Pathways in Nursing Careers: Transitions from the Role of Licensed Practical Nurse to Registered Nurse in North Carolina (2014-15)

Investigators:  Cheryl Jones, PhD, RN, FAAN; George Knafl, PhD; Mark Toles, PhD, RN; Anna Beeber, PhD, RN

Background: In a reforming health care system, nursing personnel, including licensed practical nurses (LPNs) and registered nurses (RNs), are viewed as flexible health care workers because they are readily deployed in diverse health care settings, reduce workforce shortages, and expand system capacity to deliver care to greater numbers of people.  To optimize patients’ experiences, health, and health care costs, it is essential to cultivate the flexibility and capacity of nurses as they develop professional careers and practice nursing at the highest possible levels of licensure and scope of practice (IOM, 2011 & 2012).

Objective/Aims:  The primary objective of this study is to examine the prevalence and predictors of professional transitions of LPNs in North Carolina who transition to the role of RN.  The study has three aims:

  1. Describe the overall characteristics of the LPN workforce in NC, including prior education;
  2. Describe the prevalence of nurses with professional trajectories that include a transition from  the LPN to the RN role;
  3. Identify key predictors of nurses who transition from LPN to RN roles, e.g., characteristics of LPNs (e.g., demographic, geographic, and socio-economic factors), year and location of LPN licensure; years of experience as an LPN; and education for transitioning to the RN role).

Methods: Retrospective cohort analysis using existing LPN (and RN) licensure data from 2003-2013 collected through the North Carolina Board of Nursing (NCBON) and maintained by the North Carolina Health Professions Data System at the Cecil G. Sheps Center for Health Services Research.  Descriptive, bivariate, and multivariate analyses will be conducted.

Policy Relevance: Study findings will identify benchmarks and potential levers that policymakers can use to promote the professional development of nurses across career options, incentivize educational systems to develop structures that support the transfer of nursing knowledge, skills, and training across career transitions, and stimulate future research aimed at promoting the professional advancement of LPNs and the ability of all nurses to work at the top of their scope of practice (IOM, 2011).


Related HWRC projects: 

Predicting Role Transitions for the LPN-to-RN Workforce in North Carolina (2015-16)

Barriers and facilitators for the LPN-to-RN transition: Perspectives from practicing LPNs (2016-17)

LPN Employment Transitions: A Signal of Changing Value to Employers? (2017-18)


Project Products: 


Research Briefs