Calling all LPNs?? What is and is not in your Scope of Practice compared to an RN? - page 3

Hello all LPNs, I am starting a new job at a hospital that uses the Team Nursing approach (RNs, LPNs, and CNAs). I have never worked with LPNs or CNAs before. At my last hospital, they used Techs... Read More

  1. by   johnp127
    From what I gather.... Texas is the only place where you would really be able to totally care for your pt... everywhere else LVN/LPN hands are tied. RN complain about the work load but the Nursing board with what LVN/LPN scope of pratice for us keeps the rope tight. It is an eye opener, and a motivationg factor that sends a nurse back to school. In texas you are a "NURSE". Not "I am a RN" or "I am a LPN"... "I am a nurse". never have I experienced the discrimination until I moved away from home.
  2. by   Fiona59
    Dear John: (I've always wanted to type that, sorry)

    Our practice is very much restricted by our employers. My health authority is suffereing a severe staff shortage and aging population. Guess what, my scope has just been expanded to starting and hanging IVs and their meds. Still no starting TPN, or spiking the blood bag. No extra money.

    Nursing shortages demonstrate our skills. Hopefully we demonstrate our negotating skills on the next contract renewal.
  3. by   purenholy
    Where I worked the LPN have their own assignment as the RN. We were responsible for admissions and discharges, I start IVs and hang IV antibiotics and fluids, monitor blood, insert ng tubes, supra pubics, foley catheters,draw blood...ekgs ect...no iv push meds
  4. by   TheCommuter
    Quote from johnp127
    From what I gather.... Texas is the only place where you would really be able to totally care for your pt... everywhere else LVN/LPN hands are tied.
    In general, the Southern States tend to have the widest LPN/LVN scopes of practice in the nation, which means that we can do more and function maximally in these places.
  5. by   NursePeace
    :spin:Welp in Ohio LPNs basically steer clear of IVs. No piggybacks, no blood, no pushing anything. Not even care on a picc. You may start and hang NS on someone over the age of 18 I believe it is. You must be IV certified. Which Im not. I work in a LTC setting and we have NOTHING to do with the IVs. I think most places just use the RNs anyway because theres sooooo many restrictions.
  6. by   lpn1972
    Quote from Ogopogo
    I'm an LPN student in BC, Canada.

    I know that we cannot push IV meds, start IV's, hang blood.

    As far as I know an LPN cannot work in acute care or L + D. Although my instructor told us if we were ever floated to those wards, it would be much more in a "care aid" capasity. Very basic patient care with very little assessments or interventions.

    There is an additional course LPN's in my province can now take to work in the OR. I'm not sure how long it is.
    I'm not sure your instructor knows what she is talking about. I am an LPN in BC working on Acute Surgical floor. I have my own pt load, do full head to toe assessments, give out medications ( IM/PO/SC/NEB) everything but IV meds, do care plans. We cant take Dr.s orders, but we can on the Medical floor. We also do most of the catheterizations on the floor, do I&O's. We basically work to full scope. I am guessing by your name that we are in the same Health Authority, and they want LPN's working to their full scope.
  7. by   Fiona59
    Nursing in BC varies from health authority to health authority and then within the facilities in that system.

    Campbell River, Comox, Nanaimo all had/have different ideas about how to utilize their PNs and they are all part of VIHA.
  8. by   LPN2RN1975
    in ok, lpn scope of practice is quite broad but does vary from facility to facility and even floor to floor. the hopsital floor where i work is, at least for now, quite liberal in regards to lpn scope of practice. i do all my own assessments - admission and regular q shift assessments. i take my patients' initial set of vitals (the techs get the rest) and other vitals as needed. i pass all of my own meds - iv and otherwise. i take verbal and telephone orders from mds.

    i do not do care plans. my admission assessment must be co-signed by an rn. i do not spike blood, and must verify it with an rn and have an rn present for the first 5 minutes of transfusion. i will not be assigned as a charge nurse.

    so basically, i function as an rn but get paid a little more than half what an rn is paid.

    any situation i am uncomfortable with, i seek out the help of my charge nurse. like the first time i pushed digoxin or cardizem i had someone with me. like when i know a patient has had a significant change in condition.

    ours is an initial-driven profession. too much emphasis is placed on lpn vs rn vs bsn and not enough on ability. i have worked with both rns and lpns who are fantastic and well-matched to their jobs, and with some who are just plain scary. it bothers me to this day when i come across someone who is more concerned with initials than with experience, aptitude and heart. there is nothing that shows one's inexperience more than a nurse (or doctor) who only pays attention to what's after your last name than to what's between your ears!

    so find out your facility's policy, and state regulations, to be safe.
  9. by   OgopogoLPN
    Quote from lpn1972
    I'm not sure your instructor knows what she is talking about. I am an LPN in BC working on Acute Surgical floor. I have my own pt load, do full head to toe assessments, give out medications ( IM/PO/SC/NEB) everything but IV meds, do care plans. We cant take Dr.s orders, but we can on the Medical floor. We also do most of the catheterizations on the floor, do I&O's. We basically work to full scope. I am guessing by your name that we are in the same Health Authority, and they want LPN's working to their full scope.

    Ooops, I just reread my original post. It should have been "ICU", not acute care. I know we can work in acute care which is where I hope to work when I'm done. Do you know specifically about L + D in our health authority?
  10. by   lpn1972
    Quote from Ogopogo
    Ooops, I just reread my original post. It should have been "ICU", not acute care. I know we can work in acute care which is where I hope to work when I'm done. Do you know specifically about L + D in our health authority?
    That I'm not too sure about! I used to work in Maternity all the time when I first graduated(2001) and then our nurse manager decided that LPN's shouldn't work there anymore (no reason given, just a control thing!) I still do occasionally work there but only when they are desperate! I know that in other hospitals in the region, LPN's do work in Mat. We don't do L&D although I have assisted with a few deliveries, mainly just a runner person. We can work post-partum though.
  11. by   OgopogoLPN
    Quote from lpn1972
    That I'm not too sure about! I used to work in Maternity all the time when I first graduated(2001) and then our nurse manager decided that LPN's shouldn't work there anymore (no reason given, just a control thing!) I still do occasionally work there but only when they are desperate! I know that in other hospitals in the region, LPN's do work in Mat. We don't do L&D although I have assisted with a few deliveries, mainly just a runner person. We can work post-partum though.

    Thank you! I would love to do L + D, but if I can't I would love post partum. I imagine it is a more difficult ward to get posted on though?
  12. by   shoegirl28
    Where I work LPN"s in the hospital setting (rehab or acute care) LPN's take their own patient load of up to 4-7 patients. They do all their own assessments and care, as well as medication administration. If a patient assigned to the LPN has IV meds the RN will administer them. (We work in LPN/RN teams). LPN's can assess the iv site though and change iv solution bags that do NOT have potassium in them.

    LPN's can do many of the same procedures RN"s do. However the key is LPN's must always have the most stable patient's and some procedures can't be performed on stable patent's due to other underlying conditions (example normally LPN's insert urinary catheters, but if a patient has major prostate issues or other underlying issues that might make insertion difficult, then the RN will perform the skill).
  13. by   purenholy
    I worked in subacute rehab and did admissions and discharges, assessments, ekg, blood draws and hanging of IV solutions and piggy backs. I had my side, the rn had her side. I have inserted foleys, suprapubics, ngt, gt , started iv's ect...did not hang blood, just monitored. No iv push meds

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