What are the Differences Between a Registered Nurse and Practical Nurse?

The United States is facing a nursing shortage. This shortage has existed for many years and is especially acute with registered nurses (RNs). While the shortage is expected to improve over the next decade or so, many parts of the country are still desperate for new nurses.

One of the silver linings is that there has never been a better time to graduate from nursing school. But which nursing program should you enroll in? Two of the most popular for new nurses are RN and Licensed Practical Nurse/Licensed Vocational Nurse (LPN/LVN) programs.

But what’s the difference between LPNs and RNs?

Difference #1: Education Requirements

One of the biggest differences between RNs and LPNs or LVNs is the formal education required to become one. Practical or vocational nurses need to complete an approved program. This usually means it has programmatic accreditation from an organization like the Accreditation Commission for Education in Nursing (ACEN) and/or it’s been approved by a state’s board of nursing. Most LPN or LVN programs can be found in technical schools and community colleges. They typically last 12 to 18 months and offer a diploma or certificate to graduates.

Registered nurses also need to complete an approved program, which usually means it must be approved by a state’s board of nursing and have programmatic accreditation. The most common accrediting bodies for RN programs are the ACEN and the Commission on Collegiate Nursing Education (CCNE).

These approved programs normally offer an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Either degree will be sufficient, although some employers will prefer to hire BSN-prepared RNs. Having a bachelor’s degree also offers the advantage of providing greater room for professional growth, such as earning a graduate nursing degree or shifting into a consulting or administrative nursing position. Assuming an individual only has a high school diploma or equivalent and is not enrolled in an accelerated program, it will take two years to earn an ADN and four years to earn a BSN.

Difference #2: Licensure Exam

Both RNs and LPNs are certified nurses, but they take different licensing exams. As their names imply, LPNs and LVNs take the NCLEX-PN exam, while RNs take the NCLEX-RN exam. Both are owned by the National Council of States Boards of Nursing, Inc. and administered by Pearson VUE.

Both exams cover similar topics, such as infection control and the basic care and comfort of patients. However, the NCLEX-RN will cover some topics more in-depth, like patient evaluation, while the NCLEX-PN may spend more time covering other topics in more detail, like patient data collection.

Difference #3: Job Duties

Depending on their experience and where they work, there is plenty of overlap in the professional responsibilities of LPNs and RNs. However, given the greater training requirements of RNs, they will typically have more involved duties that build off of what LPNs do.

For instance, an RN or an LPN may monitor a patient’s vital signs, but the RN is more likely to make patient assessments based on those observations. RNs are also more likely to administer patient medications and medical treatments, as well as assist with diagnostic tests.

Finally, RNs have a greater role in explaining and educating patients about good health habits and how to continue treatments once they leave the hospital or other medical providers.

Difference #4: Pay

Registered nurses will usually earn more money than licensed vocational/practical nurses. Of course, practice settings, geographic location, and years of experience are important factors in the bottom line, but generally, RNs will still earn more than LPNs. That’s a major reason why many prospective nurses choose to enroll in an RN program instead of an LPN or LVN program.

According to the U.S. Bureau of Labor Statistics, the median annual salary of an RN in the United States is $75,330, with the 10th percentile earning $54,410 and the 90th percentile earning $116,230. In contrast, the median annual salary of an LPN/LVN in the United States is $54,620, with the 10% percentile earning $40,490 and the 90th percentile earning $72,650.

Difference #5: Work Setting

RNs and LPNs can be found in most healthcare settings, and when you see one type of nurse, you’re likely to see the other. Yet, as a result of their different job responsibilities, LPNs and RNs tend to concentrate in different work environments.

The most common practice locations for LPNs are residential and nursing care facilities (35%), with 15% of LPNs working in hospitals. RNs can be mostly found in hospitals, with 59% of RNs working there and 15% working in ambulatory healthcare services (this includes physician’s offices, travel nursing, and outpatient care).

Difference #6: Professional Advancement

Both licensed vocational and practice nurses and registered nurses have plenty of professional growth opportunities. For LPNs, the most popular advancement options are LPN to RN and LPN to BSN programs. There are parallel options for RNs, such as RN to BSN and RN to MSN programs. There is also a doctorate option that’s possible for BSN and MSN-prepared RNs.

So while both LPNs and RNs can go back to school to become a different type of nurse, LPNs work to become RNs while RNs work to become advanced practice registered nurses, or APRNs. Also, because it’s easier for an RN to earn a master’s or doctorate degree in nursing, they will have more non-clinical nursing-related job prospects immediately available, such as management, administration, and teaching.

Difference #7: Projected Job Growth

Although not the biggest difference between RNs and LPNs, RNs enjoy slightly more promising job growth. The U.S. Bureau of Labor Statistics (BLS) estimates that from 2022 to 2032, the number of LPNs will grow by 5% in the United States. During that same time frame, the number of RNs will grow by 6%.

Hidden in these similar numbers is the fact that RNs will have an easier time moving into some of the fastest-growing healthcare professions. For example, from 2022 to 2032, the BLS projects that the number of APRNs will grow by 38%. There’s nothing to prevent an LPN from becoming an APRN, but they will need more training and experience to make this move than an RN will.