lpn in nursing home

  1. I have been an LPN in geriatrics for 16 years.I also work perdiem in a icu step down .I consider myself a good nurse with clinical skills.I am currently in school to receive my associates degree.anyway,I was told yesterday that we(LPNs are no longer able to administer tylenol with out an rns say so.in the mean time my job consists of administering medications.Their reasoning was,that lpns arent able to assess pain so how would we know when to give the pt tylenol.I have never been so insulted in my life. Has any one heard of this??Is this a new law?This means that when a patient complains of a headache,I would have to locate an RN and have her assess.
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  2. 10 Comments

  3. by   lita1857
    Actually, and don't kill me for the comment...I was CNA-LPN-RN ok ? Nurse practice acts are where they get this stuff...and it's true LPN's don't do assessment per their role. Now do you, YES your already functioning at a different level and so are alot of experienced LPN.It's about levels of thinking and depth. I have great nurse friends who are LPN's-RN's-NP's we all talk the same language just different depth of knowledge base. Hold your head up high, you earned where you are.They are luck to have you. Good Luck
  4. by   NurseMom
    That's insane!!! Who thought up this crap? I'm an RN, but work with AWESOME LPN's who I've learned a lot from. I've never heard of this happening. Wher I work, LPN's can't hang or start IV's, but they do pretty much everything else.I'm sure you can assess pain just as well as I can. Jeez!!

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    Laurie
    so many patients...
    so little time.....
  5. by   PPL
    I agree, it IS insane! In our facility, LPN'S can't flush PICC lines, but can hang IV'S, so an RN has to flush the lines before and after, instill Hep, etc. The LPN'S can do assessments, but the RN's responsible. There is so much ********, how do we stand it????? And how can I be responsible for someting I didn't witness; I ask you? Thanks. P.S. I need a Tylenol!!! Good thing I'm an RN!!!
  6. by   iris
    I dont get it. So many different rules in so many different places. I'm an LPN at a major teaching hospital and surprisingly enough even working in two different dept. the rules can varie. In one dept. Out Pt Internal Medicine Grp. I wasn't able to review labs, triage calls and complete an assessment form without an RN counter signing. (and one RN made sure we LPN were very aware of what we could and could not do , she was on an ego trip) But yet when they were extremely busy, it was expected. I was told that I could initiate them and have the RN follow through. Well I found myself doing all the leg work and the RN's just signing off. Well policy is policy. So we LPN's decided to let the "RN's" do what only "RN's" are allowed to do, I never saw a bunch of unhappy nurses. Yet, as an LPN I was earning half the salary they were getting and doing the same amount of work load. Even more, since we were expected to stock linen in the pts. rm. order supplies and make sure supplies never ran low, etc. etc.etc. Since I transfered fr one dept to Outpt Specialty Grp in the same hosp., I'm expected to triage all calls, review labs and even call in Rx w/o an MD order as long as there's an existing Rx in the pts. chart. (and believe me, I do this with extreme caution). So go figure. I hope we LPN"s are more appreciated and better yet "more respected"

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  7. by   GraceLPN
    That is the wildest thing I have ever heard of. I work for an agency, primarily in long term care. At the facilities I go to, most of the time there is not even an RN present in the building. What am I supposed to do, call in an RN from home to determine if a resident has a real headache or not? NOT! I think it is an insult to say that LPNs can't assess pain. Our LPN's are expected to do everything that an RN would do. True, we are not allowed to access PICC lines and such, hang blood (although once the RN hits the start button on the pump, I am on my own with it), or push IV meds. However, let me get an admit on my shift and try to defer the assessment to an RN, haha. I do full admissions and an RN will sign off necessary portions of it on her own time, often never seeing the patient. I assess pain on a regular (minutely, seems like)basis. I make MD calls, send residents out to the hospital when necessary, have had to go over a few MD's heads when I felt that my resident was not getting the proper care, start IV's, administer prn meds when I feel it necessary and just about everything else. Oh well, now that I have had a chance to vent, I will get off my soap box.
  8. by   tweetieRN
    All I have to say is - when I was a new grad, I had my behind saved by an LPN on more than one occasion.
  9. by   Nancy1
    This topic is different. I am a former CNA who is now an RN. The LPNs that work for me are wonderful and do a great job. I find in my area that the facility will determine who can do what. At my former facility LPNs did not start IVs so at my new one, I wanted someone who had started an IV more frequently than me (I am in Management), when my LPN asked me why I was calling someone over, she could do it. I made sure that I took an IV refresher class since technically the LPN is under my license.
    LPNs do a great job, and I hope that you are getting respect. NA
  10. by   Smitty,RN
    What state or country do you work in- where they have made such a silly rule??!! Having been an LPN, I can sympathize with your frustration and feeling you are insulted.
    It sounds like bureaucratic B.S. The way I always looked at it was they have to keep coming up with reasons or standards why they have to keep RNS or pay them more. I have changed that opinion since I have become an RN- but, come on, that IS ridiculous. If you want to pick apart the Nurse Practice Act- then LPN's shouldn't be doing any assessments at all- not even shift assessments. Get real.
  11. by   bunky
    Danam, you've been in long term care long enough to know that it's just another retarded rule that will be forgotten in a week when the RN tells you that they're too busy to go running over to assess someone for a Tylenol! It'll pass just like so many other ridiculous ideas. It's insulting, I agree, but you know it won't last long. Hang in there, you'll see!
  12. by   MEG4
    BOY, I AM REAAALLL SORRY TO HEAR THAT. I AM LPN X10YRS, NURSE MANAGER IN LTC. WHEN I GRADUATED LPN SCHOOL I WENT DIRECTLY TO USA HOSP. IN MOBILE AL. I WAS DRAWING BLOOD, ADMIN. MEDS, ASSESSING PAIN (ON MED-SURG), ADMIN. NARCS, STARTING/HANGING IV'S/PIGGYBACKS (MIND YOU, IF I DIDN'T GET THE IV, THE ONLY PERSON THEY CALLED "AFTER" ME........WAS THE ANESTHESIOLOGIST !!!!), THAT'S RIGHT I'M DAMN PROUD, AND STILL THE BEST IN MY TOWN.....:-) . I JUST DONT UNDERSTAND HOW MUCH MORE "THEY" FEEL THE NEED TO BEAT US DOWN, WHEN LPN'S HAVE BEEN SO OVERWORKED AND NAUSEOUSLY UNDERPAID. I HAVE WORKED WITH GREAT RN'S WHO WERE WONDERFUL MENTORS, AND UNFORTUNATLY, WHAT I HAVE SEEN IS THAT SITUATIONS LIKE THIS ONLY TEACH SOME OF OUR NEWER RN'S/GRADS......TO BASICALLY TREAT LPN'S LIKE MUD. IT IS A SAD STORY, BECAUSE I KNOW THAT I HAVE "SAVED, ALOT" OF RN BUTTS!!!! WE SHOULD ENCOURAGE TEACHING/SHARING OF OUR KNOWLEDGE, SO THAT WE ALWAYS HAVE RESPECT FOR EACH OTHER. I AM SORRY FOR YOU, I WOULD BE SAYING................AFTER 16 YEARS....SEEEEE..YAAAA!!!!!! GOOD LUCK!

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