As job opportunities vanish throughout the U.S., nursing has been touted by many as a "recession-proof" career.

And although it's true certain healthcare markets are actively hiring LPNs and RNs, the profession isn't totally immune from these tough economic times.

Some LPNs are being "phased-out" in hospital-based facilities across the country, and 50 RNs recently lost their jobs at a southeastern Pennsylvania acute care hospital.

Still, Richard Read, LPN, isn't panicking. A nurse of 25 years, he has seen his share of economic swings and their effects on the profession. He claims to never have been laid off throughout his career despite seeing friends and colleagues getting pushed out of positions and even feeling a little threatened in his own places of employment (see sidebar, page 13).

"In my experience as a nurse, I've seen this cycle go through about three or four times," he said. "I've seen layoffs, union strikes and picketing. And I think I've avoided this by being aware of what's going on in the workplace and keeping myself educated."

Read is one of a few healthcare professionals who believe the poor economy could actually provide new opportunities for LPNs, as employers start looking for more economical hiring options and begin to once again fully utilize the skills of practical nurses.

But until this happens, viable options for both novice and experienced LPNs remain plentiful for those willing to do their homework and aggressively search the job market.

Where the Jobs Are

As always, LPNs are having little trouble finding work in long-term care, assisted living and home care. But Patty Knecht, MSN, RN, president of the Pennsylvania Association of Practical Nursing Administrators and PN program director of the Center for Arts and Technology (CAT), Coatesville, said these aren't the only areas where LPNs are being hired. Though her graduates are finding fewer opportunities in med/surg, Knecht claims some have landed jobs in sub-acute care and hospitals.

That positive news adds credence to Read's belief that LPNs shouldn't limit themselves to certain career paths.

"Opportunities are out there; you just have to be willing to get out there, look and take a chance," he explained. "There's always that avenue where exceptions can be made. But, despite a struggling economy and news of layoffs, LPNs don't have to feel like they're confined to any area of care."

One growing specialty which will allow you to work to your full scope is community health, Read said. "I think this is a field where LPNs really could be of value. You're working directly with patients and triaging, with supervision of course."

Although the newly enacted American Recovery and Reinvestment Act (ARRA) doesn't specifically target LPNs or PN students, the majority of funding ($2 billion) will be spent on improving the country's community health centers, including the hiring of more nursing staff members that will presumably be LPNs, said Mary Wakefield, PhD, RN, FAAN, newly appointed administrator with the Health Resources and Services Administration (HRSA).

In fact, ADVANCE's latest salary survey shows community health as the fifth highest employment market for LPNs, with 7 percent of respondents saying they're currently staffed there. This field will continue to become a viable option for LPNs, especially those seeking an alternative to skilled care, Wakefield said, as the need for nurses in this setting will increase as more Americans lose health insurance due to growing unemployment.

"More people are likely to be getting their care in these kinds of clinics, so we want to make sure our community health centers are adequately staffed," she explained. "We're trying to get care to people who are uninsured or have low incomes; those who don't have the wherewithal to access medical care and have to go to community health centers to get their care."

Looking for Help

ARRA is also providing a stimulus boost for nurse education. This includes $500 million for the national Nursing Workforce Development and Health Professions Training programs, administered by HRSA. Unfortunately, the programs aren't designed for those looking to earn a PN diploma, according to the American Association of Colleges of Nursing (AACN).

"Thirty-four nursing organizations have signed a proposal that requests for that money to be split between scholarship programs for RN students, the nurse faculty loan program and training for advance-practice registered nurses," said Suzanne Begeny, MS, RN, director of government affairs with AACN. "The money will only last 2 years and only supports those currently in RN or graduate nursing programs."

Through her involvement with the Pennsylvania Center for Health Careers, Knecht is working with her colleagues to place PN programs on the priority list for state-allocated stimulus funds. It remains to be seen how Pennsylvania will divvy its funding, but Knecht remains optimistic.

"The state is looking at short-term training options," she said. "So, from that perspective, providing funding to train more practical nursing students fits that focus. LPNs also contribute to Obama's initiative to diversify the workforce, and as more continuing-care facilities are built in the state, more LPNs are going to be needed."

As an RN who runs a PN program, Knecht is in a unique position when considering how the stimulus funds were established by the state.

"Sometimes LPNs get lost in the shuffle," she said. "I don't think it's purposeful, but a lot of times when decision makers think 'nurses' they think of RNs. We can all help make LPNs a focus if we make our voices heard."

And while the recession may have caused you to eliminate a few expenses from your budget, Wakefield believes your professional membership fees shouldn't be one of them.

"Just when it's tough to think about maintaining memberships, that's the very time when helpful insight is needed most," she said. "There are going to be very difficult decisions made at the state and national levels because of the recession. States are paying out more money due to job losses, business closures, bankruptcies and home foreclosures. All that puts a lot of pressure on what state and federal government can and will do for healthcare."

Joe Darrah is associate editor at ADVANCE.

A Good Example

Practical nurses seeking unique specialty field placement could learn a great deal from Richard Read, LPN. A 1985 graduate of Monroe County Area Vo-Tech School, Bartonsville, PA, Read landed his first job as a hospital float nurse, despite what naysayers told him.

"Everybody said I'd never get a job in acute care," he related. "But 5 days before I graduated, they were hiring LPNs at the hospital I was doing clinicals in, and I became the first LPN hired there. So things can change rather quickly."

After a year as a float nurse, Read transferred to telemetry, where he spent 4 years. He eventually went into oncology and then dipped his feet in home care, case management and agency nursing before returning to acute care.

A fear of layoffs in 2006 at a Philadelphia hospital led Read to consider other career options.

"I was feeling like what I had to offer wasn't valued at the facility," he said, "and when I saw an opportunity, I went on an interview, was offered as job and took a chance."

Now he's a patient continuity supervisor with Cancer Treatment Centers of America (CTCA), Philadelphia, a prominent position in a specialty setting.

Working at CTCA's Eastern Regional Medical Center, a cancer hospital, Read supervises nursing assistants and ancillary staff, assists in the orientation of new hires, serves as the initial point of contact for triage patients, reviews lab work and coordinates with the care management team in handling after-hours patient calls.

He joined the staff as a care manager in the intake department and moved into his new role about a year later when administration decided it needed more help to better manage patient care.

Just the second practical nurse to be hired at Eastern Regional, Read said the CTCA has become a place where LPNs can now attain varied nursing roles, noting that his hospital hasn't experienced any layoffs to date and has hired eight additional LPNs since his arrival, three of whom he's referred from his former workplace.

"LPN hires have more than tripled here in the last 6 months," he said. "Most of our new LPNs work as care-management assistants who work under the direction of an RN and conduct phone triage, serve as liaisons with insurance companies and equipment companies, and set up patient services with oxygen and home-care providers to help meet individual needs. They've really opened things up to LPNs here and given us a chance to have jobs we can look forward to everyday and know that we make a difference."