In Canada (except for Québec[2]), the education program is two years of full-time post-secondary and students must pass the Canadian Practical Nurse Registration Exam (CPNRE),[3] administered by the for-profit Yardstick Assessment Strategies.
[4] In 2022, Ontario and British Columbia plan to discontinue CPNRE in favour of the REx-PN, administered by the National Council of State Boards of Nursing (NCSBN).
Many LPNs measure and record patients' vital signs such as weight, height, temperature, blood pressure, pulse, and respiratory rate.
To help keep patients comfortable, they assist with bathing, dressing, and personal hygiene, moving in bed, standing, and walking.
[1] In some American states, LPNs are permitted to administer prescribed medicines, start intravenous fluids, and provide care to ventilator-dependent patients.
The Occupational Outlook Handbook states that LPNs may have to work nights, weekends, and holidays; often stand for long periods and help patients move in bed, stand, or walk; and may face occupational hazards which include exposure to caustic chemicals, radiation, and infectious diseases; back injuries from moving patients; workplace stress; and sometimes confused, agitated, or uncooperative patients.
"[1] In California, licensed vocational nurses (LVNs) empty bedpans, commodes and clean and change incontinent adults.
Licensed vocational nurses read vital signs such as pulse, temperature, blood pressure and respiration.
The Occupational Outlook Handbook states that in order to be eligible for licensure, LPNs must complete a state-approved training program.
[1] In some settings, LPNs/LVNs have opportunities for advancement, including the possibility of becoming credentialed in a certain area (such as IV therapy, gerontology, long-term care and pharmacology) or of becoming a charge nurse, responsible for overseeing the work of other LPNs and various unlicensed assistive personnel, such as nursing assistants.
Practical nurses who had been functioning as such at the time new standards were adopted were usually granted a license by waiver, and exempted from new training requirements.
[9] The first formal training program for practical nurses was developed at the Young Women's Christian Association (YWCA) in New York City in 1892.
[10] In Canada, nursing, as with all other health care professions and trades, is regulated by the respective province or territory, through an enabling statute legal scheme where an act of the relevant legislature grants delegated authority to a non-sovereign entity such as a college of nurses with powers to regulate the profession within specific parameters and also grants to the respective minister of the Crown oversight and the powers to write regulations through a Ministerial Order in Council.
While the act and the regulation outline basic organizational architecture, each professional organization creates its own bylaws and codes of conduct and practice subject to ministerial and judicial review and must be in compliance with accepted norms of administrative law such as transparency and accountability in governance, fundamental principles of natural justice, an internal appeal process and compliance with the Canadian Charter of Rights and Freedoms.
Such legal schemes enable self-governance and save costs to governments by delegating regulatory responsibilities to a self-funded and self-administered professional entity, but are also known to engage in protectionist practices since the delegation also grants a monopoly for the provision of services to only one body, as widely studied by the late economist A nurse who is entitled to practice in one jurisdiction cannot work in another without applying to and being granted a license by the local regulatory body.
To apply for membership, an applicant must satisfy requirements including completion of an approved two year post secondary training program, evidence of recent practice as a nurse, pass both an entrance and jurisprudence examination, be proficient in either English or French, have legal authorization to be employed in Canada, disclosure of certain past or ongoing legal proceedings, disclosure of certain proceedings involving practice of nursing in other jurisdictions and disclosure of certain kinds of health conditions and disabilities.
[14] The CNO's definition for a nurse's scope of practice is: "The practice of nursing is the promotion of health and the assessment of, the provision of care for, and the treatment of health conditions by supportive, preventive, therapeutic, palliative, and rehabilitative means in order to attain or maintain optimal function".
[15] The College of Nurses of Ontario (CNO) outlines 13 controlled acts, 4 of which can be performed by RPNs and RNs.
Prior to the implementation of Project 2000 which radically altered the face of nurse education in the mid-1990s, SEN students used to be trained within two years.
This is by two different means: starting their training from scratch as a pre-registration student nurse, or by joining an existing cohort of student nurses starting their second year of training, and completing years 2 and 3 with them[16] Formerly, there was a large segregation between the "green" SENs and "blue" SRNs, which were the colour of uniform typically worn.
SENs were very much complementary to the nursing team, however did not have the status of SRNs and were ineligible to be promoted, e.g., to ward sister.
[citation needed] The national Australian Health Practitioner Regulation Agency (AHPRA) issues permission to practise.
Trainee enrolled nurses (TENs) become employees of the hospital for the twelve-month training period, meaning that, as well as gaining practical experience on the wards, they are paid for hours worked.
This attracts a substantial number of applicants, who may wish to pursue nursing as a career, but are unable to afford to become full-time university students.
As of 2009, however, the government has stopped working with the NSW Department of Health, and those wishing to become enrolled nurses are not being paid.
Despite the fact that the role of the EN in Australia has been greatly expanded in recent years, opportunities for career progression remain somewhat limited, and for this reason, many choose to go on and study to become registered nurses.