What is the Difference Between an LPN vs RN vs BSN?

There is a common misconception that all nurses are the same. However, it’s not the truth. Each nursing field has its own set of responsibilities and practical knowledge. If you want to become a nurse, you need to understand the difference between LPN vs RN vs BSN. 

LPN, RN, BSN – Quick Definitions

An LPN is a licensed practical nurse. This is a professional license, issued by a regulatory board (like a state board of nursing).

An RN is a registered nurse. This is a professional license, issued by a regulatory board (like a state board of nursing).

A BSN is a Bachelor’s of Science in Nursing undergraduate degree. It is not a professional license.

What’s an LPN?

Licensed Practical Nurses are licensed healthcare professionals who work under the supervision of registered nurses (RNs) and physicians. They typically provide basic bedside care such as taking vital signs, administering medication, changing dressings, and assisting patients with personal hygiene.

LPNs usually complete a one-year vocational training program, and they must pass a national licensing exam to practice (NCLEX-PN). LPN programs result in a certificate or diploma, rather than a college degree.

Which Exam Do LPNs Have to Take to Become Licensed?

LPNs in the United States are required to take the National Council Licensure Examination for Practical Nurses (NCLEX-PN) in order to obtain their nursing license. The NCLEX-PN is a computerized adaptive test that assesses the knowledge, skills, and abilities essential for safe and effective nursing practice. The exam consists of between 85 and 205 multiple-choice questions, and the length of the exam varies depending on how well the test-taker performs.

The NCLEX-PN covers topics such as pharmacology, nursing process, health promotion and maintenance, safety and infection control, and basic care and comfort. The exam is developed and administered by the National Council of State Boards of Nursing (NCSBN) and is used by state boards of nursing to determine whether an individual is competent to begin nursing practice as an LPN.

While similar to the exam RNs take (NCLEX-RN) it is not the same.

Medication Limitations to LPNs

The scope of medication administration for LPNs varies by state and facility, and LPNs are typically authorized to administer a range of medications. However, there are some medications that are restricted to RN administration only. Examples of medications that RNs can give but LPNs cannot include:

1. Intravenous (IV) medications: RNs are trained to administer IV medications, which may include administering medications via a central line or a peripherally inserted central catheter (PICC).
2. Chemotherapy drugs: RNs are trained to administer chemotherapy drugs, which require specialized knowledge and training.
3. Blood products: RNs are typically responsible for administering blood products such as packed red blood cells (PRBCs), platelets, and plasma.
4. Titration medications: RNs may be responsible for administering and adjusting medications such as insulin, heparin, and nitroglycerin that require frequent dosage adjustments based on patient response.
5. Conscious sedation medications: RNs may be responsible for administering medications for conscious sedation during procedures such as endoscopies, colonoscopies, rapid sequence intubation, and more.

It’s important to note that LPNs may be able to administer some of these medications under the direct supervision of an RN or physician, depending on state laws and facility policies.

Where Do LPNs Work?

Licensed Practical Nurses most commonly work in skilled nursing facilities, nursing homes and for home care agencies. While hospitals do employ LPNs, it is not nearly as common. With staffing issues palpable across the country, more hospitals are hiring RNs.

What is an RN?

RN stands for Registered Nurse. RNs are licensed healthcare professionals who provide patient care, educate patients and their families about various health conditions, and supervise other healthcare personnel such as LPNs and nursing assistants. RNs may work in a variety of healthcare settings such as hospitals, clinics, long-term care facilities, and home healthcare. RNs usually complete a two-year associate degree program (associates degree in nursing) or a four-year bachelor’s degree program (BSN) in nursing, and they must pass a national licensing exam to practice.

I outline the difference between an ADN and BSN degree in more detail in this post.

Which Exam Do RNs Have to Take to Become Licensed?

RNs who graduate from both Associate Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN) programs in the United States take the same licensing exam, the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The NCLEX-RN is a computerized adaptive test that assesses the knowledge, skills, and abilities essential for safe and effective nursing practice. The exam consists of between 75 and 265 multiple-choice questions and may take up to six hours to complete, depending on how well the test-taker performs.

Regardless of whether a nurse graduates from an ADN or a BSN program, passing the NCLEX-RN is required to become a licensed registered nurse (RN) in the United States. The NCLEX-RN is developed and administered by the National Council of State Boards of Nursing (NCSBN), which is responsible for ensuring that nurses are competent to practice safely and effectively.

We discuss great options for NCLEX-RN reviews here, and the 2023 update to the exam called NCLEX Next Generation here.

Where Do RNs Work?

Registered Nurses (RNs) work in a wide variety of healthcare settings, including:

1. Hospitals: RNs are the largest group of healthcare workers in hospitals, and they work in a variety of units such as emergency departments, intensive care units, medical-surgical units, pediatrics, labor and delivery, oncology, and more. RNs can also work in administrative positions that can include quality outcomes, various levels of management, throughput/patient placement, and education. (Eligibility for non-patient care roles depends on education level.)
2. Nursing homes and long-term care facilities: RNs may work in long-term care facilities and nursing homes to provide care to elderly or disabled residents.
3. Clinics and outpatient centers: RNs may work in outpatient settings such as clinics, urgent care centers, and ambulatory surgery centers to provide care to patients who do not require hospitalization.
4. Home healthcare: RNs may work in home healthcare, providing medical care and assistance with daily activities to patients who require care at home.
5. Schools: RNs may work in schools to provide healthcare services to students, such as administering medications, conducting health screenings, and managing chronic conditions.
6. Government and public health: RNs may work for government agencies or public health organizations, such as the Centers for Disease Control and Prevention (CDC), providing healthcare services or conducting research.
7. Military: RNs may work in the military, providing healthcare services to active duty service members, veterans, and their families.

RNs may also work in other settings such as research facilities, pharmaceutical companies, and insurance companies, depending on their education, experience, and career goals.

What’s an RN to BSN Program?

If you graduate from ADN program and have your RN license, your credentials would read: Jane Doe, RN. If you wanted to go back to school and upgrade your 2-year ADN degree to a 4-year BSN degree, you can do so! There are many RN to BSN programs available that are affordable, many of which are online. Once you graduate from a BSN program, your credentials would change to: Jane Doe, BSN RN.

Tip: If you’re working as a RN, see if your employer offers any type of tuition assistance! This can really curb costs.

What is a BSN?

BSN stands for Bachelor of Science in Nursing. A BSN is a four-year undergraduate degree program in nursing that prepares students for a career as a registered nurse. BSN programs provide a more in-depth education in nursing theory and practice, as well as courses in leadership, communication, and research. BSN-educated nurses are prepared to provide advanced patient care and may have more career advancement opportunities than RNs with an associate degree or LPNs.

What’s the Difference Between a BSN and ADN?

The main differences between Associate Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN) programs include the level of education, cost, credit hours, and educational focus.

1. Level of education: ADN programs are typically 2-year programs that focus on the basic knowledge and skills needed to become a registered nurse (RN). BSN programs, on the other hand, are 4-year programs that provide a more in-depth education, including more coursework in nursing theory, leadership, and research.
2. Cost: ADN programs are generally less expensive than BSN programs, as they require fewer credit hours and less time to complete. However, the cost can vary depending on the institution and location.
3. Credit hours: ADN programs typically require 60-72 credit hours to complete, while BSN programs require 120-128 credit hours. This means that BSN programs require twice as many credit hours as ADN programs.
4. Educational focus: ADN programs focus primarily on the technical skills needed to provide basic nursing care, while BSN programs provide a more well-rounded education that includes nursing theory, research, leadership, and community health.

In summary, ADN programs offer a shorter and less expensive path to becoming an RN, while BSN programs provide a more comprehensive education that includes a broader range of nursing concepts, leadership skills, and research. Ultimately, the decision to pursue an ADN or BSN program may depend on individual career goals, financial resources, and personal circumstances.

We discuss this more in-depth in this blog post.

Can You Become an RN Without a BSN?

Yes! You can pursue an Associates Degree in Nursing (ADN). Complete an accredited ADN program, pass a background check, and pass the NCLEX-RN exam and you will be an RN without a BSN!

What are the Degrees Available to Nurses?

To practice as a professional registered nurse, one must graduate from an accredited college nursing program. Let’s discuss the different possibilities.

What’s an Associate’s Degree?

An Associate’s Degree is an undergraduate academic degree typically awarded by community colleges, technical colleges, and some universities. It is generally earned after completing a program of study that typically takes two years to complete, although some programs may take less or more time. Overall, an associate’s degree is a great way to earn a degree in a shorter period of time and at a lower cost than a bachelor’s degree. It can also provide a pathway to a higher degree, such as a bachelor’s or master’s degree, if desired.

And Associate’s Degrees given by nursing programs are referred to as a Associate’s Degree in Nursing (ADN)

What’s a Bachelor’s Degree?

A Bachelor’s Degree is an undergraduate academic degree typically awarded by colleges and universities. It is usually earned after completing a program of study that typically takes four years to complete. A Bachelor’s Degree given by nursing programs are referred to as a Bachelor’s of Science in Nursing (BSN). One cannot specialize into a certain area of nursing (like pediatrics, for example) during a BSN program. BSN programs are generalized nursing education to prepare RNs for practice in a variety of settings.

Bachelor Degree Options for Nurses

Prospective nurses can either complete a BSN degree via the typical path, or via an accelerated BSN option. The typical BSN path takes approximately 4 years to complete, while an accelerated BSN program takes approximately 12-18 months of rigorous coursework. Accelerated BSN programs are more expensive and competitive. To get into one, you must already have a bachelor’s degree in another field.

What’s a Master’s Degree?

A Master’s Degree is an advanced academic degree typically awarded by colleges and universities after completing a graduate program of study that typically takes one to two years to complete, although some programs may take longer or shorter.

The Master’s Degree that is granted to a nurse is called a Master’s of Science in Nursing (MSN).

Master’s Degree Options for Nurses

You can actually start an MSN degree BEFORE you’re an RN! This is called a direct-entry MSN program. In a direct-entry (MSN) program, students can earn a bachelor of nursing (BSN) and a master of nursing (MSN) at the same time by combining the two in an accelerated program.

With an MSN degree, you can pick a focus like education, nursing administration, informatics, care coordination, or leadership. You can also choose to pursue an Advanced Practice Registered Nurse (APRN) which includes additional education and specialized training as part of your MSN. These specialties include:

• Family Nurse Practitioner (FNP)
• Acute Care Nurse Practitioner (ACNP)
• Clinical Nurse Specialist (CNS)
• Certified Registered Nurse Anesthetist (CRNA)
• Certified Nurse-Midwife (CNM)
• Psychiatric Mental Health Nurse Practitioner (PMHNP)
• Certified Pediatric Nurse Practitioner (CPNP)
• Neonatal Nurse Practitioner (NNP)
• Adult-Gerontology Nurse Practitioner (AGNP)

If a nurse practitioner has “BC” listed after their credentials, it means they are board certified.

What’s a Doctorate Degree?

A doctorate degree is referred to as a terminal degree. This means that it is the highest level of education possible within that area.

There are two main types of doctorate-level degrees available to nurses: the Doctor of Nursing Practice (DNP) and the Doctor of Philosophy in Nursing (PhD).

1. Doctor of Nursing Practice (DNP): The DNP is a terminal practice-focused degree for advanced practice registered nurses (APRNs) and nurse executives. The DNP curriculum focuses on advanced nursing practice, healthcare systems leadership, and evidence-based practice. The degree typically requires completion of a clinical practicum and a scholarly project. Graduates of DNP programs are prepared to apply advanced nursing practice concepts to real-world healthcare challenges and to lead change in healthcare systems.
2. Doctor of Philosophy in Nursing (PhD): The PhD in Nursing is a research-focused degree that prepares nurses for careers in academia, research, and health policy. The program focuses on research methods, theoretical frameworks, and the development of nursing science. Graduates of PhD programs are prepared to conduct original research and contribute to the development of nursing knowledge.

In general, you cannot begin a DNP or PhD program without first having an RN license. However, there may be some exceptions to this requirement depending on the specific program and institution. For example, some schools may offer doctoral programs in nursing that are designed for individuals who hold a non-nursing bachelor’s or master’s degree and who wish to become advanced practice nurses or nursing researchers. These programs typically provide a pathway for individuals to complete the necessary nursing education and RN licensure requirements before beginning the doctoral program.

Conclusion of the Differences Between an LPN vs. RN vs. BSN

I hope this blog post helped make sense of the many options available to prospective nurses. Got questions? Drop them in the comments below!

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More Resources

• How Long Does it Take to Become a Nurse?
• How to Apply for Nursing School?
• What is the Difference Between an ADN and BSN in Nursing?
• Prerequisites for Nursing School