The Licensed Practical/Vocational Nurse Workforce: Examining Nurses’ Practice Patterns, Workloads, and Burnout by Race and Ethnicity

Abstract

Background:

Licensed practical nurses/licensed vocational nurses, referred to as licensed practical nurses (LPNs) in the present article, provide foundational, direct patient care under the direction of registered nurses (RNs), advanced practice registered nurses (APRNs), and physicians. Overall, the LPN workforce is the most racially and ethnically diverse cohort of nurses in the United States, but their numbers are in decline as a result of slowing educational program growth, reduced program enrollment, and broader workforce turnover.

Purpose:

This descriptive cross-sectional study seeks to more closely examine the LPN workforce through the lens of race and ethnicity. In particular, this work seeks to understand the unique experiences of self-identified Black, Indigenous, and other People of Color (BIPOC) and Hispanic/Latino LPNs during the COVID-19 pandemic.

Methods:

Data from the 2022 National Nursing Workforce Survey were drawn upon for analysis. Descriptive statistics along with generalized logit statistical models were employed.

Results:

Proportionally, more BIPOC LPNs indicated they work in nursing homes or extended care facilities (36.5%, n = 90,219) relative to their White/Caucasian peers (27.3%, n = 126,223). BIPOC LPNs were more than two times more likely (OR = 2.34, 95% CI: 2.28–2.39, p < .001) to become travel nurses relative to White/Caucasian LPNs; similarly, Hispanic/Latino LPNs were more likely to become travel nurses relative to their non-Hispanic/ Latino peers, even after controlling for the highest nursing education credential earned, gender, and years of experience (adjusted OR = 1.23, 95% CI: 1.20–1.27, p < .001). Additionally, more BIPOC LPNs (12.1%, n = 34,286) changed their practice setting compared to White/Caucasian LPNs (10.9%, n = 58,498). Nearly half of all LPNs reported feeling burned out, and around a third indicated they were at the end of their rope.

Conclusion:

The LPN workforce is the most diverse cohort of nurses in the United States. However, as the discrepancy between the supply and demand of LPNs continues to grow, regulators and employers need to collaborate on ways to support and grow this diverse and critical workforce. The results of this analysis offer insights into the practice profiles of these historically marginalized LPNs and how their experiences during the COVID-19 pandemic may inform their intent to leave the profession in the years to come.