Licensed Practical Nurses - What They Do

Licensed practical nurses provide nursing care usually under the direction of medical practitioners, registered nurses or other health team members. Operating room technicians prepare patients and provide assistance to medical practitioners prior to and during surgery. Licensed practical nurses are employed in hospitals, nursing homes, extended care facilities, rehabilitation centres, doctors' offices, clinics, companies, private homes and community health centres. Operating room technicians are employed in hospitals.

Job duties

This group performs some or all of the following duties:

Licensed practical nurses

Provide nursing services, within defined scope of practice, to patients based on patient assessment and care planning procedures
Perform nursing interventions such as taking vital signs, applying aseptic techniques including sterile dressing, ensuring infection control, monitoring nutritional intake and conducting specimen collection
Administer medication and observe and document therapeutic effects
Provide pre-operative and post-operative personal and comfort care
Monitor established respiratory therapy and intravenous therapy
Monitor patients' progress, evaluate and document effectiveness of nursing interventions and collaborate with appropriate members of health care team
Provide safety and health education to individuals and their families.

Operating room technicians

Prepare patients for surgery by washing, shaving and sterilizing the patients' operative areas
Assist in surgery by laying out instruments, setting up equipment, assisting surgical teams with gowns and gloves and passing instruments to surgeons
Monitor patients' status during surgery, such as intake, output and loss of blood, and communicate and document any changes
Clean and sterilize the operating room and instruments.

Job titles

graduate nursing assistant
operating room technician
licensed practical nurse (L.P.N.)
registered nursing assistant (R.N.A.)

Employment Requirements

This is what you typically need for the job:

Completion of a vocational, college or other approved program for licensed practical nurses is required.
Registration with a regulatory body is required in all provinces and territories.
Completion of the Canadian Practical Nurse Registration Examination is required in all provinces and territories except Quebec.
Operating room technicians require either additional academic training in operating room techniques or on-the-job training.

Essential Skills

Reading

Read instructions, precautions and implications on medication packaging. (1)
Scan short notes and messages, e.g. read brief text in communication logs, patient files, email and patients' charts to get details of needed care. (1)
Read short comments in a variety of forms, e.g. read brief text descriptions of patients' conditions, reasons for treatment and any other relevant information on admission, assessment and treatment consent forms. (2)
Read short memos, e.g. read memos from department heads to learn about changes to visiting hours. (2)
Review information on patients' charts, e.g. read observations written on patients' charts by other health professionals to learn about changes in conditions or prescribed care. (2)
Read and interpret physicians' orders, e.g. read orders from physicians to learn about treatments, medications, admissions and discharge planning. (3)
Read care plans, e.g. read multi-page care plans to learn about treatment objectives and activities for patients. (3)
Read a variety of policy and procedure manuals, e.g. read policy manuals to learn about the care to be provided to patients and how to respond to medical emergencies. (3)
Read articles in bulletins, newsletters and other publications from provincial and national nursing organizations to keep abreast of nursing practices and standards. (3)
Read technical information contained in nursing care reference manuals and journals, e.g. read the Compendium of Pharmaceuticals and Specialties to learn about the use and effects of drugs on patient care. (4)

Document use

Observe symbols and icons on products, packaging and equipment, e.g. observe symbols on packaging to determine the risk of bio-hazards. (1)
Scan labels on medications to verify patients' names, dosages, administration schedules, ingredients and reconstitution instructions. (1)
Complete a variety of forms, e.g. complete tracking forms to record patients' vital signs, behaviours and their daily activities. (2)
May study assemble drawings, e.g. study assembly drawing to learn how to adjust the fit of specialized wheelchairs. (2)
Locate and enter data in a variety of charts, tables and schedules, e.g. enter data, such as tasks, times, dates, hours and quantities, in electronic heath care records. (3)

Writing

Write reminders and short notes, e.g. write short notes to remind co-workers of tasks and activities that must be performed during the next shift. (1)
May write daily logs, e.g. licensed practical nurses in community settings write log entries to record the details of health care visits. (2)
Write orders to record the service delivery requests made by registered nurses and other health team members. (2)
Write comments and behavioural observations on a variety of forms, e.g. write descriptions of patients' physical and mental conditions, behavioural concerns and dietary limitations in forms, such as nursing care plans. (2)
Write unusual incident reports to record events, such as patient falls, medication errors and injuries. (3)
May write multi-page care plans to outline the care needed to resolve patients' medical issues and support their recovery. (3)

Numeracy

Take a variety of measurements, e.g. measure patients' height, weight and vital signs, such as blood pressure and temperature. (1)
Count respiration and heart rate in beats per minute. (1)
Compare patients' vital sign measurements, such as temperature, heart rate and blood pressure, to normal ranges. (1)
Estimate quantities of materials and equipment needed for job tasks, e.g. estimate the number of dressings needed for a particular dressing change. (1)
May calculate reimbursement for travel to clients' residences, medical appointments and health facilities. (2)
Calculate drip rates for tubes feeds. (2)
Measure, reconstitute and calculate dosages using medication protocols, such as variables of volume and weight. (2)
Monitor inventories of drugs and supplies to ensure sufficient stock is available when needed. (2)
Interpret measurements of patient fluid intake and output to establish the health of patients. (2)
Interpret multiple data readings, e.g. interpret multiple readings of blood glucose to determine the effectiveness of changes to diet and exercise programs. (2)

Oral communication

Listen for ringing bells, intravenous pump alarms and patients calling for assistance. (1)
Greet and converse with patients and family members. (1)
Exchange information collaboratively with co-workers about a variety of operational matters, e.g. speak with supervisors to co-ordinate activities, report on the condition of patients and clarify ambiguous orders. (2)
Converse with patients and family using therapeutic communication skills, e.g. talk with clients and family members to learn about their concerns, obtain information, lend support and explain medical procedures. (2)
Participate in meetings, e.g. take part in group discussions about how to maintain safe work conditions. (3)
Provide detailed instructions, e.g. explain to clients and their caregivers how to change dressings and self-administer injections of medication, such as insulin. (3)
Provide clear information and listen to detailed instructions during medical emergencies, such patients in cardiac arrest. (3)

Thinking

Establish that there are not enough medical supplies to complete procedures. They secure the needed materials before starting the procedure. (1)
Assess the need for assistance when carrying out strenuous job tasks, such as moving heavy patients from one location to another. (1)
May find discrepancies between the quantities of drugs and supplies listed in records and actual amounts. They resolve the discrepancies and report shortages to supervisors. (2)
Find that patients or their families are not satisfied with the care being provided. They talk to the complainants to learn about their concerns. They address the complaints directly and refer those that cannot be addressed to their supervisors. (2)
Encounter non-compliant or combative patients. They speak with the patients about their behaviours and ask them to comply with their medical treatment programs. They report those patients who remain combative or non-compliant to their supervisors for follow-up. (2)
Decide the order of job tasks, e.g. establish time management plans to deliver care. (2)
Decide to change patients' daily routines or schedules of activities, e.g. licensed practical nurses may decide to move a patient into the lounge to socialize with other patients or move an immune suppressed client to a private room. (2)
Decide if they are competent and properly credentialed to perform procedures, such as changing surgical dressings. (2)
Decide to inform supervisors about changes in patients' vital signs when they feel the changes are medically significant. (2)
Evaluate the ability of patients to understand instructions regarding self care by asking questions and listening to the responses. (2)
Assess the ability of friends and family to give proper health care support to a patient living at home. They review materials provided by the patients' doctors, gather information about the home situation and gauge the willingness and abilities of potential caregivers to provide care. (2)
Assess best learning practices related to patient education. They consider factors, such as the age of the patient, the complexity of the information to be provided and the patient's readiness to learn. (2)
Organize their days, under the general direction of physicians, managers or registered nurses, around regular schedules and around the needs of patients and clients within health facilities, communities or geographic areas. They frequently encounter unexpected situations that require schedule changes and job task reorganization to ensure patients are safe and are receiving optimal care. Their schedules and daily plans must be coordinated with many regulated and unregulated health providers. (2)
Locate information about the status of patients by speaking with them, referring to their charts and files, and talking to other health care team members. (2)
Learn about patient treatment plans by reading patient files and charts and by speaking with patients, family members, co-workers, supervisors and other health care professionals. (2)
Find information about pharmaceutical products by conducting Internet research, consulting references, such as the Compendium of Pharmaceutical and Specialties and speaking with co-workers and suppliers. (2)
Encounter patients whose medical conditions deteriorate suddenly and unexpectedly. They take immediate action as required, provide information to other members of the health team and follow directions and specific protocols established for emergency situations. (3)
May decide to adjust rehabilitation programs, e.g. decide to reduce the amount of therapy a patient is to receive because of their discomfort and pain. (3)
Evaluate the general health of patients through conversations, assessments and measurements, such as vital signs, and by reading patient charts. (3)
Evaluate the severity of injuries and medical conditions by considering factors, such as the criticality of the injury and medical condition and the age of patient. (3)

Digital technology

May use spreadsheets to record numerical information, such as patients' vital signs. (1)
Operate hand-held scanners to determine vital signs, such as body temperature, blood pressure and blood glucose levels. (1)
Use word processing software to write short procedures and reports. (2)
May use specialized health care administration databases to enter the names of clients, locations visited and the durations of treatment. (2)
Enter information into journal databases to record their activities. (2)
Use communications software to exchange email and attachments with other members of the health care team. (2)
Use the Internet to locate health-related information on medical websites. (2)
May use the Internet to access training courses and seminars offered by suppliers, employers and trainers. (2)
Operate digital tools, such as intravenous pumps, by imputing data, such as rates of flow. (2)
May use time management software to track the amount of time spent with patients and report hours worked. (2)

Other Essential Skills:

Working with Others

Licensed practical nurses usually work as members of a health care team in a variety of institutional settings. They coordinate their work with other nursing staff and health care professionals. Although licensed practical nurses may work alone with patients, they communicate with immediate team members to coordinate all actions taken on behalf of patients. In emergency situations, licensed practical nurses must work quickly as part of their team. Licensed practical nurses work independently in home care, health education, in management roles and other independent roles. Licensed practical nurses who work independently share information and coordinate job tasks with others involved in clients' welfare. They participate in collaborative nursing practice with other members of the health care team.

Continuous Learning

Licensed practical nurses learn continuously on the job and at courses provided to develop and enhance their skills. Some courses are provided by provincial associations or through their employer. Specific courses, such as cardio-pulmonary resuscitation, are mandatory and require regular re-certification. Some licensed practical nurses may take courses for specific areas of practice, such as rehabilitation therapy or operating room technology. Continuing education is mandatory for licensing in some provinces.