By Erica Carbajal

The primary places of practice for licensed practical nurses are often outpatient clinics, nursing homes and other ambulatory care settings. Throughout the past few years, however, LPNs have made a hospital comeback as a growing number of health systems embrace nursing team models that aim to ensure registered nurses are able to work at the top of their licenses.

"We have been on that journey for a few years of reintegrating LPNs and trying to understand the best use case of all professionals to the top of their license," Kristen Wolkart, RN, executive vice president and chief nursing officer of Franciscan Missionaries of Our Lady Health System. "How do we help train and integrate them back into the acute care setting?"

The Baton Rouge, La.-based system has been working with local nursing schools to grow the region's LPN programs and allow for more clinical rotations within the system so LPNs have a better familiarity with the hospital setting upon graduating.

Two years ago, LPNs weren't a part of nursing care models across Altamonte Springs, Fla.-based Advent Health's 53 hospitals. Now, 86 units operate on team models and hundreds of LPNs and patient care techs have since been hired. It's part of the health system's larger nurse staffing strategy to leverage RNs effectively and reduce workload intensity, said Trish Celano, MSN, RN, the system's senior vice president, associate chief clinical officer and chief nursing executive.

"Intensity of work is not just staffing. It's three things: acuity of the patient, intensity of the work and the experience of the nurse," Ms. Celano said. "You can have a patient who is low acuity — they aren't a critical care patient — but they are someone who needs to be bathed, fed and walked; that's high intensity," which are all things within LPNs' scope of work.

Livonia, Mich.-based Trinity Health and St. Louis-based BJC Healthcare have also hired more LPNs this year as part of virtual and hybrid nursing team models.

"With 31,000 associate degree nurses graduating in Missouri and about 19,000 LPNs, that was an untapped source for us," said Tommye Austin, PhD, MSN, RN, senior vice president and chief nurse executive at BJC.

According to data from the Bureau of Labor Statistics, there were 655,000 licensed practical and vocational nursing jobs in 2022.