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?!

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..... or chart that their pt had voiced suicidal ideation? An old LPN I work with asked me to manually stim her pts rectum, per pts request, claiming that she can't because she is "only an LPN". #1: I flat out refused to do this for fear the pt would 'vagal out'. This nurse has tried to defer a few of her sections duties to me all under the name of "hey, im only an LPN" and was wondering if anyone has even heard of such scope limitations!?

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Specializes in Public Health.

You can very easily check your BON website for scope of practice in your state.

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You can very easily check your BON website for scope of practice in your state.

Thank you, but no these topics are not specifically addressed on my state's BON website. The definition of scope as it pertains to these topics is vauge

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Specializes in Public Health.

On my BON website there is a section for the nurse practice act. This itemizes what you can and cannot do. Also practice decisions get very specific on what is and isn't legal.

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On my BON website there is a section for the nurse practice act. This itemizes what you can and cannot do. Also practice decisions get very specific on what is and isn't legal.

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!

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

Without specifics.....Rectal stimulation may be a part of the bowel regime....and as far as I know can be performed by an LPN. If you heard the threat of SI yes you should document it.

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Specializes in Pediatrics, Emergency, Trauma.

To answer your first question: I dig stim as a LPN; but that was because I worked with SCI pts and it was necessary; and part of a bowel regimen.

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Specializes in Complex pedi to LTC/SA & now a manager.

Why can LPNs not chart suicidal threats? We are mandated to in my state. Digital recital stimulation may be performed by an LPN (in my and most other states) only under the order of a physician as part of a treatment plan (it's not a nursing intervention)

Why are you charting for another nurse ? That is the only issue I see. I would not chart on my patient that nurse crystal, LPN states that patient reported suicidal ideation including a plan to stockpile Valium and overdose. I would document patient stated "I don't want to live anymore, I am going to stockpile all the Valium you give me and overdose!" 1:1 monitoring initiated, Dr IB Grumpy, MD notified of patient status, psychiatry & counseling consults ordered stat, request entered to move pt room closer to staff area.

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Specializes in Pediatrics, Emergency, Trauma.
Without specifics.....Rectal stimulation may be a part of the bowel regime....and as far as I know can be performed by an LPN. If you heard the threat of SI yes you should document it.

This.

I have dig stimed and charted SI as an LPN...bowel regimens and charting was a part of my scope...however, your facility's policy may differ in terms of what a LPN can do; best to find out what the policy is.

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Specializes in Complex pedi to LTC/SA & now a manager.

Not without a physicians order, can't be done by patient request or nursing intervention unless bowel regime/ protocol in place.

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Legally, you can do both as a LPN. Your facility's policy might be another matter.

I have manually removed feces from rectums more times than I care to think about. Working with paraplegic pts who take buckets of narcotics, it's a routine task for LPNs where I work. Never once have I caused any pts to "vagal out". Personal experience shows to me that the phenomenon is obviously pretty rare. I doubt very much that there's any special technique a RN's expertise would have over a LPN. If a pt were to ever have an episode of syncope during the treatment, you would obviously stop and assess.

as for charting suicidal ideation, why wouldn't a LPN document what they hear? How is that beyond your scope?

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