History of the LPN Field

Originally, practical nurses took care of children, light housekeeping, and people who were sick at home. In 1897 in New York City, the Ballard School started classes for nurses. Diseases had been spreading in the slums of New York. Practical nurses knew this was preventable with better sanitation. Instead of waiting for people to become ill, the practical nurses went into the slums and taught families about cleanliness.

By 1914, practical nursing had spread across the nation and the state of Mississippi had passed a law to license practical nurses. The idea did not catch on with the other states, however. In 1917, the National League of Nursing Education began standardization of nursing requirements. During World War I, nurses were in big demand for the the war effort. This left a shortage of practical nurses in the United States. The shortage of practical nurses, unfortunately, continued into the 1920ís due to the trauma of World War I, as many nurses were so troubled by their war experiences that they did not desire to return to the profession.

From 1920 to about 1940, most practical nurses were found in public health agencies. Then, the advent of World War II made practical nursing blossom. Women flocked to nursing to help in the war effort, and practical nurses began to move into the hospital environment. By 1952, 60 percent of the workforce in nursing was made up of practical nurses.

Starting in the 1950s, practical nursing became what we know today. Most states began to require licenses for practical nursing and many of the professional nursing organizations began. The 1960ís and 1970ís saw a dramatic formalization of the profession with competencies and accreditation standards being established for schools. In the 1980s, a period of confusion ensued regarding how to develop the different levels of nursing, and there was no consensus between the entities involved. Again there was a nursing shortage and the process was stopped. Many LPNs left the hospitals and moved back out into community work.

The 1990s had a major impact on LPNs with the start of the National Council Licensure Exam. This national exam standardized practices across the states. In this decade, practical nurses moved into long-term care positions. The trend soon reversed itself by the year 2000, and LPN jobs began to appear back in hospitals as regulation increased for health care facilities. This trend is expected to continue.

Last Updated: 05/22/2014

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