Barriers and facilitators for the LPN-to-RN transition: Perspectives from practicing LPNs

Investigators:  Cheryl B. Jones, PhD, RN; Mark Toles, PhD, RN; Anna Beeber, PhD, RN

Background and Policy Relevance: The Institute of Medicine Future of Nursing Report (IOM, 2011) called for an increase in the percentage of registered nurses (RNs) with a baccalaureate degree to 80% and a doubling of the percentage of RNs with a doctorate degree by 2020.  A follow-up IOM report assessing progress on these original recommendations indicates that there is still much work to do to understand and promote educational mobility in the nursing workforce.  Because the US nursing workforce includes more than 690,000 LPNs, an important approach to increasing the RN workforce is to promote the transition of licensed practical or licensed vocational nurses (LPNs, LVNs) to RNs. However, little is known about why LPNs/LVNs do or do not make the transition.

It is unknown whether LPNs themselves face barriers that prevent them from making the transition, or whether educational programs and health care systems are not structured to encourage LPNs interested in transitioning to become RNs. For practicing LPNs, the transition to the RN role is viewed as a natural pathway to greater autonomy and income in nursing practice; yet, data are not available to help us understand why LPNs choose not to advance their education or whether the programs and health care systems where they work put up roadblocks to LPN progression.  Importantly, policymakers lack evidence needed to develop incentives and recruit greater numbers of LPNs to the RN role.

In our previous research (Year 2 Project, Role Transitions for the LPN-to-RN Workforce in North Carolina), we described the number of LPN to RN professional transitions in North Carolina from the years 1993 to 2013, and the demographic and professional characteristics of LPNs who transitioned to the RN role1. In our current study (Year 3 Project, Predicting Transitions in the Nursing Workforce: Professional Transitions from the Role of LPN-to-RN), we are using modeling techniques to examine the professional trajectories of LPNs, and predictors of their transitions to the RN role, including demographic (e.g., age gender and self-reported race), professional (e.g., setting of LPN employment, role as a LPN, years of employment as a LPN, full time versus part time employment and others) geographic (e.g., rural versus urban address and others), and, as available, socio-economic factors (e.g., unemployment).  The proposed project will build on our Years 2 and 3 quantitative projects by using qualitative data from LPNs to examine the barriers and facilitators for LPNs to make a transition to an RN.

Study aims: This project will examine the barriers and facilitators to LPN-to-RN transitions.