Yes, a licensed practical nurse (LPN) is higher than a certified nursing assistant (CNA) in the nursing hierarchy. LPNs complete significantly more training, earn a higher salary, and are authorized to perform clinical tasks that CNAs cannot. In many states, LPNs can even supervise and delegate tasks to CNAs.
How the Nursing Hierarchy Works
The standard nursing ladder, from entry level to advanced practice, runs: CNA, LPN, registered nurse (RN), and then advanced practice roles like nurse practitioners. Both CNAs and LPNs are considered non-degree positions, meaning neither requires a college degree. But within that grouping, the LPN role carries more responsibility, more clinical authority, and higher pay.
In most healthcare settings, RNs oversee both LPNs and CNAs. LPNs act as the primary communicator between the broader healthcare team and the patient, while CNAs serve as the main point of contact between patients’ families and the facility. This distinction reflects the difference in their roles: LPNs handle more medical tasks, and CNAs focus more on personal care and daily living support.
Education and Licensing Differences
The gap in training is substantial. CNA certification programs typically require about 100 hours of combined instruction, split between 60 hours of classroom learning and 40 hours of clinical training. After completing the program, candidates pass a written and skills exam to earn their certification. The entire process can be finished in a matter of weeks.
LPN programs, by contrast, run about 12 months through a community college or technical school. The curriculum covers pharmacology, parenteral therapies, and other clinical nursing subjects in depth. Graduates must then pass the NCLEX-PN, a five-hour computerized adaptive licensing exam administered by the National Council of State Boards of Nursing. That licensing exam alone signals a meaningfully different level of preparation.
What Each Role Does on the Job
CNAs focus on helping patients with the basics of daily life: bathing, dressing, eating, mobility, bringing meals, and maintaining hygiene. They monitor patients’ health in a general sense, prepare them for examinations, and make sure patients have taken their prescribed medications. Their work is essential but centers on personal care rather than clinical intervention.
LPNs perform a wider range of medical tasks. They take blood pressure, insert catheters, start IVs, change bandages, collect samples for lab tests, and position patients for procedures. They also maintain detailed patient records and reinforce care instructions given by RNs and physicians. The scope of practice for an LPN is closer to what most people picture when they think of “nursing” in a clinical sense.
Can LPNs Supervise CNAs?
In many states, yes. The National Council of State Boards of Nursing recognizes LPNs as potential delegators, meaning they can assign certain nursing tasks to assistive personnel like CNAs where state law permits. The specifics vary by jurisdiction. Some states give LPNs clear supervisory authority over CNAs, while others restrict delegation to RNs only. If you’re in either role, it’s worth knowing what your state’s nurse practice act allows.
Salary Comparison
The pay difference reflects the gap in training and responsibility. As of May 2024, the median annual wage for CNAs was $39,530, with the lowest 10 percent earning under $31,390 and the highest 10 percent earning above $50,140. LPNs earned a median of $62,340 per year, or about $29.97 per hour. That’s roughly $23,000 more per year at the midpoint.
Moving From CNA to LPN
Many CNAs use their experience as a stepping stone to become LPNs. Bridge programs designed specifically for this transition can be completed in as few as 12 months (typically three 16-week semesters). Having hands-on patient care experience as a CNA can make the clinical portions of an LPN program feel more familiar, and some programs give credit for prior experience or coursework.
Working as a CNA first is not a requirement to become an LPN, but it’s a common path. The CNA role gives you direct exposure to patient care environments, helps you decide whether nursing is the right fit, and provides income while you plan further education. From LPN, the next step up the ladder would be an RN program, which opens up even broader clinical responsibilities and higher earning potential.