Confused about LPNS role

  1. 0
    SO i'm pretty confused about this....what exactly can Lpn's do? I know they can't teach or evaluate outcomes. I know they can take care of patient's with stable outcomes (does that mean they can assess them)? I also know they can complete dressing changes. But that's about it. Can they give meds, do I.V's, handle trach stuff, caths? I basically have no clue what lpns do. Oh can they give tpn or blood products? Thanks for the help!
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  3. 12 Comments so far...

  4. 0
    Moved to the LPN/LVN corner

    Each state will have their own requirements on what PN can do. Is there any state particular you are looking at regarding PN's or just general stuff?
  5. 1
    here is how I think of it.

    LPNs cannot reassess. with blood products lpns cannot even check the blood product. that requires 2 RNs. and you have to stay with the pt. for 15mins. to reassess, evaluate how the are responding to the transfusion. same with tpn, that is an RN responsibility. the LPN can do some sterile produres. like dressing changes, trach care. but these should be simple procedures, which won't require the RNs assessment (that is the key, does it require reassessment). anytime you have a pt. with a sign or symptom, like restlessness, confusion, pain, headache. it requires the RNs assessment. the RN needs to assess the level of pain, are they confused/restless because they are short of breath. this requires the RNs asssessment skills. The RN is also responsible for admission and discharge. admission requires you to assess the pt. and discharge requires teaching in some ways. both of these only the RN can do. as long as the situaiton requires you to assess, reassess, plan care, evaluate, admit, discharge, teach, it will be the RN responsibility. so you have to think about are they needing something requiring me to reassess. before you give pain med. you have to assess there pain. after you give the med you have to reassess. so if it is a prn med or a med that requires reassessment. then that is the RNs patient.
    lindarn likes this.
  6. 0
    Thank you soo much!!!!
  7. 1
    Quote from gutcheck
    here is how I think of it.

    LPNs cannot reassess. with blood products lpns cannot even check the blood product. that requires 2 RNs. and you have to stay with the pt. for 15mins. to reassess, evaluate how the are responding to the transfusion. same with tpn, that is an RN responsibility. the LPN can do some sterile produres. like dressing changes, trach care. but these should be simple procedures, which won't require the RNs assessment (that is the key, does it require reassessment). anytime you have a pt. with a sign or symptom, like restlessness, confusion, pain, headache. it requires the RNs assessment. the RN needs to assess the level of pain, are they confused/restless because they are short of breath. this requires the RNs asssessment skills. The RN is also responsible for admission and discharge. admission requires you to assess the pt. and discharge requires teaching in some ways. both of these only the RN can do. as long as the situaiton requires you to assess, reassess, plan care, evaluate, admit, discharge, teach, it will be the RN responsibility. so you have to think about are they needing something requiring me to reassess. before you give pain med. you have to assess there pain. after you give the med you have to reassess. so if it is a prn med or a med that requires reassessment. then that is the RNs patient.
    It really depends on the state you live in, the scope of practice of the LPNs and policy/procedure of the facility. It is true, that an LPN is not to assess. However, in my state, if trained, we can initiate blood products, but the bloods have to be signed with an RN, not an LPN. Some states say that the LPN cannot do an initial assessment, but can do follow-ups (on the same situation if they are stable), and if there is a new situation, then, this is where consultation with the RN takes place.

    Again, I am speaking of my state only, but we can do teaching for common place situations that are already established, such as diabetes, hypertension, etc...(no new and exotic diseases). Some nursing homes will have an LPN create an initial care plan, but it has to be countersigned by an RN; so, it can change based on the RN's judgement. Some states have a broader scope of practice for their LPNs, some are more limited.

    I keep hearing about some places were their LPNs are not allowed to medicate their patients at all...that astounds me. What on earth can they be learning for 9 months to a year only not to be allowed to adminster basic medications is beyond me, but I guess it happens.
    Silverdragon102 likes this.
  8. 5
    Quote from gutcheck
    here is how I think of it.

    LPNs cannot reassess. with blood products lpns cannot even check the blood product. that requires 2 RNs. and you have to stay with the pt. for 15mins. to reassess, evaluate how the are responding to the transfusion. same with tpn, that is an RN responsibility. the LPN can do some sterile produres. like dressing changes, trach care. but these should be simple procedures, which won't require the RNs assessment (that is the key, does it require reassessment). anytime you have a pt. with a sign or symptom, like restlessness, confusion, pain, headache. it requires the RNs assessment. the RN needs to assess the level of pain, are they confused/restless because they are short of breath. this requires the RNs asssessment skills. The RN is also responsible for admission and discharge. admission requires you to assess the pt. and discharge requires teaching in some ways. both of these only the RN can do. as long as the situaiton requires you to assess, reassess, plan care, evaluate, admit, discharge, teach, it will be the RN responsibility. so you have to think about are they needing something requiring me to reassess. before you give pain med. you have to assess there pain. after you give the med you have to reassess. so if it is a prn med or a med that requires reassessment. then that is the RNs patient.
    Jeeeeesh! What state do you live in? Why even bother being an LPN wherever you are? I constantly assess my patients every time I see them. Administer PO meds, Injections (IM and SC) IV meds (Can't push) All kinds of dsg changes, from bandaids to Wound Vacs. Do admission assessments. Discharges, including pt teaching.

    I see these posts all the time. I have to wonder if some of the responses are true or not. If they are then get the hell out of those states, lol.
    BrandonLPN, krazy_coconuts, mc3, and 2 others like this.
  9. 0
    I am only speaking in terms of nclex. nclex is a national test. state laws do not apply. for example, some hospitals in my state allow the NA to insert foleys which is a sterile procedure. but, if it were an nclex question, I would get it wrong on the test, because one has to think broadly on the nclex. and accordingly, NAs cannot perform sterile procedures.

    I am not saying that you won't encounter LPNs or NAs functioning beyond their "scope" in the work (hospital) setting. I am only answering this question in terms of nclex. nclex doesn't refer to state laws. in some states things may be able to be delegated. but this doesn't apply to nclex. for nclex it is the nurses job to teach, assess, etc., it can't be delegated. the LPN can not assess. doesn't matter how your state allows you to function. like the previous poster said you would have to get more training as an LPN to do blood products, etc.
    Last edit by gutcheck on Jul 26, '08
  10. 0
    sorry this question was in the nclex forum and moved. I was posting my answer only in terms of nclex. now I see it has moved to the lpn forum.
  11. 0
    Quote from gutcheck
    I am only speaking in terms of nclex. nclex is a national test. state laws do not apply. for example, some hospitals in my state allow the NA to insert foleys which is a sterile procedure. but, if it were an nclex question, I would get it wrong on the test, because one has to think broadly on the nclex. and accordingly, NAs cannot perform sterile procedures.

    I am not saying that you won't encounter LPNs or NAs functioning beyond their "scope" in the work (hospital) setting. I am only answering this question in terms of nclex. nclex doesn't refer to state laws. in some states things may be able to be delegated. but this doesn't apply to nclex. for nclex it is the nurses job to teach, assess, etc., it can't be delegated. the LPN can not assess. doesn't matter how your state allows you to function. like the previous poster said you would have to get more training as an LPN to do blood products, etc.
    http://www.mass.gov/Eeohhs2/docs/dph/regs/244cmr003.pdf

    Please read.
  12. 0
    I am glad mass. allows you to function as such.

    according to the national council state boards of nursing rns cannot delegate the nursing process. which includes assessing. this however, may differ in state nurse practice acts (such as mass). I am only speaking in terms of nclexrn, and the national board.

    https://www.ncsbn.org/Joint_statement.pdf


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