Documenting for another nurse?

  1. Feel free to correct me if I am wrong on this. A friend of mine works at a snf that wants the RN's to document on the LPN's patients, even though they do not work on that unit and don't even see those residents during the shift. I told her that that is a really bad idea, I personally think it's a legal nightmare waiting to happen. What's worse is that her DON is on board with it.
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    About Barnstormin' PMHNP

    Joined: Mar '12; Posts: 355; Likes: 989


  3. by   CaringGerinurse525
    At the LTC facility I work at the RN is the supervisor and therefore is responsible for all the residents in the building. The LPNs are in charge of each hall and chart on their patients. The RN charts on falls, incidents (they all must be followed up for 72hrs). The RN also charts any deaths or change in condition that they assess. There are many other circumstances in which the RN would chart on a resident. I don't think it is ridiculous to ask your friend to chart on patients. Obviously she should know the patient or assess their condition before doing so.
  4. by   classicdame
    It is against the law in Texas. Each license carries its own authoirty, responsibility, and accountability. You cannot document what you did not witness. We are not allowed to "sign after" an LVN, student or anyone else, unless we witnessed the event.
  5. by   Barnstormin' PMHNP
    Classicdame, that is exactly the concern I have for her. She doesn't even see these people, there are forty beds on each unit as well as her own. She is supervisor of the three units weekends and when needed, the only residents she is actually familiar with are her own. She can't even place names with faces on the other units. How can you be expected to chart on patients without actually caring for them?
  6. by   classicdame
    someone needs to look at the nurse practice act or call the BON for clarification. The LVN has a license to protect too.
  7. by   chare
    What exactly is your friend being asked to document?
  8. by   xoemmylouox
    What do they expect her to document? She may have to get to know ALL of the residents at that facility to document safely and legally. Such is the joy of being an RN sometimes.
  9. by   MomaNurse
    Quote from xoemmylouox
    What do they expect her to document? She may have to get to know ALL of the residents at that facility to document safely and legally. Such is the joy of being an RN sometimes.
    Or the joy of being an RN supervisor. If your friend is a supervisor on the weekend covering 3 units, yes she can, and should, cosign the lpn documentation (incident reports, admissions,etc). If she is the only RN in the building on her own floor doing a med pass and someone she doesn't know two units down falls and fractures a hip, I don't think she's required to document that situation inasmuch as taking responsibility for it under her license.
  10. by   ak2190
    This reminds me of the days when I "supervised" my LPN supervisor in a SNF. She had about 35 years of experience, I had 2 weeks.
  11. by   DedHedRN
    Uggg, I worked at a facility that wanted me to do all the charting on all the wounds, even though we had a RN who was the wound nurse and I have 30+ pts and rarely saw the wounds. Management can be pretty stupid sometimes.
  12. by   BrandonLPN
    I'm betting your facility is engaging in unecessary and redundant documentation policy. Whoever makes the policy there ought to check with the BON on this. LPNs can complete their own documentation.

    I've worked in skilled nursing for nearly four years now, and I've never once had to have a RN document anything for me.

    This reminds me of some book I read about hospitals in the sixties where the RNs would stay over to "chart" on patients cared for by practical nurses. And the RNs in question never even saw these patients. All because charting was considered a "RN only" task.

    Terribly inefficient. There are some things a RN an do that a LPN cannot. Charting is not one of those things.
    Last edit by BrandonLPN on Sep 19, '13
  13. by   proud nurse
    When I was an LPN, the only time my RN supervisor charted on my patients was when I called her about a change of condition of a patient. She would come to my unit, assess the patient, and document. Most of the time it was very redundant, like the previous poster said. I would chart my own assessment, then she'd come and observe the same findings and chart her assessment. The patient didn't change that much and she did the same type of assessment that I did. I'm guessing it is done as proof that the protocol of assessment and documentation is followed.
  14. by   Barnstormin' PMHNP
    The charting that the LPN's are asking them to do is not the supervisor type of thing like falls, ER admits, or when a patient needs a secod set of eyes on them for an assesment (they already do that as their Supe position). From what I understand there are about ten to twenty patients/residents on "charting" on each unit. That means they may be on abx, had a fall recently, new admits, behavior etc. The charting is done at the end of the shift, basically the snapshot of the shift or more if something came up. The LPN' know their residents on their 40 bed unit. The RN supervisor does NOT. They do not usually have any kind of contact with the residents on the other units because they have their own that they work plus the other units have an RN as well. The issue is when they are the Supe and the LPN's are alone on the unit and want the Supe to chart for the LPN's shift so they don't have to. Which brings me back to my question. How can a nurse be legally expected to chart on a resident that she doesn't even see? If they are unit Supe does that imply they have had report and therefore the RN is technically responsible? They do not get report on anything on the other units other than incidents and patients who are unstable from the outgoing Supe. I know I personally would not agree to chart on people I have not assesed and observed over the course of a shift. The LPN's are telling the RN's what has happened for the shift and expect the RN' to document off of their obsevations. Can you just imagine the problems that can arise?