Practical Nursing in Delaware
Delaware depends on having a supply of high-caliber nurses, including Licensed Practical Nurses, or LPNs. LPNs most often work with patients who are elderly, convalescent, or have chronic illnesses. However, they can work with many populations.
LPNs provide nursing interventions (for example, medication, wound care, and fluids). They also play a role in patient assessment and evaluation, although a more limited one than RNs do. State regulations are very explicit about scope of practice for different levels of nurse, for example, what types of intravenous therapy (IV) duty an LPN can perform.
LPN practice will vary, dependent in part on work setting. Delaware LPNs care for people with stable or predictable health care needs. They can also care for people whose condition is fluctuating or critical when working under direction or supervision.
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LPNs in Long Term Care and Home Health
Nursing facilities care for people with serious health needs. Some patients are there for the long-term in the truest sense of the word. Others are there for therapy and nursing services with the eventual goal of returning to a less restrictive setting. According to the AARP scorecard, less than 9% of new Delaware nursing home stays last 100 days or more (http://www.longtermscorecard.org/databystate/state?state=DE).
Nursing facilities may have separate programs for long-stay and short-stay residents. They may offer specialized services such as neurorehabilitation. The Center for Medicare and Medicaid services considers long-stay and short-stay residents separately when determining quality indicators. CMS also considers safety inspections and staffing when issuing star ratings.
The American Health Care Association and National Center for Assisted Living have a program with progressive levels of achievement and recognition. In 2017, one Delaware facility achieved Silver Level: Loftland Park Center.
Typically, nursing home residents are older adults — but not always. Delaware boasts a highly acclaimed nursing facility for pediatric populations (infant through very young adult): Exceptional Care for Children. Many residents have trachs or ventilators or are otherwise technology dependent. Like adult nursing home residents, they may be in residence for varying lengths of time. For many, though, development is on their side!
Some children receive nursing services in their homes. Bayada Pediatrics is a well-known company that works across state lines.
LPNs Working in Assisted Living
Assisted living facilities are distinct from skilled nursing facilities; they provide only limited amounts of skilled nursing care. This is intended for residents whose health conditions are “essentially stable”. State regulations place restrictions on what types of health needs may be met. A resident cannot, for example, be ventilator dependent. Massachusetts also prohibits housing of residents who are bedridden more than 14 days or (with some exceptions) who require an IV. Facilities do sometimes request waivers to care for patients for the short-term who have needs that are normally not met in assisted living. Residents who are receiving hospice care may also have needs normally not met in assisted living. In this case, a licensed hospice will have a role in ensuring needs are met.
Assisted living facilities have nursing home administrators. A person can meet basic requirements for administrator with four years of experience at the LPN level.
Dementia Care
LPNs who work in long-term facilities will often have responsibility for care for people with dementia. This is an area where Delaware has been proactive. Delaware mandates dementia training. The State Dementia Care Coalition notes the following among the state’s recent efforts and successes:
- Statewide support of Music and Memory (a program that utilizes personalized music)
- Peer coaching and sharing of best practices in reducing use of antipsychotic medications
Facilities are at different stages in re-envisioning dementia care. Some boast their own innovative programs. Rockland Place boasts a program called Thrive Dining for residents who have cognitive and/ or physical disabilities. The goal is to serve nutritious food and do so in a way that preserves mealtime dignity and also prevents unintended weight loss – a not unusual occurrence in nursing home settings. Meals are made up of a selection of finger foods which include freshly cooked foods reborn in the style of one- or two-bite hors d’oeuvres. There’s an acclaimed chef on board!
In early 2018, Rockland Place sought an LPN director for memory care.
Becoming a Delaware LPN
A prospective LPN will need to complete an approved Delaware program or an acceptable program located in another state. The program will include at least 200 hours of clinical experience (LPN programs in Delaware).
Nurses who live in other nurse compact states don’t seek Delaware licensing; they can work in Delaware on the strength of a license issued by another qualifying state.
An early 2018 Delaware LPN job search will turn up a number of positions in long-term care facilities. The following are among the other positions for which help was recently sought:
- Dispensing methadone for medication-assisted drug treatment
- Acting as physician office nurse at a walk-in clinic
- Providing services such as care coordination and management, screenings, and patient education (a role for an LPN with considerable experience)
Career Outlook and Average LPN Salary in Delaware
Delaware practical nursing has been projected to see 10% occupational growth over the course of the 2014 to 2024 decade.
Delaware LPNs averaged $24.20 in 2016.
Related:
Medical Assistant Programs in Delaware
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