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Practical Nursing (LPN) vs. Certified Nursing Assistant (CNA)

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Licensed practical nurses (LPNs) and certified nursing assistants (CNAs) have career paths worthy of comparison. Both provide routine care that includes assisting patients with daily tasks such as eating and personal hygiene. However, some distinctions between these two paths are worth exploring. Job prospects, education, and supervision are different for these two roles. Individuals interested in a nursing related career should carefully consider both options to determine which approach best suits their personal goals, skills, and job preferences.

What Is a Certified Nursing Assistant (CNA)?

A certified nursing assistant (CNA) is a health care professional responsible for providing basic care and daily assistance to patients under the supervision of a registered nurse (RN) or licensed practical nurse (LPN). A CNA will often serve as a patient's primary caregiver in a long-term facility. These professionals must have great empathy and compassion as well as strong people skills.

A CNA's daily responsibilities may include the following:

  • Helping patients bathe and dress.
  • Serving meals and recording a patient's food and liquid intake.
  • Helping patients eat.
  • Repositioning bedridden patients.
  • Emptying and supplying bedpans.
  • Transferring patients to wheelchairs, beds, and other locations.
  • Changing sheets.
  • Cleaning a patient's living space.
  • Recording vital signs.
  • Documenting a patient's condition.
  • Collaborating with other caregivers, nurses, and doctors.
  • Communicating with the patient and patient's family about the individual's condition.
  • Dressing wounds.
  • Assisting with basic medical procedures.

This physically demanding role requires long hours and much time spent on one's feet. A CNA will often transfer patients in and out of wheelchairs, push wheelchairs, and do basic housekeeping tasks in the patient's room or home. These physically demanding tasks require stamina and a good level of fitness. As a CNA, you should have a friendly demeanor and the ability to handle stressful situations gracefully.

Although you'll face many challenges in this role, CNAs also have a rewarding job that allows them to form strong connections with their patients and know that they're making a difference in these individuals' everyday lives.

What Is a Licensed Practical Nurse (LPN)?

An LPN is a health care professional who provides basic patient care under the supervision of doctors and RNs. LPNs are referred to as licensed vocational nurses (LVNs) in California and Texas, but their job duties are the same. The responsibilities of an LPN are similar to those of a CNA and include many tasks related to routine care and assistance. However, an LPN can also perform more complex procedures.

An LPN's job includes the following responsibilities:

  • Recording vital signs.
  • Assisting patients with toileting and bathing.
  • Changing dressings.
  • Inserting catheters.
  • Assisting with tests and medical procedures.
  • Recording patient health histories.
  • Collecting samples, such as blood or urine.
  • Caring for patients' ventilators or tracheostomy tubes.
  • Feeding patients through gastronomy or nasogastric tubes.
  • Administering medications and vaccines.
  • Executing nursing care plans as set forth by an RN.

An LPN has a demanding job that requires compassion, attention to detail, and stamina. LPN professionals spend long hours on their feet and work closely with their patients. These health care professionals may have a greater opportunity to get to know their patients than a physician or RN might.

How to Become a CNA

A high school diploma or GED is required to pursue CNA training. Individuals can become a CNA with four to 12 weeks of training, depending on the state's requirements. A college degree is not required for this role.

The training program to become a CNA will include:

  • CPR, first aid, and AED certification.
  • Infection control.
  • Communication and teamwork.
  • Patients' rights.
  • Delivery of personal care.
  • Workplace safety.
  • Vital signs recording.
  • Range of motion exercises with patients.

Many certificate programs are available for CNAs. Look for a school approved by your state board and accredited by the Accreditation Commission for Education in Nursing (ACEN) or Commission on Collegiate Nursing Education (CCNE). Those who choose to advance their careers later by pursuing an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) will need a certificate from an accredited institution to proceed.

After earning a CNA certificate, students must pass a competency exam. This exam contains a written or oral test administered in a group environment. The test consists of a series of multiple-choice questions on topics such as medical terminology, anatomy, physiology, and the responsibilities of a CNA. The exam also includes a clinical skills test administered one on one by a nurse or other health care practitioner. For this test, the proctor chooses from a list of more than 20 essential skills and asks the test taker to demonstrate them. These skills may include items such as recording a pulse or practicing proper hand washing procedures.

Certification requirements for becoming a CNA vary by state. Some states require a background check or specific number of training hours. After passing the certification and completing any other state requirements, the individual's name will appear as a CNA in the state's registry.

Many states require continuing education for CNAs. Every two years, CNAs may need to complete 48 hours of continuing education in order to maintain their professional status. Employers often cover the cost of this education. CNAs may also need to submit a renewal form and fee every two years. Those individuals who have not maintained employment as a CNA during this time will typically have to take and pass the CNA competency exam again.

How to Become an LPN

To become an LPN, individuals must obtain a high school diploma or a GED and complete an LPN program. These programs usually take one year of coursework and practical application to complete.

LPN programs cover the following subject areas:

  • Anatomy and physiology.
  • Biology.
  • Chemistry.
  • Psychology.
  • Medical terminology.
  • First aid.
  • Physical education.
  • Pharmacology.
  • Emergency medical technology.
  • Nutrition.
  • Human growth and development.

Upon completion of the training program, prospective LPNs must take the National Council Licensure Examination for Practical Nurses (NCLEX-PN). The exam is required in all states. This computerized exam contains 85 to 205 test items that the test taker must complete in five hours. The test evaluates the student's aptitude as he or she progresses through the questions. It adjusts the subject matter and difficulty accordingly.

Topics covered on the exam include the following areas:

  • Physiological integrity.
  • Psychosocial integrity.
  • Health promotion and maintenance.
  • Safe and effective care environments.

LPNs may also pursue additional certifications in specialty areas that will help increase their employability and enhance their skill set.

Available certifications include the following:

  • Wound Care Certification (WCC).
  • Advanced Cardiac Life Support (ACLS).
  • Pediatric Advanced Life Support (PALS).
  • IV Therapy.
  • Basic Life Support (BLS).
  • Certified Peritoneal Dialysis Nurse (CPDN).
  • Certified Hemodialysis Nurse (CHN).
  • Pharmacology (NCP).
  • Developmental Disabilities (DDC).
  • Gerontology (GC).
  • Urology (CUA).
  • Long-term Care (LTC).
  • Transplant Coordinator (CCTC & CPTC).
  • Certified Clinical Research Coordinator (CRC).
  • Certified Clinical Research Associate (CRA).
  • Registered Cardiovascular Invasive Specialist (RCIS).

Continuing education requirements vary from state to state. Some states do not require continuing education. Others require up to 30 hours of continuing education every two years.

Skill Set: CNA vs. LPN

While CNAs and LPNs perform many of the same duties, some notable differences exist in the required skill sets for each of these jobs. Exploring these distinctions may help individuals determine which career path is best suited to their talents.

A CNA's job is more focused on forming positive patient relationships and providing nurturing daily care. Essential skills include effective patient scheduling and treatment planning. They should be skilled at assisting with daily activities such as bathing, taking care of personal hygiene, cleaning, and cooking. CNAs are often required to have a valid driver's license and the ability to transport patients to doctor's appointments and other activities.

An LPN's role involves more medical duties and procedures. LPNs should have excellent attention to detail that enables them to notice changes in a patient's health. LPNs provide patient and family education, and they should have good communication skills and the ability to teach others about health concerns effectively. Medical administration takes up a significant portion of an LPN's day. These professionals must be comfortable and competent in providing basic medical care.

Where Do CNAs Work?

Some of the places that a CNA may work include the following environments:

  • Nursing homes: Providing long-term care to residents.
  • Home health care: Visiting patients at their individual homes to assist with daily tasks under minimal supervision.
  • Assisted living facilities: Working with older adults who need minimal assistance with daily tasks.
  • Adult daycare: Assisting mentally or physically challenged adults when other caregivers are unavailable.
  • Hospitals: Monitoring admitted patients for their reactions to treatments and medications.
  • Physicians' offices: Recording patients' vital signs and preparing them to see a doctor.
  • Outpatient centers: Providing short-term care post-surgery.
  • Correctional facilities: Providing acute or long-term care to individuals in these facilities.
  • Schools: Assisting students with minor injuries or illnesses in school.

Where Do LPNs Work?

LPNs can work in a variety of health care facilities where they administer medical treatments to their patients. Some possible work environments include the following:

  • Nursing care facilities: Assisting and treating older adults.
  • Physicians' offices: Following doctors' orders to administer care.
  • Hospitals: Handling advanced nursing practices supervised by nurses, doctors, or surgeons.
  • Nursing care facilities: Caring for patients who are chronically ill, mentally ill, or in rehabilitation.
  • Home health care facilities: Evaluating and caring for patients in private facilities.

How to Choose Your Career Path

The most significant difference between an LPN and CNA is the training required for the position. In some states, the path to becoming a CNA takes only a month of training to get the appropriate certification. This option is best for those who want to get started on their careers in a shorter amount of time. LPN programs are more in-depth, requiring about a year of study. An LPN program can provide students with a foundation for pursuing an ASN and eventually a BSN later on.

The job outlook is slightly better for LPNs than for CNAs. The U.S. Bureau of Labor Statistics (BLS) projects growth of 11% for LPNs (1) over the 2018 to 2028 decade. The projected growth for nursing assistants is 9% (2)over the same time period. Both jobs have good potential, however, as the average growth for all occupations in the United States is 5%.

How to Advance From a CNA to an LPN

For those who want to get a start on their careers but still progress to enjoy the benefits of being an LPN, the transition from a CNA to an LPN is fairly straightforward. With prior experience as a nursing assistant, students may be able to pursue a slightly shortened educational program.

Some schools will credit some CNA training to their LPN programs; however, Concorde does not guarantee the transfer of credits. Students still need to pass the NCLEX-PN exam, but they will likely find the topics more familiar with a prior history in nursing.

Nurses who want to further their careers can pursue an LPN to RN bridge program later as well. Some schools allow LPNs to complete their bridge program in about a year. Students can then complete an optional master's degree in nursing in only one to two years. It's possible to begin with a CNA program and still work up to a career as an RN later. Interested professionals should also be aware of an RN to BSN degree completion program, too, which can help with furthering one's career in the field.

Those who are interested in a career in nursing can choose from several routes that allow entry to this field. Take the time to thoroughly explore all the options available to you to find the most appropriate path. Any type of nursing occupation can develop into a rewarding career.


Footnotes:

1. "Licensed Practical and Licensed Vocational Nurses," U.S. Bureau of Labor Statistics, https://www.bls.gov/ooh/healthcare/licensed-practical-and-licensed-vocational-nurses.htm 2. "Nursing Assistants and Orderlies," U.S. Bureau of Labor Statistics, https://www.bls.gov/ooh/healthcare/nursing-assistants.htm

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