LPNs can't chart suicidal threats and they can't digitally stimulate rectums?!

Nurses LPN/LVN

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First, let me start by saying that I was not about to digitally stimulate the rectum of my coworker's patient for fear that s/he would 'vagal out'. Nevertheless, I was still asked to do that AND chart a suicide threat of the pts of a LPN I work with. LPNs, was this lady FOR REAL?!

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

duplicate threads merged as per the TOS

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Specializes in Pediatrics, Emergency, Trauma.
On my BON web pg, as far as I can see it's not mentioned. Maybe I should move to a state where scope.is more cut and dry. Or get out of LTC bc this continual can they/ cant they is getting annoying!

There is no need to "get out" of your specialty; just know where your policies and procedures are and look it up; if there isn't one, then surely you can always find the nurse educator or higher up and find out if there should be a clear-cut policy; advocate for a better policy for the pts. :yes:

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The charting thing is BOGUS. Any Nurse can chart what a patient did or said. With a suicidal ideation you also need to document that the Md was notified. The stimulation needs an order if I recall as it can cause some issues.

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Specializes in LTC,Hospice/palliative care,acute care.
The charting thing is BOGUS. Any Nurse can chart what a patient did or said. With a suicidal ideation you also need to document that the Md was notified. The stimulation needs an order if I recall as it can cause some issues.
In LTC both of those issues can raise red flags. We have p and p in place to follow through if a resident verbalizes a suicidal ideation. Our admin does not want us to document "digitally removed feces from rectum" in that way, it's something the DOH used to really focus on. I don't like to do it, I have seen a couple of folks vagal down when other nurses were in their up to their wrists (seemingly) I will push and pull on the external area and try to grab the actual feces only. Walking the resident if possible helps as does my magic drink, the Brown Cow (MOM in warm prune juice) The goal in LTC should be aggressive prevention. You as an RN really need to know the scope of practice for yourself and your co-workers and your facility policy and procedures should be in your memory bank,too.
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Specializes in Emergency, Telemetry, Transplant.
The charting thing is BOGUS. Any Nurse can chart what a patient did or said. With a suicidal ideation you also need to document that the Md was notified. The stimulation needs an order if I recall as it can cause some issues.

I don't know about policy in a LTC facility, but in the ED and staff member with chart access can and should chart SI.

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Specializes in Gerontology RN-BC and FNP MSN student.

.LPNS can handle both of those tasks. I would ask the DON then let the LPN know what is expected....or just say....

Nice try, just do your job.:rolleyes:

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.LPNS can handle both of those tasks. I would ask the DON then let the LPN know what is expected....or just say....

Nice try, just do your job.:rolleyes:

LOL, good idea. This coworker often says "I can't do xyz because I'm just an LPN." I did ask our DON if there was a certain company policy against either act and she said it was against co policy for Lpns to do digital rectal stim the first time, and that it IS ok for LPN s to chart SI. She said she's glad I asked and that I can keep contacting her w any Qs.

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