Unsafe, possibly illegal situation at my workplace

BlueDevil, DNP · Mar 16, 2014

One hundred years ago, I took a temp position as the RN supervisor of an AL facility. I was in the building 10 minutes a month, to sign some forms and pick up my check. Very occasionally, someone called me with a question. Technically, I was supervising everything going on. In actuality, I offered telephone triage and my signature on a piece of paper. It was legal.

applesxoranges, BSN, RN · Mar 16, 2014

Aren't you acting under your own license to give care as directed by the patient's physician and the registered nurse who does the intake assessment?

Rivalicious · Mar 16, 2014

Is there an RN in charge anywhere? Even the Corporate office? In my state an assisted living facility had to have an RN as part of the team. They don't have to be in the building all the time but has to be on call 24/7. There can be an LPN on call but she had to have an RN to call if things fall out of her scope.

No, there is no RN working for them in any capacity.

Aren't you acting under your own license to give care as directed by the patient's physician and the registered nurse who does the intake assessment?

The LPN/resident care manager does all of our intake assessments. The patients physician orders the medications and treatments though, so I guess that is what makes it kosher.

And I'm sorry if this was a stupid assumption/question everyone, in my defense I recently moved from a state where the LPN's scope of practice was extremely limited and you pretty much couldn't wipe a butt without a RN supervising you directly.

Rivalicious · Mar 16, 2014

Why not contact the state and ask them instead of asking here.

Because the BON doesn't answer calls on weekends, and I was on-call this weekend.

Anyways, thanks for the responses everyone. I feel much more reassured. :x3:

NurseDirtyBird · Mar 17, 2014

You are following the direct orders of a physician. The MD is who delegates the care to you. As far as there being an RN, I worked in an assisted living facility at one point where the care manager was a CNA. There was one RN on staff, part time as a floor nurse, and they were responsible for signing care plans devised by the care manager (check box careplans), as required by law. It may seem a bit shady, but assisted living facilities are not under the same regulations as LTC or SNFs. They are classified as boarding homes, not health care facilities. The caregivers don't even have to be CNAs. They are essentially apartments with nurses who just happen to be on staff. The situation you described does not sound illegal, although rules and laws regarding ALFs differ some state by state. I would advise you to become familiar with the boarding home regulations in your state before you make any accusations.

applesxoranges, BSN, RN · Mar 17, 2014

The LPN/resident care manager does all of our intake assessments. The patients physician orders the medications and treatments though, so I guess that is what makes it kosher.
And I'm sorry if this was a stupid assumption/question everyone, in my defense I recently moved from a state where the LPN's scope of practice was extremely limited and you pretty much couldn't wipe a butt without a RN supervising you directly.

In our state, our LPN's scope of practice is pretty broad but they can't do initial assessments and the care plans. Our LPNs can also perform patient education and discharge teaching too which most states do not allow. It drove the school nuts because the test banks were always set up to be more inline with a national standard.