An RPN, or Registered Practical Nurse, is a regulated nursing professional who provides direct patient care after completing a diploma nursing program and passing a licensing exam. The title is used primarily in Ontario, Canada. In most other Canadian provinces and in the United States, the equivalent role is called a Licensed Practical Nurse (LPN). RPNs work alongside Registered Nurses and other healthcare providers, but their education is shorter and their scope of practice differs in specific ways.
What RPNs Do
RPNs deliver hands-on nursing care. Their day-to-day work includes monitoring vital signs, administering medications, wound care, helping patients with daily activities, and documenting health changes. They work with patients whose conditions are generally stable and predictable, though many RPNs also contribute to care in more complex settings under the direction of a Registered Nurse or physician.
The distinction between an RPN and a Registered Nurse comes down to the complexity of patient situations each is prepared to manage independently. An RN completes a four-year degree and is educated to handle unpredictable, rapidly changing patient conditions. An RPN completes a shorter diploma program and is prepared for situations where outcomes are more expected. In practice, both roles overlap significantly, and RPNs are essential members of care teams in nearly every healthcare setting.
Where RPNs Work
RPNs are employed across a wide range of healthcare environments. Long-term care and residential facilities are the single largest employer, accounting for roughly 37% of practical nursing positions. Home healthcare services and physicians’ offices each represent about 12% of employment. Hospitals, community health clinics, mental health facilities, and government agencies round out the remaining settings. RPNs who work in home health travel directly to patients’ residences, which offers a different rhythm than facility-based work.
Education and Training
Becoming an RPN requires completing a diploma nursing program approved by the provincial regulatory body. In Ontario, that body is the College of Nurses of Ontario (CNO). These programs are offered at community colleges and typically take two years of full-time study. The curriculum combines classroom learning in anatomy, pharmacology, and nursing theory with supervised clinical placements in hospitals and other care settings.
This is notably shorter than the path to becoming a Registered Nurse, which requires a four-year Bachelor of Science in Nursing. The shorter timeline is one of the main reasons people choose the RPN route: it gets you into the workforce faster and at lower cost, while still opening the door to a meaningful nursing career.
Licensing Exam
After completing an approved program, you need to pass the Regulatory Exam for Practical Nurses (REx-PN) before you can practice. This computer-adaptive test became the required registration exam for Ontario practical nurses in January 2022, replacing the previous national exam (CPNRE). British Columbia also uses the REx-PN for its LPN candidates.
The exam adapts to your ability level as you go, so there is no fixed number of questions. You pass when the computer determines you’ve demonstrated knowledge and judgment above the minimum standard required for safe entry-level practice. If you don’t pass, you can retake it once every 60 days, up to six times per year. There is no lifetime limit on attempts.
Regulation and Professional Standards
In Ontario, RPNs are regulated under the Nursing Act of 1991 and the accompanying provincial regulation (O. Reg. 275/94). The College of Nurses of Ontario oversees registration, sets practice standards, and handles complaints. Once registered, you are legally required to use only the title “Registered Practical Nurse” or the abbreviation “RPN” when practicing. Using the title without proper registration is a legal offense.
This regulatory framework exists to protect the public. It means every RPN you encounter in Ontario has met specific educational requirements, passed a standardized exam, and is held accountable to professional conduct standards throughout their career.
Salary and Compensation
In Ontario, RPNs earn a median hourly wage of $31.00, based on 2023-2024 data from Statistics Canada. Wages at the lower end sit around $25.32 per hour, while experienced RPNs in higher-paying settings earn up to $37.94 per hour. For a full-time RPN working standard hours, that median translates to roughly $60,000 to $65,000 per year before overtime or shift premiums.
Pay varies depending on the setting. Hospital positions and unionized long-term care facilities tend to offer higher wages and better benefits than private clinics or physician offices. Night and weekend shifts often come with premium pay as well.
Career Advancement
One of the clearest paths forward for RPNs is a bridging program that leads to Registered Nurse designation. Ontario colleges offer these programs specifically for healthcare professionals with prior education and clinical experience. Rather than starting a four-year nursing degree from scratch, bridging programs recognize your existing knowledge and build on it with advanced coursework in health assessment, nursing research, and complex care management.
After completing a bridging program, you become eligible to apply to the CNO for registration as an RN, which involves writing additional registration and jurisprudence exams. Some bridging pathways also lead to Nurse Practitioner designation, which carries an even broader scope of independent practice. For RPNs who enjoy clinical work but want more autonomy, higher pay, or the ability to work in specialized areas like emergency or critical care, bridging is a well-established route that thousands of Ontario nurses use each year.
Personal Support Workers follow a similar ladder in reverse: PSW-to-RPN bridging programs exist for those looking to move into a regulated nursing role without starting entirely from the beginning.