Do you know your (LPNs) scope of practice? - page 2
Care to venture any guesses guys?... Read More
0Dec 29, '12 by BrandonLPNQuote from caringinpracticeYes, I believe all 50 states say that the LPN is supervised by a RN or a doctor. So in a doctors office where there's a doctor present..... a RN isn't required to supervise the LPN. The doctor fills that role. In LTC, LPNs do function under the supervision of a RN, but that supervision can be in the form of the RN being a phone call away. Many, many, nursing homes in many many states function with no RNs present at all on after hour shifts. Everyone knows most facilities operate with only LPNs in the building much of the time. LTC would grind to a halt if a RN was required to literally supervise in person all the LPNs.Is anyone else concerned , in an effort to save money that LPN's are being used as RN's. If that's the case then RN's are no longer needed. The BON guidelines between RN and LPN states that the LPN is supervised by the RN, however in this case there is NO supervison and management is permitting this violation of the BON nursing scope of practice to be allowed....the patient is assessed from the getgo by the LPN and the RN is bypassed in an effort for more pt's to be processed.
1Dec 29, '12 by Esme12, ASN, BSN, RN Senior ModeratorQuote from hfullerCNANo one is arguing here.......Why don we direct them to a web site?Why can't we all just get along? Instead of arguing, why don't we just direct this person to a link that shows all 50 states Scope of Practice for an LPN?
There isn't just one.....each state has their own rules and regs within the individual states nurse practice acts. Then it varies from facility to facility what they are will to allow the LPN to do because then they have competencies and documentation of continuing education that allow the LPN a larger scope of practice.
It then depends on the RN's in their employ and how many they employ per LPN for ensure that the LPN is under the RN direction as most states allow LPNS a pretty wide scope although some tasks need to be directly observed by the RN. Many facilities do not want the hassle.....nor do they employ the correct ratio of RN to LPN.
LPN' in an LTAC setting are pretty independent and in fact do many of the same things the RN does.....in my state that is.....after they are given competency exams approved by the state and medical staff to enure the LPN is up to par for the position and added responsibility.
Lastly....if this is a school assignment we a re glad to help them to the right answer but just doing the homework for them will not make them a better nurse.
1Dec 29, '12 by Esme12, ASN, BSN, RN Senior ModeratorQuote from KRODDPlease explain further....whether or not a specific nurse is with in their scope of practice depends of their experience, addition training and policy to the facility.I meant this as a General scope of practice
Ie. stable patients or patients with predictable outcomes!
I have had LPN's take unstable patients that have the background and experience to know what to react to and know when to ask for help. LPN"s are limited in their practice, unfortunately. For example if I had a GI bleed that was actively receiving massive amounts of blood and blood products...I might consider not giving that patient to the LPN and give it to the RN....depending on the other patients on the unit. But I just might give the LPN that patient as long as the RN is available to start and stop the transfusions with the LPN....if the LPN ha the experience to know how to deal with that patient and the RN is a new grad.
There are many factors that go into the delegation of care.....what is the point you are trying to make? you are New a LPN correct? Did someone upset you? What exactly are you looking for?
0Dec 29, '12 by jadelpn GuideQuote from CapeCodMermaidAnd if you were to hire new grad RN's, or RN's with little clinical experience, an LPN just may be the better choice to assess such patients. I graduated LPN school in 2007. The amount of hours in both acute and skilled care clinical settings was considerable. I could clinically think in my sleep after all that. Even RN's take on leadership roles in acute care when having little to no clinical experience. Just like everything else, depends on the state, the facility, and the LPN's experience.I hire all the RNs I can for my facility. The 5 star rating system is based in part on numbers. And, with the sicker and more clinically complex patients we are getting, I need RNs who can assess these residents.
0Dec 29, '12 by SeasQuote from jadelpnI bet she wasn't talking subjective (who vs who). She rather goes with the standards and BON. Assessments is not within LPN's scope of practice by most states if not all. However, states don't say how much of experience a RN needs. A RN is a RN is a RN. (I just made this up, but it really fits).And if you were to hire new grad RN's, or RN's with little clinical experience, an LPN just may be the better choice to assess such patients. I graduated LPN school in 2007. The amount of hours in both acute and skilled care clinical settings was considerable. I could clinically think in my sleep after all that. Even RN's take on leadership roles in acute care when having little to no clinical experience. Just like everything else, depends on the state, the facility, and the LPN's experience.
2Dec 29, '12 by Kooky KorkyMy job will not allow an LPN to do an Admission assessment. but, with extra education and subsequent certification, an LPN can give IV drips, such as KVO rate and IV piggybacks into saline or hep locks. But they can't titrate drips in ICU or ER, for instance. Go figure.
I've known LPN's who are much better at IV starts than some RN's.
To OP: you've got to check with your state Board if you have questions about your Scope of Practice. I do know what LPN's may and may not do on my job, as I have familiarized myself with the rules/laws by reading them for my state, for both RN and LPN. I have never had an employer that required or authorized an LPN to do things that violated the law.
0Dec 30, '12 by nursel56 GuideIt would be foolish for anyone to take at face value opinions on legal issues like one's Scope of Practice from people who clearly don't understand the concept or the specifics contained in them. Especially when the information you seek is so readily available online. We have a list of all state Boards of Nursing with current contact information here. That's a good place to start.
Quote from SeasIf people really believed that we wouldn't have a constant repetition of the other common topic of argument here.A RN is a RN is a RN. (I just made this up, but it really fits).Last edit by nursel56 on Dec 30, '12 : Reason: bad format
0Feb 3, '13 by oldlvnWe have Lead Rn's where I work. Occasionally -like once a week or so we hear a code that we have a patient down. There is a team that goes to that location and the RN leads in the assessment and makes decisions based on our protocal and the patients condition. Rarely is it serious. Usually a drop in blood sugar. Occasionally an seizure. We are not equipped for a trauma or serious injury...we call out for transfer to the ED for that type of situation. We also do not take on walk in injury that should be rerouted to the ED.
That team is made up of Lvn's, Rn's and mostly....unlicensed personel. WELL TRAINED, MANY years of experience...unlicensed personel. I don't have issue with that at all. But if it were ME....I wouldn't put myself in that situation. That is a HUGE liability.
I never go when that code is called...short of obtaining a wheelchair or o2 supplies if directed because I am in the area.
I am a NEW lvn with very little experience. I cannot assess. I have no business involved in that situation. That is CLEARLY outside the scope of "predictable outcome". For those that can and do participate I wonder if they realize they are working outside their scope of practice.
I think I will just mind my business and keep my mouth shut.