Do RN's co-sign assessment sheets at your hospital? What does it mean to you? - page 2

I work on a surgical floor and our hospital just began requiring RN's to co-sign the LPN's assessment papers. The hospital says it does not mean that we agree with there assessment. We have talked to... Read More

  1. by   nurse_robin
    I'm in Cali also, and some hospitals require us to co-sign the assessment while other hospitals don't have that requirement. If I have to co-sign, then I do a focused assessment on the LVN's patient just to be sure I agree with the findings. I've never had a problem where I didn't agree with the LVN's assessment. It's usually not that hard to do the assessment....go in to hang an IV med or help w/pt care and do a quick assessment while I'm in there.
    All about CYA!
  2. by   Spidey's mom
    Ah bukko . . . sounds nice. I wish we could just grandfather all LVN's into RN's and be done with it. The LVN that works our day shifts is absolutely great and I trust her to do a wonderful assessment. What we usually do since we start assessments at the 4 a.m. vitals is the LVN, the CNA and I go in, wake the patient up, the LVN helps the CNA with vitals, weight, refilling ice, etc., and I do a physical assessment. I chart that initial assessment. For the rest of the day the LVN will do the p.o. meds and I do IV meds. We share other patient care such as dressing changes, etc.

    What is the point in having a LVN if she can't do an assessment?

    steph
  3. by   plumrn
    How many LVN's are you talking about that you have to sign after? 1? 6? If you have your own set of pts, and the LVN(s) has a set, how can you possibly assess (completely) all of their pts, do all the admission assessments, blood transfusions, IV's, etc., and even think about getting off on time?
    I just don't see how you can completely assess, and review all the documentation on another nurses patients. It's hard to get everything accomplished on mine alone!!
  4. by   mattsmom81
    To be honest I work with some LVN's I would trust with my life ...if they have time to do the admission head to toe and I don't, I HAVE in a pinch quickly eyeballed the pt and signed the paperwork. But...it IS a risk...and several of my RN coworkers would never take this risk. I'm selective and would never automatically do this without knowing and trusting the other nurse completely.
  5. by   Tweety
    Quote from gwk
    quick question..ive never worked with lvns til I moved to TX sooo can anyone explain to me why the LVN cannot do an initial assessment but is competent to do later assessments either we trust their skills or we dont what is up with that!!!

    Because it is from that initial assessment that you are initiating the care plan, nursing diagnosises, etc. whatever your institution uses. These are RN thingies.
  6. by   Spidey's mom
    Quote from plumrn
    How many LVN's are you talking about that you have to sign after? 1? 6? If you have your own set of pts, and the LVN(s) has a set, how can you possibly assess (completely) all of their pts, do all the admission assessments, blood transfusions, IV's, etc., and even think about getting off on time?
    I just don't see how you can completely assess, and review all the documentation on another nurses patients. It's hard to get everything accomplished on mine alone!!
    Well, it is funny . . . .the new ratio law counts the LVN in as a nurse who can have the 6:1 ratio of patients. If we both have 6 patients, I do as I stated above. At 4 a.m. when the CNA goes around taking Q4H VS, we all go into the room and I do the initial physical assessment. My goal is to have all my assessments charted by 5:30 a.m. We are lucky in a way to start so early in the morning . . not so many things to do that early. Then the LVN does her own patient's med (not IV meds) and dressing changes, etc. The LVN I work with is very good at her job and could easily assess the patients BUT that is not our understanding of the law in California . . not in their scope of practice. Fortunately the LVN I work with is IV certified and can start IV but CANNOT hang IV meds or push IV meds BUT can hang IV fluids.

    Go figure .. . .

    steph
  7. by   zacarias
    Quote from 3rdShiftGuy
    Because it is from that initial assessment that you are initiating the care plan, nursing diagnosises, etc. whatever your institution uses. These are RN thingies.
    Exactly. While states vary in what they will and will not let LPN's do, the law is very clear that only RNs can initiate the nursing plan of care.

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