Direct Patient Care: Understanding RNs, LPNs, and CNAs

The three primary direct patient care roles in healthcare settings:

1. Registered Nurses (RNs): Independent assessment, care planning, medication administration, IV therapy, patient education, delegation, advocacy. Scope defined by state Nurse Practice Act.
2. Licensed Practical/Vocational Nurses (LPN/LVNs): Direct care under RN/physician direction: meds (varies by state), wound care, monitoring, ADLs, data collection. Scope narrower than RN.
3. Certified Nursing Assistants (CNAs): Basic care under RN/LPN delegation: hygiene, mobility, vital signs, feeding, toileting, comfort, observation/reporting. No assessment/medication authority.

Key Distinctions

Aspect	RN	LPN/LVN	CNA
Education	ADN/BSN	12–18 mo certificate	75+ hr training
Licensure	NCLEX-RN	NCLEX-PN	State competency exam
Assessment	Independent	Data collection	Observation only
Meds	Full (IV, IM, PO)	Limited (state-dependent)	None
Care Planning	Develops	Contributes	Implements tasks

All three are essential; effective care requires clear role understanding and teamwork.