NOT TRYING TO START A DEBATE: but what is the differences between LVN and RN scope ?

[HeartsOpenWide, RN]

My friend is an LVN that is "bridg-ing" to RN. He (along with another LVN in my micro class a few years ago) told me that the gap between RN and LVN is starting to close. I thought that LVNs could only start IVs but not push meds. My friend (and this other girl from micro) told me that LVNs can push meds just not certain ones. What are the differences? I am not trying to start a debate in anyway. I am just curious about all the people I will be working with one day.

[Katnip, RN]

Each state is different.

The best way to find out the differences in scope is through your state's BON.

[antidote]

As stated above, it does vary depending on which state you live in, and what type of facility and their specific requirements and guidelines.

Although the hospital I work in is primary RN's, and PCT's as far as nursing goes, when we do hire an LPN/LVN they are allowed to do a lot of things RN's can do. However, they must have their IV Therapy certification as well as pharmacology. They can...

• start IV's
  
• push IV meds (limited)
  
• administer medication (limited)
  
• respond to codes
  
• physical rehabilitation
  
• assist with patient care
  
• perform hypnotherapy

So as you can see in my hospital, they could do pretty much the same things as an RN with the exception of pushing IV's and admistering medications (limited)

[Boston-RN, RN]

I am an LPN and where I work in an acute rehab the only things we CANT do that RN's do is:

IV push meds - although we can insert IV and maintain IV's solutions and meds

Hang Blood (although we can monitor it and co-sign the verification)

Admission assessment (although we obviously do the ongoing assessments)

All for the low price of approx $8-10/hr difference

Yes I am 1/2 through my RN program

[Lilnurse0803, RN]

I think another key difference between RN and LPN's is that RN's are trained to and are responsible for assessments, diagnoses (NANDA), and evaluating/re-evaluating a plan of care for the patients. The implementation portion of the nursing process is usually accomplished by various team members, but it is the RN that is responsible for everything that falls under the patient's plan of care.

The state practice act sets forth a minimum standard of practice based for RN's and LPN's. What each facility allows can be more rigid than the state practice act, but not less.

[realnursealso/LPN, LPN]

I feel their are numerous threads that answer this question.

[jjjoy, LPN]

The thing is that I don't see that there is a clear differentiation between the functions of RNs and LPNs. There are the legally proscribed scopes of practice but we see that many states get around this through additional certifications for LPNs. Theoretically, the RN may be "coordinating" the nursing care plan, but in reality we know that nursing care plans are often only maintained perfuntorily. I'm not saying the nursing care isn't done, it's just that the nursing care is part of the overall patient care plan - as opposed to requiring a separately designed and administered nursing care plan. So functionally, in many setting, the LPNs are practically doing everything the RNs do, yet getting paid significantly less. It does get seem a bit confusing. Compare it to nurses and doctors working together. An experienced nurse will know better than a new MD what to do in many cases and will often give guidance to the new MD. However, it's still very clear that the nurse's role and the MD's role are different. Also, there's clear distinction between nursing assistants and nurses, even when the NAs are certified to perform a wider range of skills such as ECGs, blood draws, etc. On the other hand, the roles between RN and LPN are less distinctive and sometimes can seem rather arbitrary. Is the RN delegating to the LPN? Or is the LPN working independent of the RN? Maybe someone sees this more clearly than I do. If so, please elaborate.

[emmycRN]

An LVN/LPN can "do" most all nursing tasks, although as already stated this varies from state to state. But, they must function under the supervision of a RN. Nursing is more than just tasks, as we all know.

[jill48, ASN, RN]

I think another key difference between RN and LPN's is that RN's are trained to and are responsible for assessments, diagnoses (NANDA), and evaluating/re-evaluating a plan of care for the patients. The implementation portion of the nursing process is usually accomplished by various team members, but it is the RN that is responsible for everything that falls under the patient's plan of care.

The state practice act sets forth a minimum standard of practice based for RN's and LPN's. What each facility allows can be more rigid than the state practice act, but not less.

This may be the case in your state, but in mine, Missouri, the LPN does all these things. LPN's are also DON's. The only thing the LPN cannot do in my state is 1) spike the blood for a transfusion, and 2) IV pushes.

[Lorie P.]

Again each state board of nursing is different and each facility one works at is different also. As an LPN, I can do everything an Rn does except, spike and hang blood( but can check off with Rn and watch for s/s of reactions) and push certain critical cardiac meds.

[sonja77]

i live in tx and i can insert ivs, give ivp meds (except cardiac meds), hang ivpb, ...

i cannot spike blood for a blood transfusion and i cannot monitor the pt. for the first 15 min. i cannot do the initial assessment for a pt. arriving on the unit.