There is a clearly cut reason as to why LPNs/LVNs possess their own nursing licenses: accountability for their own actions. If the LPN in this situation has a license, she should be accountable for her own med passes, dressing changes, and nursing actions. If she happens to make a mistake while under your watch, you should not
be accountable because you were not the one who made the error.
Your original question reads: "My question is how responsible really is the RN for what the LPN does?" Unfortunately, that all depends on your state's board of nursing. Many states, especially the southern states, have extremely wide LPN/LVN scopes of practice and these nurses are expected to be responsible for their own actions. A few northern states, such as Minnesota and Pennsylvania, have extremely restrictive LPN scopes of practice which leads to more RN responsibility.
I am going to opine that there should be only 1 uniform
scope of practice for LPNs/LVNs instead of these minor and major differences that seem to exist from state to state.