Can a LPN work under a doctor in CT?

Nurses LPN/LVN

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I have not been hired but I had an interview and I know for a fact that the doctor is checking my references. :) The job is at an allergy clinic. It is only a one doctor practice and he only has one nurse (LPN), who is cutting back her hours to retire. I am really excited about the position because everything about it is really what I was looking for!

However, I remember during nursing school one of my instructors saying that in Connecticut a LPN has to work under a RN or APRN. They cannot work directly under a doctor. Is this true? I was reading the scope of practice for a LPN in CT and it seems that she may be correct but those documents are quite confusing to interpret sometimes. It seems to read that a RN or APRN needs to be either at the office or available on call at all times for a LPN. But again, I am not positive, so this is why I am asking for some input.

I am a new graduate and don't want to make any newbie mistakes. Anyone know what the rules are? Thanks in advance!

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Specializes in Complex pedi to LTC/SA & now a manager.

LPNs (in most states) work under the direction of an RN, APRN, MD, DO, DPM, DDS or DMD

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Specializes in Hyperbaric Medicine and Wound Care.

The regs are referring to nurses only. Yes, you can work under the direction of an MD.

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Yes, but aren't LPNs only supposed to take direct orders from RNs or APRNs? And the APRNs and RNs take the orders from MDs? If something were to go wrong and they saw that a LPN was taking orders from a MD with no RN/APRN on site/call wouldn't that be very bad?

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Specializes in Hyperbaric Medicine and Wound Care.
Yes, but aren't LPNs only supposed to take direct orders from RNs or APRNs? And the APRNs and RNs take the orders from MDs? If something were to go wrong and they saw that a LPN was taking orders from a MD with no RN/APRN on site/call wouldn't that be very bad?

No. That's not how the "chain of command" works. LPN's can take direction from an RN AND/OR an MD. There is no requirement that an MD give orders to an RN and then have the RN give orders to the LPN. You are overthinking this.

Look at it this way. As an LPN you can take phone orders from an MD, right? Where in that scenario is the RN? Nowhere. You have a license, and that license has a scope of practice. Taking orders from an MD is well within that scope.

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Specializes in Complex pedi to LTC/SA & now a manager.
No. That's not how the "chain of command" works. LPN's can take direction from an RN AND/OR an MD. There is no requirement that an MD give orders to an RN and then have the RN give orders to the LPN. You are overthinking this.

Look at it this way. As an LPN you can take phone orders from an MD, right? Where in that scenario is the RN? Nowhere. You have a license, and that license has a scope of practice. Taking orders from an MD is well within that scope.

Exactly. An LPN can take orders/direction from an RN or APRN or MD or DO or DDS or DMD ( some states do not permit LPNs to take orders from PA-C. In home care & private duty nurses (RN or LPN) can only take verbal/signed orders from MD, DO, DDS, or DMD due to Medicare regulations. They cannot accept orders from an APRN or PA-C unless consigned by a physician or dentist)

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Oh, okay. Thanks guys! I was getting worried because I read this on a different allnurses post:

"Definitely check with your own state Board of Nursing. How "close" the supervision of the RN has to be varies. I have worked in states (like CT) where an LPN cannot work anywhere except in a client home without an RN in the building. I have worked in other states (like MA) where an LPN can work in non-hospital settings as long as an RN is immediately available by phone. In all states there must be some type of RN supervsion for the LPN/LVN."

I can always ask the doctor about it if I do end up getting hired just in case.

Thanks. :)

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Specializes in Complex pedi to LTC/SA & now a manager.

The point is LPN needs supervision available. It can be a physician OR dentist OR registered nurse OR advanced practice nurse. Most non-hospital facilities do not have a physician on site 24/7 but will have an RN, so it's often easier to just say nurse. A physicians office is a different setting

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Specializes in Home Health (PDN), Camp Nursing.

I can always ask the doctor about it if I do end up getting hired just in case.

Thanks. :)

YOU are responsible for knowing your scope of practice. I recommend you find it and read it, until you understand it front and back.

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Specializes in HH, Peds, Rehab, Clinical.

YOU should understand what you can and can't do. Honestly, if I were your new boss, I'd have to really wonder about a nurse who doesn't know this most basic information about his or her own license. And, as we're all aware, Dr's are sometimes the LAST person you would ask about this--keep in mind that they are perfectly content to call an MA a nurse AND allow/expect them to perform some of the duties of a nurse--phone triage comes to mind.

Educate yourself about yourself. It will be worth it.

Oh, okay. Thanks guys! I was getting worried because I read this on a different allnurses post:

"Definitely check with your own state Board of Nursing. How "close" the supervision of the RN has to be varies. I have worked in states (like CT) where an LPN cannot work anywhere except in a client home without an RN in the building. I have worked in other states (like MA) where an LPN can work in non-hospital settings as long as an RN is immediately available by phone. In all states there must be some type of RN supervsion for the LPN/LVN."

I can always ask the doctor about it if I do end up getting hired just in case.

Thanks. :)

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Call your local board of nursing, who can clarify this for you.

There are MD offices staffed by medical assistants, and they take direction from an MD. However, every state is different.

Per TOS, we can not give legal advice, however, when in doubt or needing clarification, call and ask.

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You've been given some very good advice here. Please, for the sake of your license and future career, be very certain that you don't do something that you CANNOT do with your state's LPN license. What I mean is, physicians sometimes doesn't have an RN on staff because they don't want to pay the extra money, and for *most* things an LPN will be just fine.

Just be darned sure that they aren't asking/expecting you to do things that are NOT within your scope of practice because "a nurse is a nurse is a nurse", know what I mean? And since the scope varies by State....well, just be careful. Would hate to see you back in 3-4 months saying "I love my new job, but my MD boss expects me to do all these things that an LPN here can't do....so what do I do?"!

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