The licensed practical nurse workforce in the United States: one state's experience.

Background: Licensed practical nurses (LPNs) are employed in multiple health care settings in the United States, with the largest portion providing nursing care in long-term care, skilled nursing, and nursing home facilities, which largely provide custodial care and rehabilitative services to elderly residents. Rapid growth in the size of the elderly population in the U.S., combined with retirements from an aging LPN workforce, are expected to increase the demand for LPNs in the coming decades. This paper describes the characteristics of LPNs in one state, Washington, and makes projections of LPN supply and demand in the state through 2026.

Methods: The study uses data from a 2007 survey of LPNs with Washington State licenses to describe the demographic, education, and practice characteristics of the workforce. The projections of LPN supply and demand were built from the baseline survey data and changes over time were estimated using available data and literature from a variety of sources.

Results: Of the 14,446 LPNs with Washington licenses in 2007, 72% practiced in the state. The work setting in which the largest percentage worked was long-term care (37%). Of the average 37 hours worked per week by LPNs, 25 hours were spent in direct patient care. The average age of practicing LPNs was 46 and 12% of LPNs were male. The racial/ethnic distribution of Washington's LPNs resembled that of the overall state population, with 17% non-White and 4% Hispanic. Nearly three quarters obtained their LPN education within Washington. If the 2007 number of completions from LPN schools in Washington is sustained, the projected supply of practicing LPNs in 2026 will be more than 3,500 (24%) below estimated demand. If the current education completion number increased by 200 LPNs (nearly 20%) in 2011, and this number was maintained through 2026, the projected supply of practicing LPNs would increase but would still be 2,052 LPNs below estimated demand in 2026. Neither projection scenario produces enough LPNs to maintain the 2007 LPN-to-population ratio through 2026. CONCLUSIONS/POLICY IMPLICATIONS: It is not known precisely whether or how LPN workforce roles will change in the future, but the projected LPN shortages in Washington State mirror similar findings from other parts of the U.S., with major growth in projected LPN demand due to increases in, and aging of the state's population. The number of LPNs completing education programs in the state is unlikely to keep pace with the decline in supply from retirements unless a significant expansion of education programs takes place. The LPN profession is an important entry point into the nursing profession, and increasing the number of LPNs educated in-state could expand the pipeline leading to registered nurse (RN) careers, another nursing profession for which major shortages are predicted. Carefully articulated LPN-to-RN education programs could improve the attractiveness of the profession and increase the supply of LPNs.