I had an interesting and humbling experience today. I'm a new grad and was lucky to start a hospital position on a med-surg floor. I was going to give a norco when one of my co-workers, an RN, asked why I was preparing to give a PRN Norco. I said it was within the time allotted and the patient ranked their surgical incision pain as an 8/10. I've done this 50 times since I started working a few months ago. The other LPNs do the same thing, the LPNs and RNs share the patient load and this patient was under my care.
Now, this person/RN doesn't regularly work our floor but seemed to be verging on rude or simply boldly inquisitive. Yet, they really made me think and stop to question myself and if I'm practicing outside of my license- if all LPNs are practicing outside of their license.
The RN said that performing a pain assessment (1-10 scale) is still an assessment. She was very clear as I'm very aware LPNs are not allowed to perform assessments. She then pushed it further to giving scheduled BP meds and checking blood pressure. Should I even be giving scheduled BP meds since I'm only to collect the data, not interpret whether it is acceptable or unacceptable. This RN just kept going on and on.
I was lost and felt very flustered. I didn't know how to respond. I felt so stupid because I could see her point but then again most of my LPN training was with regards to assessment! How can I not take a patient's pain scale and interpret it? I always felt so autonomous in my role. The RN would always do the head to toe assessment each morning for all 6 of our patients while I did med pass for them. After that, I was to be in charge of 3 patients while she took over for the other three. From my understanding that is how that floor has always worked.
Later that day another LPN asked me if I should even be responding to the patient when I ask their name and date of birth- apparently that would be an assessment and I should report it immediately to the supervising RN to be sure that she can interpret it before I give any medication.
I just felt so humbled- is that even the right word? I felt below my ability like there are people out there that think less of me for my license. Am I just a medications aide? I do IVs and foleys and the occasional enema. Is that all I'm good for? Am I just to do tasks and not act on information provided by the patient such as pain scale when I have a PRN order? Am I not allowed to count respirations before giving that Norco or document the stated pain number? Should that be the RNs responsibility? Should the RN be in charge of all PRN medications? Are PRN medications outside of the LPNs scope of practice because they require an assessment?
I've turned this into a very very long rant. I just can't help but think, what if she's right?
:edit: i attached my state's practice act below for further clarification.