Program for LPNs fills up

March 20, 1995|By Sherry Joe | Sherry Joe,Sun Staff Writer

On the Howard Community College campus, 20 students are taking part in a quiet shift in the way nursing care is provided.

Driven by shorter hospital stays and increased competition in the health care market, the college is helping to fill demand for licensed practical nurses through a new program that filled up in its first year.

Licensed practical nurses have less training than registered nurses and are allowed fewer responsibilities, but it costs less to employ them though they still have the confidence of patients and employers concerned about safety and comfort, health care experts say.

And for students such as Donna Burley, the community college program that started in September offers a welcome career choice. "I've always wanted to be a nurse," said Ms. Burley, a 28-year-old Woodlawn resident who has worked 11 years as a certified nursing assistant and nursing coordinator.

Campus officials say the 11-month program is tailor-made for those looking for a quick entry into the health care field.

"There's a need for that person who is licensed," said Dr. Emily Slunt, director of nursing education for Howard Community College. "Patients are going home much quicker, and there's a need for follow-up care."

Unlike registered nurses who receive two years of training, licensed practical nurses study for an average of a year. They then work under the direction of doctors and registered nurses. Their duties can include monitoring vital signs such as blood pressure and pulse, administering medication and helping patients with hygiene.

Registered nurses also are allowed to give initial assessments of patients, and to treat more acutely ill patients. Licensed practical nurses typically deal with healthier, more stable patients.

Licensed practical nurses play an important role in long-term-care facilities, where they often supervise and manage the care of relatively healthy patients. In hospitals, registered nurses typically care for acutely ill patients who often are using high-tech equipment.

According to the state Board of Nursing, Maryland has 10,339 active licensed practical nurses, compared with 10,137 in 1990. By contrast, there are 55,091 active registered nurses in the state, compared with 44,999 in 1990.

Howard Community College is one of 14 colleges in the state offering programs for registered nursing and practical nursing. It is the only one in the Baltimore metropolitan area to offer a college-level licensed practical nursing program, said Deborah Feldman, nursing education consultant for the state Board of Nursing.

Some high schools offer programs in practical nursing, but many have dropped the courses as nursing grows more complex, Dr. Slunt said. Four years ago, 10 high schools offered practical nursing programs, according to the state Board of Nursing. Now, high school programs exist only in Carroll, Anne Arundel and Baltimore counties.

Union Memorial Hospital in Baltimore also offers a practical nursing program.

Howard Community College started its practical nursing program after surveying about 20 hospitals, long-term-care facilities and clinics in the metropolitan area.

"We were getting a lot of inquiries from long-term-care facilities," Dr. Slunt said. "There wasn't any LPN program here in Howard County."

In the 43-credit program, students learn the fundamentals of nursing and other areas of care, including pediatrics, psychiatry and long-term care. Classroom instruction is blended with experience at local hospitals such as Howard County General and Harbor Hospital in Baltimore.

For a full-time student, the program can cost about $3,800, including tuition, books and materials.

The program also provides what academic advisers call a "career ladder," since many licensed practical nurses eventually become registered nurses.

"The hardest part is managing your time and getting everything done," said Ms. Burley, who estimates that she spends about 30 hours a week on her course work. She will graduate this summer.

Once graduates pass a license exam, they earn a starting salary of about $20,000 to $24,000 a year, according to the college. Starting salaries for registered nurses run from $26,000 to $30,000 a year.

Licensed practical nurses have the right level of skills for home health care and long-term-care facilities, where patients tend to need less care than those in hospitals, say managers of long-term-care institutions.

"Patients are not as acutely ill," said Carol Gibbons, clinical director of Maryland Health Enterprises, an Ellicott City firm that oversees three nursing homes where licensed practical nurses make up about 70 percent of the nursing staff. "It's become a point in hospitals where technology is so high that they need RNs."

The lower salary levels also are important in long-term care, where insurance reimbursement rates are considerably less than in acute-care settings.

"We have to be very efficient," Ms. Gibbons said. "The LPNs fit into our picture."

Licensed practical nurses still have a place in hospitals, administrators say.

"A patient feels comfortable with a licensed care-giver," said Susan Goodwin, a vice president at Howard County General Hospital. "They've had education. They have standards of education. They can administer medications."

Ms. Burley expects that her new license will elicit more respect from patients.

"There'll probably be a different attitude," she said. "Patients rely more on licensed people."

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