
Bureau of Labor Statistics
The Bureau of Labor Statistics is a unit of the United States Department of Labor. It is the principal fact-finding agency for the U.S. government in the broad field of labor economics and statistics. The BLS is a governmental statistical agency that collects, processes, analyzes, and...
, licensed practical nurses care for patients in many ways:
According to the Occupational Outlook Handbook, while most LPNs are generalists and will work in any area of health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
, some LPNs work in specialized settings, such as nursing home
Nursing home
A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...
s, doctor's offices, or in home care
Home care
Home Care, , is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as domiciliary care or social care), is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as...
. In some U.S. states, LPNs are permitted to administer prescribed medicines
Medical prescription
A prescription is a health-care program implemented by a physician or other medical practitioner in the form of instructions that govern the plan of care for an individual patient. Prescriptions may include orders to be performed by a patient, caretaker, nurse, pharmacist or other therapist....
, start intravenous fluids
Intravenous therapy
Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...
, and provide care to ventilator
Medical ventilator
A medical ventilator can be defined as any machine designed to mechanically move breatheable air into and out of the lungs, to provide the mechanism of breathing for a patient who is physically unable to breathe, or breathing insufficiently....
-dependent patients. While about 18 percent of LPNs/LVNs in the U.S. worked part-time in 2008, most work a 40-hour week
Working time
Working time is the period of time that an individual spends at paid occupational labor. Unpaid labors such as personal housework are not considered part of the working week...
. The Occupational Outlook Handbook states that LPNs may have to work nights, weekends, and holidays; often stand for long periods and help patients move in bed, stand, or walk; and may face occupational hazards
Occupational safety and health
Occupational safety and health is a cross-disciplinary area concerned with protecting the safety, health and welfare of people engaged in work or employment. The goal of all occupational safety and health programs is to foster a safe work environment...
which include exposure to caustic chemicals, radiation
Radiation
In physics, radiation is a process in which energetic particles or energetic waves travel through a medium or space. There are two distinct types of radiation; ionizing and non-ionizing...
, and infectious disease
Infectious disease
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...
s; back injuries
Back injury
Back injuries result from damage, wear, or trauma to the bones, muscles, or other tissues of the back. Common back injuries include sprains and strains, herniated disks, and fractured vertebrae. The lumbar is often the site of back pain. The area is susceptible because of its flexibility and the...
from moving patients; workplace stress
Workplace stress
Workplace stress is the harmful physical and emotional response that occurs when there is a poor match between job demands and the capabilities, resources, or needs of the worker....
; and sometimes confused, agitated, or uncooperative patients."
In May 2008, the median annual wages of LPNs/LVNs in the United States was $39,030, with the middle 50 percent earning between $33,360 and $46,710, the lowest 10 percent earning less than $28,260, and the highest 10 percent earning more than $53,580. Median annual wages differed by setting:
| Setting | Median annual wages |
|---|---|
| Employment services | $44,690 |
| Nursing care facilities | $40,580 |
| Home health care services | $39,510 |
| General medical and surgical hospitals | 38,080 |
| Offices of physicians | 35,020 |
According to the Occupational Outlook Handbook, in 2008 there were some 753,600 jobs held by LPNs/LVNs in the United States, with about 25 percent working in hospitals, 28 percent in nursing care facilities, and 12 percent in physicians' offices. Other LPNs/LVN worked for home health care services; employment services; residential care facilities; community care facilities; outpatient care centers; and federal
Federal government of the United States
The federal government of the United States is the national government of the constitutional republic of fifty states that is the United States of America. The federal government comprises three distinct branches of government: a legislative, an executive and a judiciary. These branches and...
, state, and local government
Local government in the United States
Local government in the United States is generally structured in accordance with the laws of the various individual states. Typically each state has at least two separate tiers: counties and municipalities. Some states have their counties divided into townships...
agencies. In the United States, employment of LPNs is projected to grow by 21 percent between 2008 and 2018, much faster than average. The growth is expected to be driven by the "long-term care needs of an increasing elderly population and the general increase in demand for healthcare services."
In the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, training programs to become a LPN/LVN last about one year and are offered by vocational/technical schools
Vocational school
A vocational school , providing vocational education, is a school in which students are taught the skills needed to perform a particular job...
and by community college
Community college
A community college is a type of educational institution. The term can have different meanings in different countries.-Australia:Community colleges carry on the tradition of adult education, which was established in Australia around mid 19th century when evening classes were held to help adults...
s. The Occupational Outlook Handbook states that in order to be eligible for licensure
Licensure
Licensure refers to the granting of a license, which gives a "permission to practice." Such licenses are usually issued in order to regulate some activity that is deemed to be dangerous or a threat to the person or the public or which involves a high level of specialized skill...
, LPNs must complete a state-approved training program. A high school diploma
High school diploma
A high school diploma is a diploma awarded for the completion of high school. In the United States and Canada, it is considered the minimum education required for government jobs and higher education. An equivalent is the GED.-Past diploma styles:...
or equivalent usually is required for acceptance into a training program, but some programs accept candidates without a diploma and some programs are part of a high school
High school
High school is a term used in parts of the English speaking world to describe institutions which provide all or part of secondary education. The term is often incorporated into the name of such institutions....
curriculum. According to the Occupational Outlook Handbook states that most programs include both classroom study (covering basic nursing
Nursing
Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death....
concepts and subjects related to patient care, including anatomy
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...
, physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
, medical-surgical nursing, pediatrics
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
, obstetrics
Obstetrics
Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...
nursing, pharmacology
Pharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...
, nutrition
Nutrition
Nutrition is the provision, to cells and organisms, of the materials necessary to support life. Many common health problems can be prevented or alleviated with a healthy diet....
, and first aid
First aid
First aid is the provision of initial care for an illness or injury. It is usually performed by non-expert, but trained personnel to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care...
) and supervised clinical practice (usually in a hospital setting, but sometimes elsewhere).
The National Council Licensure Examination-Practical Nurse
NCLEX
NCLEX is an examination for the licensing of nurses in the United States. There are two types, the NCLEX-RN and the NCLEX-PN....
(NCLEX-PN), a computer-based national licensing exam developed and administered by the National Council of State Boards of Nursing, is the exam required to obtain licensure as a LPN/LVN. In many states, LPNs/LVNs are required to obtain continuing education
Continuing education
Continuing education is an all-encompassing term within a broad spectrum of post-secondary learning activities and programs. The term is used mainly in the United States and Canada...
credits throughout their career.
Advancement
In some settings, LPNs/LVNs have opportunities for advancement, including the possibility of becoming credentialed in a certain area (such as IV therapy, gerontologyGerontology
Gerontology is the study of the social, psychological and biological aspects of aging...
, long-term care and pharmacology) or of becoming a charge nurse
Nursing management
Nursing management is performing leadership functions of governance and decision-making within organizations employing nurses. It includes processes common to all management like planning, organizing, staffing, directing and controlling...
, responsible for oversee the work of other LPNs and various unlicensed assistive personnel
Unlicensed assistive personnel
Unlicensed assistive personnel is an umbrella term to describe a job class of paraprofessionals who assist individuals with physical disabilities, mental impairments, and other health care needs with their activities of daily living and provide bedside care — including basic nursing...
, such as nursing assistants. Some LPNs/LVNs choose to undergo further education and become registered nurse
Registered nurse
A registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
s. LPN-to-RN training programs ("bridge programs") exist for this purpose. These include further classroom study to obtain at least an Associate of Science in Nursing
Associate of Science in Nursing
An Associate of Science in Nursing is a tertiary education nursing degree. In the United States, this type of degree is usually awarded by community colleges or similar nursing schools. Some four year colleges also offer this degree...
(ASN) and clinical practice followed by another exam, the National Council Licensure Examination-Registered Nurse
NCLEX
NCLEX is an examination for the licensing of nurses in the United States. There are two types, the NCLEX-RN and the NCLEX-PN....
(NCLEX-RN).
The origins of the practical/vocational nurse can be traced back to the practice of self-taught individuals who worked in home care in the past, assisting with basic care (such as bathing) and light housekeeping duties (such as cooking). Licensing standards for practical nurses came later than those for professional nurses; by 1945, 19 states and one territory had licensure laws, but only one state law covered practical nursing. By 1955, however, every state had licensing laws for practical nurses. Practical nurses who had been functioning as such at the time new standards were adopted usually granted a license by waiver, and exempt from new training requirements.
The first formal training program for practical nurses was developed at the Young Women's Christian Association
Young Women's Christian Association
Young Women's Christian Association or YWCA or YWCA Building or Old YWCA Building or variations may refer to:*World YWCA, the organization formerly known as Young Women's Christian Associationor it may refer to:...
(YWCA) in New York City
New York City
New York is the most populous city in the United States and the center of the New York Metropolitan Area, one of the most populous metropolitan areas in the world. New York exerts a significant impact upon global commerce, finance, media, art, fashion, research, technology, education, and...
in 1892. The following year this became the Ballard School of Practical Nursing (after Lucinda Ballard, an early benefactor) and was a three-month-long course of study concerned with the care of infants, children and the elderly and disabled. The curriculum included instruction in cooking and nutrition as well as basic science and nursing. The school closed in 1949 after the YWCA was reorganized. Other early practical nursing education program include the Thompson Practical Nursing School, established in 1907 in Brattleboro, Vermont
Brattleboro, Vermont
Brattleboro, originally Brattleborough, is a town in Windham County, Vermont, United States, located in the southeast corner of the state, along the state line with New Hampshire. The population was 12,046 at the 2010 census...
(still in operation today) and the Household Nursing School (later the Shepard-Gill School of Practical Nursing), established in 1918 in Boston
Boston
Boston is the capital of and largest city in Massachusetts, and is one of the oldest cities in the United States. The largest city in New England, Boston is regarded as the unofficial "Capital of New England" for its economic and cultural impact on the entire New England region. The city proper had...
. In 1930, there were still just 11 schools of practical nursing, but between 1948 and 1954, 260 more opened. The Association of Practical Nurse Schools (APNS) as founded in 1942, and the next year the name of the organization was changed to the National Association was changed to National Association for Practical Nurse Education and Service (NAPNAS), and the first planned curriculum for practical nurses as developed.
Canada
In Ontario, there are two basic types of nurses; The RN must have a BScN in nursing, 4 years of university for entry to practice. Registered practical nurses (RPNs) must have a 2 year diploma program for entry to practice. A lot of registered nurses were "grandfathered" in when this change occurred and have 2 and 3 year diploma programs. In Ontario RPNs have a greater scope of practice than most provinces, they can do most skills that an RN can do, however the complexity of the client's condition determines if they are the nurse in charge of care, or receiving direction from an RN if the care is complex and the condition of the client is very unstable.United Kingdom
The state enrolled nursing qualification can no longer be gained in Britain. Prior to the implementation of Project 2000 which radically altered the face of nurse educationNurse education
Nurse education consists in the theorical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. This education is provided to nursing students by experienced nurses and other medical professionals who have qualified or...
in the mid 1990s, SEN students used to follow the first twelve months training of the state registered nurses
Registered nurse
A registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
(SRNs, now known as level one nurses), and then had another twelve months of training before sitting SEN exams and becoming registered. Some auxiliary nurses with many years of experience used to be allowed to sit the SEN exams and enter the register without requiring further training. People training to be SRNs who failed their exams at the third attempt were also able to enter the nursing register as a SEN. No new SENs are trained in the UK, the Nursing and Midwifery Council
Nursing and Midwifery Council
Established in 2002, the Nursing and Midwifery Council is a statutory body set up by the Parliament of the United Kingdom through the . The NMC is the UK regulator for nursing and midwifery professions with a stated aim to safeguard the health and wellbeing of the public...
(the regulatory body for nurses in the UK) previously used to allow people to be added to the register as level two nurses if they are moving from a similar position from within the European Union, however this has now stopped. Level two nurses from the EU wishing to gain entry to the Register in the UK must be willing to train as a first level (staff) nurse. This is by two different means: starting their training from scratch as a pre-registration student nurse, or by joining an existing cohort of student nurses starting their second year of training, and completing years 2 and 3 with them
Formerly, there was a large segregation between the "green" SENs and "blue" SRNs, which were the colour of uniform typically worn. SENs were very much complementary to the nursing team, however did not have the status of SRNs and were ineligible to be promoted, e.g. to ward sister. Many SENs sat or re-sat the SRN exams, however a large number did not and were quite content being a SEN. Nowadays, the divide between level one and two nurses is diminishing due to the small number of SENs still in practice. The demise of the SEN is lamented by many who saw it as a balanced way to staff a ward. However, the divide also meant that potentially, the gap in clinical excellence could be too wide.
Auxiliary nurses draw blood samples, change bandages, and record ECGs. At present, they work under the direct supervision of a registered nurse
Registered nurse
A registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
.
Australia
Enrolled nurses (EN) in AustraliaAustralia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
usually spend twelve months training, consisting of fourteen (14) weeks theoretical component at TAFE colleges, followed by practical experience in hospital wards for the remainder of the time. The majority of ENs eventually move on to attend university
University
A university is an institution of higher education and research, which grants academic degrees in a variety of subjects. A university is an organisation that provides both undergraduate education and postgraduate education...
and become registered nurses, although a substantial number remain as ENs in public and private hospitals, and nursing homes. Trainee enrolled nurses (TENs) become employees of the hospital for the twelve month training period, meaning that, as well as gaining practical experience on the wards, they are paid for hours worked. This attracts a substantial number of applicants, who may wish to pursue nursing as a career, but are unable to afford to become full-time university students. As of 2009, however, the government has stopped working with the NSW Department of Health, and those wishing to become enrolled nurses are not being paid. The enrolled nurse programme also allows people to ascertain whether or not they are suited to nursing before they make the decision to study it at university level.
The role of enrolled nurses in Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
has greatly increased in recent years in response to the continuing shortage of registered nurses in the Australian public health care system. In 2004, a medication endorsement certificate was introduced, allowing ENs to administer some oral medication (excluding schedule 8
Standard for the Uniform Scheduling of Drugs and Poisons
The Standard for the Uniform Scheduling of Medicines and Poisons, abbreviated SUSMP, is a document used in the regulation of drugs and poisons in Australia. It is produced by the National Drugs and Poisons Scheduling Committee , a committee of the Therapeutic Goods Administration...
drugs of addiction) upon completion. Endorsement also permits the administration of some intravenous (IV) medications and fluids (intravenous therapy or IVT), as well as intramuscular (IM) and subcutaneous (SC) injections. Endorsed enrolled nurses (EENs) are also permitted to check & give S4D and S8 medications with a registered nurse. Most enrolled nurses working in public hospitals are permitted to conduct ECGs, collect pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
specimens, and routinely take a patient load under the direct supervision of a registered nurse
Registered nurse
A registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
.
Despite the fact that the role of the EN in Australia has been greatly expanded in recent years, opportunities for career progression remain somewhat limited, and for this reason, many choose to go on and study to become registered nurse
Registered nurse
A registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
s. In terms of financial remuneration
Remuneration
Remuneration is the total compensation that an employee receives in exchange for the service they perform for their employer. Typically, this consists of monetary rewards, also referred to as wage or salary...
, the earning capacity of an enrolled nurse is capped at five (5) years of service, whereas registered nurses continue to eight (8) years before salary capping is applied.
See also
- Nurse
- NursingNursingNursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death....
- Registered nurseRegistered nurseA registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
- Enrolled Nurse Professional AssociationEnrolled Nurse Professional AssociationThe Enrolled Nurse Professional Association was formed in August 1994 at Ashfield NSW by the enthusiasm of 4 enrolled nurses.The Association was founded after the Inaugural State Conference for Enrolled Nurses identified a need for an association to be formed to pursue the professional, career...