Can anyone give me an exact link that tells me ALL the specifics for the scope of practice for an LPN is? I found a link on the state board of nursing that tells me all about the IV med things (and of course that is out of my scope of practice) but I need even more specifics on ALL things I am running into on the soon to be all rehab floor I am working.
I am VERY upset right now. Last night the overnight LPN told me that I need to refuse to do a strictly saline flush of a nephrostomy tube because that is out of my scope of practice. Only an RN is aloud to do this!
What's worse is I ALREADY did it. Not just once either. I was in training and an RN super took me to my first nephrostomy tube showed me what was to be done and ever since they have been having me not only do this but teach other nurse's how to do it?! I do the dressing changes around these tubes every evening also?
I am REALLY questioning everything I am told to do and not do at this facility. So if I cannot do saline flushes on nephrostomy tubes does that also mean I should not be doing saline flushes on PICC lines? They also taught me to do those too and have me doing them all the time too?! (Mind you I must get an RN to do the dressing changes on these. They do NOT have me do those?)
I do not ever start or hang IV fluids or meds but they DO have me do the saline flush to the line after meds are completed? The RN comes, hangs the meds then tells me what time to expect them to be completed and I am to go saline flush and disconnect them.
I never touch anything to do with TPN. The RN does all that and no one tries to make me do that.
I am do confused and upset right now. I can't even remember what I was taught at school I am so upset!
Jul 28, '12
There is no such document as scope of practice varies from state to state. Have you tried calling your board of nursing?
Since you said you are in PA, I've found these documents:
21.414. Interpretations regarding the functions of Licensed Practical Nurses (LPN)—statement of policy.
(a) Collection of venous blood samples fall within the scope of Licensed Practical Nurse (LPN) practice under 21.145(a) (relating to functions of the LPN).
(b) The following nursing practices fall within the scope of LPN practice under 21.145(b):
(1) Changing cystostomy tubes after the stoma heals.
(2) Changing gastrostomy tube when stoma is healed.
(c) The following nursing practices fall within the scope of LPN practice under 21.145(a) and (b):
(1) Insertion of nasogastric tubes.
(2) Changing outer tracheostomy tube after stoma is healed.
(3) Addition of medications to peritoneal dialysate in the care of those patients with chronic renal disease.
(4) Removal of sutures of a simple and uncomplicated nature.
The specifics regarding LPNs and IVs are due to come out in the upcoming weeks as per a notice on the BoN website, http://www.portal.state.pa.us/portal...egulations_pdf
(this seems to include expectation regarding LPNs and central lines)
Last edit by JustBeachyNurse on Jul 28, '12