LPNs in home health in Illinois & telephone orders

Trauma Columnist · Mar 15, 2012

Hmm - I'm an APN in IL and I give phone orders all the time to LPNs in NH.

ruthalittle · Mar 15, 2012

Thanks much for the response. I've spoken with an LPN who works at an assisted living facility where I visit patients (in Illinois). In assisted living the LPN's are not allowed to provide wound care (!) but can take phone orders. I am allowed to provide wound care, but not take phone orders. She said, "Each of us is half a nurse. Together we make 1 whole nurse!" In a hospital or SNF setting in Illinois I can take phone orders as long as they are co signed by an RN. I don't know the regs in other states, except that I'm told in Wisconsin an LPN can do anything an RN can do as long as the LPN is certified in that area of nursing.

I'm really hoping someone can tell me if there is anywhere it is stated in writing that in the state of Illinois specifically, an LPN in home care is prohibited from taking phone orders.

The Illinois board of nursing has not responded to my NUMEROUS phone calls & emails on this matter over a period of 2 years

ruthalittle · Mar 18, 2012

I put this question out there a few days ago. Saw a wonderful post with a link for rules & regs in PA. Does anyone have or know of a link that spells it out for the state of Illinois?

Thanks so much for sharing if you do!

xoemmylouox, ASN, RN · Mar 19, 2012

I have seen lots of vague nurse practice acts out there. Not to mention quite a few frustrating BONs to boot. Good luck to you finding your answer. Most likely your homecare had an incident or two with LPNs taking orders so to deal with it they just don't allow it anymore..

ruthalittle · Mar 19, 2012

Thanks for the input. I've heard this now from 2 employers, who said it came directly from the state surveyor. I just wish The Illinois Board or Association of nurses would respond to me. I'm not certain if the lack of response is due to bureaucracy or the fact that I am an LPN.

anniv91106 · Mar 22, 2012

Thanks much for the response. I've spoken with an LPN who works at an assisted living facility where I visit patients (in Illinois). In assisted living the LPN's are not allowed to provide wound care (!) but can take phone orders. I am allowed to provide wound care, but not take phone orders. She said, "Each of us is half a nurse. Together we make 1 whole nurse!" In a hospital or SNF setting in Illinois I can take phone orders as long as they are co signed by an RN. I don't know the regs in other states, except that I'm told in Wisconsin an LPN can do anything an RN can do as long as the LPN is certified in that area of nursing.
I'm really hoping someone can tell me if there is anywhere it is stated in writing that in the state of Illinois specifically, an LPN in home care is prohibited from taking phone orders.
The Illinois board of nursing has not responded to my NUMEROUS phone calls & emails on this matter over a period of 2 years

Who does the BON answer to--gather your documentation of attempts to communicate and go higher.

ruthalittle · Mar 22, 2012

Thanks for all the feedback. It's not the company or BON I'm having an issue with, it's the state board who is not returning my enquiries.

I really WOULD have a problem with not being able to take orders if the RN case managers & LPN's hadn't thought up a way to ensure safety for our patients. The LPN is usually the one who's seen the patient, so if we call the RN case manager with our assessment, then the case manager calls the MD or APN & relays the information it's like the game of telephone we played as children. Each time the information is repeated, there is the risk of some small thing changing, increasing the risk for error & injury to the patient. All of the RN's & LPN's are in agreement on this. What we do to remain within the guidelines we're given is to call the MD directly with our assessment, then document the assessment briefly on a verbal order sheet (we're now computerized so depending on the program used there's also a way to do this), write below our assessment in caps "PLEASE WRITE ORDERS HERE" & fax it to the MD or APN & notify the RN case manager. The original is given to the case manager.

Occasionally an MD will insist on giving orders directly to me. I then document the orders given & notify the RN. She then is supposed to verify the orders & write a phone order.

It's all a little silly, but as long as we put our pt's safety first it's not that big of a deal. The RN's I work with are really great. They're competent & respectful. Unfortunately that hasn't always been the case. I start the 2nd job with the new company closer to my home today. I have no idea what my co workers & supervisors will be like, so I definately haven't resigned from the company where I have to drive long distances. I keep wondering if it's possible to have such great co workers at 2 companies! We will see.

Owloveyou · Mar 23, 2012

In assisted living the LPN's are not allowed to provide wound care (!) but can take phone orders. I am allowed to provide wound care, but not take phone orders. She said, "Each of us is half a nurse. Together we make 1 whole nurse!"

In our ALF's in F.L. the LPN's do not do any nursing care that is unrelated to the meds, like wound care, iv's, pt/inrs, etc. That's why the HH nurses are in. Here, it varies on the contracts the ALF's have with the patients. Most are medication only. There are some ALF's that are starting their own home health agencies to then be able to treat patients, but they follow the same rules for certification periods, etc.