ANCC & LVN's

[Mary Lynn Briggs]

I have two question for anyone out there who cares to answer.

First of all I am taking the ANCC med surg exam 10/98. Has anyone else taken it? Have any tips on what to expect?

Next question. My hospital has developed a new acuity system with new charting. THhe new requirment is that Rns now have to cosign all LVN charts. I am very uneasy about it and am trying to fight it. Anyone have any suggestions? Thanks in advance

[Marni Hancock]

Mary Lynn, I, too, would be concerned. To me, my signature after the LVN/LPN's would imply that I had knowledge that the care documented had, indeed, been given and that all significant data had been recorded. Unless I have the opportunity to truly supervise the LVN/LPN, I wouldn't want to cosign that licensed care giver's notes.

The second question I would have is why a licensed nurse would need his/her documentation cosigned. I am aware that the LPN nurse practice act in my state defines the LPN as one who gives care under the supervision of an RN, MD, etc. The reality, however, is that the LPN gets as much of an assignment as I do, and neither of us usually has time to check on the other.

I think you need to determine the logic behind the demand and disprove the logic if at all possible. Good luck,

Marni Hancock

[crista]

I am a nurse in California and at the hospital I worked in the RN's had to co-sign for the LVN's charts and assessments too. When setting up the assignment for the day, we would assign an RN to "cover" for an LVN(s) on duty that day. I really didn't have any trouble with this system. Possibly due to the fact that I was a new grad at the time and just learned to incorporate it into my daily routine. Also, the LVN's that I worked with were very experienced nurses and I respected them and their work alot, so I therefore trusted their judgement and had no problem signing off orders for them. This may be a policy in your facility or even a statewide policy of practice. Good luck!

[lisat]

I am a new grad RN working at an inpatient rehab. hosp 11p-7a. I too am required to co-sign the charts of the LPN who works with me. A typical patient load is 12-17 patients each. With this many pts. of my own to care for, it is impossible for me to know much if anything of what is going on with the LPN's pts unless there is a problem and they come discuss it with me. My co-signing a chart that I truly know little or nothing about makes me very nervous from a legal standpoint.