Pathways in Nursing Careers: Transitions from the Role of Licensed Practical Nurse to Registered Nurse in North Carolina

Investigators: Cheryl B. Jones, PhD, RN, FAAN Mark Toles, PhD, RN, George J. Knafl, PhD, Anna S. Beeber, PhD, RN

Background: A more diverse registered nurse (RN) workforce is needed to provide healthcare in North Carolina (NC) and nationally. Studies describing licensed practical nurse (LPN) career transitions to RNs are lacking. This study explored the feasibility of using NC Health Professions Data System (HPDS) data to describe LPN-to-RN transitions in NC and, to the extent possible with the data, to characterize the occurrence of LPN-to-RN professional transitions.

Methods: A retrospective cohort design was conducted using licensure data on LPNs from 2001 to 2013. Cohorts were constructed based on year of graduation.

Results: It was partially feasible to use the HPDS data to describe LPN-to-RN professional transitions. Out of 39,398 LPNs in NC between 2001 and 2013, there were 3,162 LPNs (8.0%) that had a LPN-to-RN career transition between 2001 and 2013. LPNs were more likely to transition to RN if they were male; from Asian, American Indian, or other racial/ethnic groups; held a baccalaureate, associate or doctoral degree in their last year as an LPN; worked in a hospital in-patient setting; worked in the medical/surgical nursing specialty; and were from a rural area.

Limitations: This study’s findings are limited by the use of secondary data, from only one state, and with missing data elements, and the use of descriptive analyses.

Conclusion: This study fills an important gap in our knowledge of LPN-to-RN career transitions. Our findings indicate that the odds of an LPN-to-RN transition were greater if LPNs were: male; from all other racial groups than white; of a younger age at first LPN licensure; working in a hospital setting or in the specialty of medical-surgical nursing; employed part-time or working in a rural setting during the last year as an LPN.

• Jones CB, Toles M, Knafl GJ, Beeber AS. An untapped resource in the nursing workforce: Licensed practical nurses who transition to become registered nurses. Nursing Outlook. 2018 Jan 1;66(1):46-55.

• Jones C, Toles M, Knafl G, Beeber A. Pathways to a Nursing Career: Transitions of Licensed Practical Nurses who become Registered Nurses in North Carolina. Policy Brief. Carolina Health Workforce Research Center. University of North Carolina at Chapel Hill.

• Jones CB. 2017 June 7. An untapped resource in the nursing workforce: Licensed practical nurses who transition to become registered nurses. National Forum of State Nursing Workforce Centers Annual Conference.