The Healthcare Navigator Resource Guide

Licensed Vocational Nurse

Occupational Duties

Most LVNs provide basic patient care, such as taking vital signs, giving medications, monitoring patients, and helping with hygiene duties. LVN's scope of practice is more limited than the Registered Nurse scope of practice, so LVNs may not be able to start IVs or perform certain procedures (such as inserting catheters or changing ventilator settings). The LVN scope of practice is determined by the state where the LVN practices. It must be mentioned that LVNs in Silicon Valley are currently utilized primarily in the long term care industry, home care environment, psychiatric facilities and correctional facilities. For those unwilling to work in the above-mentioned environments, it would not be a reasonable career choice to become an LVN. LVNs are employed less frequently in the acute care (general hospital) setting.

Significant Points

Several large Bay Area hospitals have pared down or eliminated their LVN workforce in the acute care setting which has moved large numbers of LVNs toward skilled nursing and residential care settings.

LVNs generally work under the supervision of Registered Nurses. The LVN profession is not currently receiving the attention or high regard that Registered Nursing receives–a scenario that is unlikely to change in the near future due in part to the LVNs more limited scope of practice as defined by California law. Click here to view the California regulations that define the LVN scope of practice.

LVN training is offered at vocational schools (the training is more expensive and the educational credits earned may not transfer to community or state college nursing programs) and community colleges. LVN training programs in the vocational setting do not generally require prerequiste coursework, though some require completion of a Certified Nursing Assistant program. Prerequisites for community college LVN training programs are fewer than for some of the other allied health care training programs and may be completed in 1-2 semesters.

LVNs, regardless of work experience, will be at an advantage when applying for Registered Nursing training programs. Community college trained LVNs should be able to complete the additional training necessary to sit for the National Council Licensure Examination (NCLEX-RN) and to earn an associates degree of nursing (ADN) in less than two years of study. Though the LVN-RN bridge programs are only one year long, LVNs must satify prerequisite course requirements and this frequently takes 2 or more terms of study to complete.

The LVN occupation is an excellent career ladder occupation because students should be able to find per diem work during their RN training, will be familiar with many of the concepts of the RN training, and will theoretically be more desirable to employers upon graduation because of their healthcare work experience. Many LVNs have a career ladder mentality and view the LVN occupation as a stepping stone.

LVNs with at least one year of work experience will be able to work in home healthcare, which may be desirable to some individuals due to the job flexibility and increased independence it would provide the LVN. This area is expected to grow and should present more opportunities for LVNs.

When working to their full scope of practice, LVNs have a great deal of interaction with patients and this is a very special part of the job for many LVNs. The desire to provide patient care is often the reason that individuals pursue vocational nursing in the first place. LVNs do less paperwork than RNs and generally have fewer administrative and supervisory duties than RNs, and this is preferable for some individuals.

Demand

There are job openings for LVNs in skilled nursing facilities (also known as "snfs"), home health care, psychiatric facilities, the penal system, and the VA. LVN jobs are difficult to get in the general hospital setting as several general hospitals have pared down their LVN staff in 2006 and 2007. Several individuals interviewed indicated that LVN hiring in the general hospital setting is at an all-time low.

Per diem work is becoming more common as employers seek to offer benefits to fewer employees as a cost saving measure. LVNs may work part-time at one or more facilities. At this time, demand for LVNs seems to be greatest in the Gilroy/Monterey/Salinas area.

Multiple private training programs for LVNs have emerged in the Bay Area within the last three years--this has quickly increased the supply of LVNs, particularly in Santa Clara County. As a result, some suggest that there is a small glut in the market and that there are more LVNs competing for jobs. As private training programs continue to develop and existing programs expand enrollment, it will be important for individuals considering a career as an LVN to evaluate the number of available job opportunities and to speak with LVN employers about their demand for LVNs.

Wages

Most employers pay part-time and full-time LVNs between $23 and $28 per hour. Jobs in skilled care facilities usually pay wages on the lower end of this range; jobs in acute care, correctional facilities and per diem shifts may pay several dollars more per hour. Click here to see the quarterly wage survey for LVNs in Santa Clara County. Click here to see the quarterly wage survey for LVNs in San Mateo County.

Education

To be eligible to take the NCLEX-PN, the national licensing exam that allows LVNs to practice in California, an individual must graduate from a State-approved LVN program or possess a combination of paid work experience and education. Individuals should seek out only California-approved programs and should not attend an unaccredited program because they are unlikely to find an employer that will hire them to perform the work-study component necessary to be NCLEX-PN eligible. To see a list of accredited LVN schools, click here.

Candidates’ transcripts must be submitted to the Board directly from the school where the courses were taken and must show theory and clinical hours completed, as well as the grades for each course. Applicants must achieve a grade of "C" or better in the course in order to be given equivalency credit. Education credit will only be granted for those courses taken in approved vocational nursing, practical nursing or registered nursing programs.

To see LVN programs on the ETPL, click here and enter "voc" in the program name category and specify County (do not fill in other fields).

The cost of LVN training programs ranges from $6,700 at the community college level, to more than $30,000 at some private schools.

The Gavilan College Lock-step CNA-LVN-RN program may be an attractive option for WIA clients. The program is on the ETPL and students can work as a CNA while pursuing LVN training. Wait time for individuals who have completed the CNA component of the program is one year before progressing to LVN training.

Licensure

Vocational Nursing is a licensed profession--it is not possible to work as a vocational nurse in California without a California State-issued Vocational Nursing License. To achieve licensure, an individual must graduate from an accredited LVN training program and pass the NCLEX-PN. Individuals who are considering LVN education are strongly encouraged to take into account an educational institution's NCLEX-PN passage rate when selecting an LVN training program--Bay Area LVN training program NCLEX-PN passage rates range from 45% to 94%. NCLEX-PN passage rates for all LVN training programs can be viewed by clicking here.

LVNs must also be fingerprinted and pass a criminal background check before gaining licensure. It is the responsibility of the student to contact the BVNPT if s/he has a criminal record--it is important to learn whether or not an offense precludes the individual from achieving licensure prior to beginning a training program.

Click here for more information on the NCLEX-PN and licensing process.

Career Ladder

Click here to view the nursing career ladder diagram designed by the healthcare navigator.

Many LVNs pursue RN training in the interest of increased wages and broader scope of practice. Some LVN training programs emphasize to students that the LVN profession should be viewed as a stepping stone to Registered Nursing.

Some schools have special transition programs designed for LVNs (City College of San Francisco, DeAnza College, Gavilan College in Gilroy–others are currently in the planning stages, such as the Mission College LVN-RN program), and some other schools will accept LVNs into the second year of the RN training program. Community college-trained LVNs with an associate's degree may also be able to enter the San Jose State University nursing program in the 4th year and earn a bachelor's degree in nursing and be NCLEX-RN eligible in approximately one year.

FAQs

Can LVNs be clinical instructors?

An LVN who wants to teach should follow the career ladder path and become an RN and then pursue a bachelor’s degree. Vocational colleges may hire LVNs to teach some of their classes.

What are the curricular requirements for State-approved LVN programs?

1,530 Total Hours consisting of: Theory - *576 Hours (*Includes Pharmacology - 54 Hours); Clinical-954 Hours. Program Length: Full-time=14-18 Months of Training; Part-time=18-20 Months of Training

What is the course content for LVN programs?

Anatomy & Physiology, Psychology, Pharmacology, Nursing Process, Communication, Patient Education, Nutrition, Normal Growth and Development, Rehabilitation Nursing, Maternity Nursing, Nursing Fundamentals, Pediatric Nursing, Medical/Surgical Nursing, Gerontological Nursing, Supervision, Leadership and Communicable Disease.

The concepts taught in the LVN program are similar to the concepts taught in RN programs, but LVNs do not take classes that satisfy all RN requirements. For individuals interested in pursuing a career ladder model, s/he should speak with an advisor to discuss whether or not it would be possible to take the intense prerequisite psychology, nutrition, and anatomy and physiology courses designed for RNs instead of the survey courses designed for LVNs, since this could potentially save time when the LVN returns to school for RN training. Note: The aforementioned courses are often prerequisites at the community college level, but may be built in to the vocational college LVN program and are non-transferable to community or 4-year college programs.

How many people pass the NCLEX-PN?

To view the NCLEX-PN passage rates at California accredited LVN schools, click here. The National average passage rate is usually about 70% but varies slightly by year.

What kind of material is on the test?

To learn what material is on the NCLEX-PN, click here for an overview. Students may also take a review course offered through Kaplan or other agencies and test-prep is usually recommended for students who struggled through the training program, completed their training more than one semester prior to taking the exam, and for anyone who did not pass the test in their first attempt. The NCLEX-PN results will inform the student in which areas they were defficient, and the student can seek out a refresher course, test prep, or independent study resources as appropriate.

What if I trained as an LVN outside of California?

Click here to read about the licensing process for individuals that completed LVN training outside of California. Foreign-trained nurses may find the Commision on Graduates of Foreign Nursing Schools (CGFNS) to be a helpful resource. Click here to visit the CGFNS site. Jewish Vocational Services in San Francisco offers an LVN Refresher Program in conjunction with City College of San Francisco. The program is designed to assist foreign-trained LVNs. Click here for more information.

How has the nursing shortage affected LVNs?

Demand for LVNs was projected to skyrocket due to the critical nursing shortage, but the limited scope of practice and a number of political issues have kept LVNs from enjoying the kind of demand that Registered Nursing is currently experiencing.

Numerous individuals interviewed indicated that LVNs could help solve the nursing shortage, but that RN unions have not allowed this to happen because the RN shortage is driving up RN salaries and demand for RNs and encouraging more people to pursue Registered Nursing, and there is a fear among Registered Nurses that hiring LVNs to fill the RN vacancies might change this momentum. Click here to read a press release from the California Healthcare Association regarding this issue.

The nursing ratios stipulate that 5 patients can be assigned to 1 licensed nurse. Though LVNs are licensed, there has been a movement to recognize only the RN licensure in meeting the nursing ratios. Because experienced LVNs are paid approximately 30-50% of an experienced RN salary and the inflated RN salaries are contributing to serious financial problems in many healthcare organizations, some individuals believe that hiring LVNs could solve some of the problems caused by the nursing shortage. In spite of the need for licensed nursing professionals and the difficulties that many hospital environments are experiencing due to the nursing ratio legislation, jobs for LVNs in the hospital environment appear to be decreasing.

Which training program do employers prefer?

Individuals interviewed indicated that employers may prefer community college graduates because the programs are longer and more competitive and students complete other general education coursework that may assist them in the workplace.

How can new LVN grads increase their chances of being hired?

LVNs can improve their chances of being hired by graduating from a community college LVN training program (again, preferred by some employers), working on their English language skills, being bilingual (English-Spanish is most needed), becoming IV-certified, and making the most of their internships (some LVNs may be offered employment from the organization that sponsored their internship).

How long is the wait-time to get into the LVN-RN transition programs?

Some students may be accepted immediately, and others may be on a waiting list for more than a year. Students with poor grades may not be accepted at all. At this time, RN training in California must take place at a community college or secondary institution--LVN to RN transition is not offered at vocational schools. Because this type of transition program is expensive, requires clinical space and faculty with advanced degrees, these programs are difficult to develop. At Gavilan College, the waiting period before progressing from LVN to RN is usually one year. Mission College has developed an LVN-RN transition program that will admit its first class in Fall 2007. Wait time for future classes in not known at this time.

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Training Programs

LVN

Mission College LVN Program

Gavilan College CNA-LVN-RN Program

Hartnell LVN Program

WestMed College LVN Program

Unitek College LVN Program

Bay Area College of Nursing LVN Program (Palo Alto and Daly City campuses)

Institute for Medical Education

St. Francis Career College LVN Program

Nursing Care Providers LVN Program (South S.F. Campus)