Suggestions for RN's covering LPN's please

Nurses General Nursing

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Specializes in Orthopedics.

I'm a new RN previous LPN. I work on an orthopedic floor and an RN has to cover the LPN for the shift to do push meds, sign off orders, and whatever else the LPN cannot do. Being that I'm new at this I'm not quite sure what is going to work for me. For those Rn's how do you usally do it? When I was an LPN I've been pulled to other units before and the RN and I would make rounds on both our patients together just to peak in and say hello and move onto the next. I like that idea, especially now since i'm the RN and responsible for the LPN. For those RN's out there what do you do when you cover the LPN? Also for report reason's the LPN cannot give her own report. Last time I covered someone I just gave them a blank piece of paper for her to write down her update, since we listen to one another's report in the a.m. anyway. Then I just read the information I had and her updated information she had given me. Seemed to work OK but any other idea's would be great.

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Specializes in Hospital Education Coordinator.

she might as well give the report herself if all you are doing is reading. I do not understand why she cannot give her own report.

As for covering, our state requires an RN to do an assessment every 24 hours, plan the care and plan the education. Also, IV meds cannot be done by LVN's unless they have special certification, and then only certain drugs. So the RN has to look at the care plan & discuss with the LVN what the goals are for that shift. Some of our RN's round with the LVN and some rely on the written documentation to cover everything. There are exceptions and people have to communicate frequently. We are getting away from LVN's in this hospital since their delegation is another burden to RN's and the patients are sicker and stays are shorter.

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Specializes in Orthopedics.

It just started the beginning of the year sometime where the LPN can't give her own report for some odd reason. I think the LPN can do her own assessment, I don't think we have to go behind them an reassess the patient. As far as the initial assessment, such as an ER admit I think we do have to do that first assessment. I'm going to check with the manager of my unit as well and find out exactly what I have to do as far as covering the LPN. I want to do it right that's for sure!

I know the whole push medication thing is different from hospital to hospital because I think other sister hospital of ours they're allowed to do some of their own medications, depending on what it is.

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Hmmm...burden?

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i can't see the rationale behind lpns doing assessments and not doing report

as you know the people and learn the requirements of the floor everything wil fall into place

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Specializes in ER, Acute care.

say what??????? the only thing i am not allowed to do is spike blood. as for ivp it depends on the hospitals policies. i worked in one hospital where i did picc line care, blood draws and ivp from and to the picc line, another hospital an rn has to do it. but as for lpn's being a burden, i have to say very offensive. good luck with your management skills, that is all i can say.................................:eek:

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Specializes in Orthopedics.

There is a lot that LPN's can't do at the hospital I work at: they can't draw blood from picc/central lines, change the initial picc/central line dressing change, flush piccs/c-lines do anything with PCA's besides clear the pumps, spike blood, IVP meds, sign off orders...i'm sure there's more too that i left off.

I know it sounds rediculous that the LPN can't give their own report and I agree! They're the ones that have been taking care of the patient all day and here I am giving report on a patient that I barely know?!

I guess everything will come with time and i'll ask around on my unit to see what others do as well. I too know that hospitals are fading out LPN's because I remember when I graduated LPN school it took awhile for me to find a job in the hospital setting. It's very hard being that LPN too when you can't do a lot of the things I listed, especially since the floor I work on a lot of the pain meds are given IV which I then would have to grab an RN to do it for me. But, it had to be done and now I'm just glad that I do it myself.

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But as for LPN's being a burden, I have to say very offensive.

Classicdame didn't say LPNs are a burden, she said the delegation is a burden.

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Specializes in Med surg, Critical Care, LTC.

I like the idea of doing a walking report together on all your patients, use that time to do a quick priority assessment on your patients. Use that time to delegate your expectations to the LPN your working with as well as asking her advice on how she would like to split the load.

I would then MAKE time to do a full head to toe on all my patients prioritizing the most critical to the walkie talkies as the shift progresses.

I can't tell you how many times I found CHF in previous patients without CHF, DVT's, bowel obstructions etc... because it seems each shift of nurses thought the other shift would do a full assessment. So I always did. Not only did this help me learn, it was good for my patients, AND covered my butt.

No offense to the LPN's on this site, but the education we recieve between RN and LPN is VERY different. As such, more is expected of the RN's, and mistakes will often come down on your head.

Good luck

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Specializes in EMERGENCY.

Its All In The Wording, Lvn's Can Data Collect. I Think It Would Fine If The Lvn Stated For The Next Shift All Of The "data" That He/she Collected. Its Technically Not A Report Then. I Used To Be An Lvn Too And From What I Remember, Lvn's Have A License Too And Im Sure That They Want To Keep It, I Did. Its Always A Good Idea To Keep An Eye On All Of The Patients, Just To Make Sure That They Dont Circle The Drain. But My Guess Is That If The Floor Deems It Appropriate For Lvn's To Be There, The Patients Must Be Mostly Stable. Another Thing You Can Do Is Always Educate Your Lvn, Let Them Know What You Know And Your Thinking Process. It Will Only Benefit Both Of You.

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Specializes in Cardiac Telemetry, ED.

In my state, the LPN may practice nursing tasks within the LPN scope of practice under minimal supervision of an RN.

I want to protect my license too, so I have made a point of knowing my scope of practice very well. What is the most helpful for an RN to do for me is not to actively supervise me or follow after me (which would not be "minimal supervision"), but rather, to be a resource for me to turn to when I need help. Help can be spiking a blood bag or giving an IVP into a central line, or it can be if I have a question about a patient situation, or make an observation while "collecting data" that I feel, in my clinical judgment as a nurse, warrants attention.

My function as an LPN in the clinical setting in which I work is not one of being delegated to by an RN. I function as a team member, a colleague, providing care for the patients to which I am assigned, under minimal supervision of my charge nurse, and within my legally prescribed scope of practice. If the charge nurse assigns an RN to buddy up with me, it is not in order to "supervise" me, but rather, to be the one I go to when one of my patients needs something that is outside my scope.

Since I do not wish to be a burden to anyone, I always offer to assist the RNs I work with as well. If I can pass a few pills for an RN while he or she does an IVP for me, it's a win-win.

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