Licensed Practical Nurses (LPNs) are also known as Licensed Vocational Nurses (LVNs) in California and Texas and as Registered Practical Nurses (RPNs) in Ontario. They are called Enrolled Nurses (ENs) in Australia and State Enrolled Nurses (SENs) in the United Kingdom.

United States

These individuals usually have twelve months to two years of training in anatomy and physiology, medications, and practical patient care. They must pass state or national boards (such as NCLEX-PN in the U.S.) and renew their license periodically. Patient care is part of a nurses role in implementing a care plan. ... The NCLEX-PN (National Council Licensure EXamination-Practical Nurse) is a computer-adaptive test of entry-level nursing competence. ... It has been suggested that Licensing (strategic alliance) be merged into this article or section. ...

LPNs can perform simple as well as complex medical procedures, but must operate under the supervision of either a professional Registered Nurse (RN) or a physician. They can administer most medications (usually with the exception of IV push medications), perform measurements (blood pressure, temperature, etc), record-keeping, help with patient-care planning, surgery, first aid, CPR, sterile and isolation procedure and basic care. Vintage photo of a nursing school class Registered Nurses are professional nurses who often supervise the tasks performed by Licensed Practical Nurses, orderlies and nursing assistants. ... A Surgical Technologist is an allied health professional in the United States, part of the operating room team, also called scrubs or operating room technicians. ...

LPNs are often found working under the supervision of physicians in clinics. In long term care facilities, they sometimes supervise nursing assistants and orderlies. In the United States, Certified Nursing Assistants or Certified Nurse Assistants (CNAs) assist residents or patients with activities of daily living (ADLs) and provide bedside care--including basic nursing procedures--all under the supervision of a Registered Nurse (RN) or Licensed Practical Nurse (LPN) (Meyer, 2001:1-33,1-36). ... An orderly is a hospital attendant whose job consists of assisting medical and/or nursing staff with various nursing and/or medical interventions. ...

The United States Department of Labor's Bureau of Labor Statistics estimates that there are about 700,000 (1) persons employed as licensed practical and licensed vocational nurses in the U.S.

LPNs must at least be high school graduates. They follow the rules of State Boards of Nursing. Requirements for taking boards usually include a clean criminal record and graduation from an approved vocational nursing program.

United Kingdom

State Enrolled Nurses (SENs, also known as Level 2 nurses) are no longer trained. They used to follow the first 12 months of the training for State Registered Nurses (SRNs, now known as Level 1 nurses), and then had another 12 months of training before sitting SEN exams and becoming registered. Some auxiliary nurses with many years of experience used to be allowed to buy their SEN license with no further training. People training to be SRNs who failed their exams at the third attempt were also granted an SEN license. Although no new SENs are trained in the UK, the Nursing and Midwifery Council (the regulatory body for nurses in the UK) does allow people to be added to the register as Level 2 nurses if they are moving from a similar position abroad, or if they are previously registered SENs who complete a return to practise course. The Nursing & Midwifery Council (NMC) is the UKs regulatory body for the Nursing, Midwifery and Health Visiting Professions. ...

Formerly, there was a large segregation between the "green" SENs and "blue" SRNs (the colours referring to the colour of nurse's uniform they each wore). SENs were very much complementary to the nursing team, performing tasks which the SRNs have time for. SENs were stuck permanently at the bottom of the career ladder, and were not eligible for promotion (eg/ to senior staff nurse or ward sister). However, people entering SEN training were aware of this at the beginning. Because of this, many SENs stayed as such for only a few years, until they passed their SRN exams, although many SENs had no desire to rise in the ranks, and were quite happy to be able to concentrate on the bedside nursing, and have more patient contact than the often stressed and busy SRN who might also be in charge of the ward as well as having a group of patients to look after at the same time.

Nowadays, there are still some SENs in practice, although the numbers are falling as they either retire or complete conversion courses to become 1st level nurses. Whilst they are still not eligible for promotion to senior positions, there is less of a distinction between the two groups of nurses on the wards - they often do all the things which 1st level nurses do.

There are signs that the government is trying to go back on this decision to abolish SENs - Auxiliary Nurses (also known as Healthcare Assistants, or Clinical Support Workers) are taking on a lot of tasks which have until now been done by the registered nurses - things like taking blood samples, changing dressings, and recording ECGs; and there is some talk of them having their own part on the nursing register. They are still only paid as Auxiliary Nurses, far below the scale that Enrolled Nurses are on. They are still not at the stage where they would be considered professional nurses in the same way the old SENs were, and many aspects of nursing practice (eg/ giving medication) are still not open to them, however. At the moment though, the unqualified nursing assistants are not accountable for their practice as SENs and RGNs are, and this would need to be addressed. At present because they work under the direct supervision of the qualified nurse, and it is the Registered Nurse who is accountable for their actions. Enrolling Auxiliary Nurses on their own part of the Register would have huge implications regarding pay and conditions. British nurses are poorly paid compared to their international counterparts, and it is unlikely that any British government of whatever colour would be willing to pay more money for untrained unaccountable health care providers, when it cannot adequately compensate the qualified tiers of the health service. It seems unlikely that the second level nurse will survive in its current form as a trained, qualified, educated registered, accountable, professional care giver, and that the RN will have to rely on untrained, unqualified and unaccountable assistance at half the salary of the SEN.

See also

• Nurse
• Nursing
• Registered Nurse
• Enrolled Nurse Professional Association