responsibility

  1. Can anyone tell me if an LPN is put in the charge position over an RN, and something goes wrong, is the RN held responsible even though the LPN was in charge? This situation came up at work a couple days ago, resulting in the RN quitting her job. This is not a n LPN versus RN thing, cause there's been enough of those on here, just asking a question. Any replies are greatly appreciated.
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  2. 15 Comments

  3. by   pickledpepperRN
    Some links. I think it differs from state to state

    http://www.csuohio.edu/ce/programs/C...HCHS458301.htm
    http://www.ohnurses.org/InsideONA.asp
    http://www.ohnurses.org/PracStatDeta...ts_Action=Find('Description','Guidelines+for+Registered+Nurses+D irecting+Licensed+Practical+Nurses')&PracStatement s_Position=FIL%3AORD%3AABS%3A4KEY%3AGuidelines+for +Registered+Nurses+Directing+Licensed+Practical+Nu rsesPAR%3A
    Too bad. The Ohio Nurses Association charges $4.00 for each statement.

    http://www5.state.oh.us/nur/
    http://www5.state.oh.us/nur/Law_and_Rule.htm
    Check chapter 13 from your Board of Nursing
  4. by   Good_Queen_Bess
    I often hear about LPN's on here. What does it stand for? What different "ranks" of nurses do you have.

    All we have is RN's (registered nurses) who start at "D" grade (junior level) and go up the scale, "E" grade is a more senior nurse, "F" grade is charge nurses or sister, the "G" grade being senior charge nurse/senior sister.
    We also have EN's (enrolled nurses) which are gradually being phased out as all qualified nurses are now RN's. They are usually junior to RN's, though only because of less time at university rather than experience.
    Other ranks are either auxillary nurses/health care assistant/clinical support nurses; same rank, different name; which are basically un-qualified nurses.
    Though they are changing it all soon.

    I realise I maybe should have started this on a seperate forum, but I've started it now, so I'll finish!

    Ta!
  5. by   pickledpepperRN
    Licensed practical nurse or (in Texas & California) licensed vocational nurse have less education. In California high school graduation is not even required. I went to school 12 months with a 2 week holiday in winter and one week in the spring.
    Often very smart people take classes and gain experience so they know much more than required for their license.
    In California the regulations that license hospitals require each patient to have a registered nurse responsible for the nursing process.
    A certified nursing assistant (CNA) in CA is a minimum of 50 hours of didactic and 100 clinical hours. Their certificate is not called a license.
    Last edit by pickledpepperRN on Jun 18, '03
  6. by   kermit27
    Thanks for asking that question GQBess. I've been stewing over that one myself. I've guessed that a CNA is like a health care assistant is here, but LPN had me stumped. Wondered whether it might be like the old State REgistered Nurses in the UK? as far as I know they were people who didn't quite pass the RN courses?

    I find the A B C D business much easier to understand (speaking as a soon-to-be student nurse and current grade A with all of 8 shifts to my name!) I'm also wondering whether there is any difference between a Diploma RN, and a degree RN once they're working?

    Maybe this should be a different forum?
  7. by   AHarri66
    In my facility the charge nurse has to be an RN, although in the LTC facility I used to work in, LPN could be charge over RN, but the RN was ultimately responsible. Didn't like that...if I'm gonna be responsible, I want control! LOL!
  8. by   rebel_red
    Our LTC facility requires an RN who is house supervisor especially on 3-11 and 11-7. She/he is in charge. The only exception to this rule is when our regular house supe is sick. (And she has to be knockin on death's door not to come in.) Usually one of our weekend RN's will come in, or our in house pool (all are very familiar with our residents.) If that doesn't happen our LPN's run the show with our DON as backup. In the year I have been there this has only happened once.

    Tres
  9. by   Tweety
    Around here only RNs can be in charge. Very interesting question. Let me know what you find out.
  10. by   canadiannurse21
    As a reply to all posts so far here, I am a Canadian nurse, and LPN means RPN here (registered practical nurse), and an RPN needs 2 years of college (and a high school certificate as a prerequisite of course) and an RN needs 4 years in college. The RN is in charge of so many patients, and an RPN is hired to help take the "less acute" patients from the RN's load, care for them, and report back to the RN during the shift as necessary. We pretty much work on a level playing field, with the occasional exception (such as certain skills like IV's which are strictly RN's domain). I never heard of RPN being charge nurse, but if they are in charge, it should be their responsibility.
    Good question momrn50
  11. by   Shamrock
    In this state the RN is responsible for LPN's, CMA's and CNA's no
    matter who is "charge". LPN's cannot delegate to RN's. I'm with
    AHarri66, if it's my license on the line, I want control. (NO, I'm
    not implying that JUST because you are an RN that you are better
    or smarter than an LPN), so please, don't beat me.
  12. by   ScarlettRN
    To be more specific in answering GQ Bess's question:
    LPN/LVN is a vocational nurse with about 12 month's training.
    There are "levels" of RN here, which are ADN with a 2 yr associate degree, Diploma RN which is approx 3 yr, BSN is a bachelor's degree, and MSN is the master's. There is such an animal as a Doctorate in Nursing, but there are not many around, that I know of.
  13. by   Huq
    Kermit.

    Wondered whether it might be like the old State REgistered Nurses in the UK? as far as I know they were people who didn't quite pass the RN courses?

    Until recently all RN's in the UK were State Registered Nurses. Don't ask why!
    We used to joke that SRN's were licensed by the General Nursing Council for England and Wales and could work anywhere . American nurses were RN's, but could only work in the State in which they graduated.. Seem crazy?

    I can assure you that these SRN's were not nurses who could not quite pass the courses.
  14. by   purplemania
    In Texas the Licensed Vocational Nurse works under the license of the Registered Nurse. LVN's have less education initially, although many continue to take courses related to practice and some get RN license. They may not do initial assessment or initiate the plan of care in this state. Pushing IV meds and admin. blood transfusions depends on policy of facility, but ours does not allow LVN to do either UNLESS they have specific training. I believe we need MORE LVN's or none at all, as the conflicts I've witnessed arise when RN and LVN are doing same tasks for different salaries. ($10/hr different average). CNA, Techs, Nurse externs are all unlicensed and their duties don't vary much. Depends on facility.

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