Every state licenses practical nurses to provide basic bedside care. In most states, they're referred to as licensed practical nurses, while in Texas and California they're called licensed vocational nurses. The board of nursing in each state defines what level of care LVNs can and can't provide, through an official document called their "scope of practice." There are significant differences in an LVN's scope of practice between California and Texas.
California Scope of Practice
California's scope-of-practice document is detailed and specific about what you can and can't do. For example, a registered nurse does the formal assessment of a new patient, but you can help by taking vital signs and conducting a basic physical examination. You can perform basic CPR during emergencies, change dressings, catheterize patients, perform electrocardiograms or blood sugar testing and assist patients with basic personal care. You aren't allowed to intubate patients, dispense medications or start an IV, though you can work with an existing IV drip once it has started. You always practice under the direction of a registered nurse or physician.
Texas Scope of Practice
Texas takes a more permissive approach to its scope of practice for licensed nurses, opting for common sense and broad rules rather than tight regulation. You're expected to be familiar with the state's Nursing Practice Act and the board of nursing's position statements on subjects such as nurses' duties, suitable supervision or the administration of drugs. It's your responsibility to judge whether you're trained and competent for specific forms of care. If you feel you've been asked to do something that violates state law or the standards of your workplace, you can and should refuse. In general, state law allows you to perform most nursing duties that don't require you to exercise independent medical judgment.
Specific Qualifications
If you want to advance in your job, or if your workplace places a value on LVNs with added qualifications, you might want to look into advanced professional certifications. The National Association for Practical Nurse Education and Service and the National Federation of Licensed Practical Nurses offer certification for LVNs in several areas, including pharmacology, intravenous therapy and long-term care or elder care. An LVN with the pharmacology or IV certification can administer medications and start IVs independently, and a long-term care or elder-care certification can help you become a supervisor in those care settings.
Career
To be an LVN in either California or Texas, you'll need to complete a certificate or diploma program at a trade or technical college, then pass the National Council Licensure Examination for Practical Nurses or NCLEX-PN. After that, you're eligible for state licensing. If you've trained as a licensed practical nurse in another state, you can transfer your license to California or Texas and practice there as an LVN. Your job prospects should be excellent. The U.S. Bureau of Labor Statistics projected 22 percent employment growth for LVNs and LPNs between 2010 and 2020, better than average, and Texas and California are the top two states for LVN/LPN jobs.
References
Writer Bio
Fred Decker is a trained chef and certified food-safety trainer. Decker wrote for the Saint John, New Brunswick Telegraph-Journal, and has been published in Canada's Hospitality and Foodservice magazine. He's held positions selling computers, insurance and mutual funds, and was educated at Memorial University of Newfoundland and the Northern Alberta Institute of Technology.