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This is a discussion on LPN scope of practice in Michigan in Michigan Nursing, part of United States Nursing ... Hi all, I am a new(er) LPN who will finish her RN in about 12 weeks! :yeah: In the meantime, I...by happynewLPN Sep 16, '08Hi all,
I am a new(er) LPN who will finish her RN in about 12 weeks! In the meantime, I am employed at long-term care facility and there is question regarding my scope of practice, what things I can and cannot do as a licensed practical nurse.
1. Can we pass oral medications without having taken any sort of test, such as NAPNES?
2. Are we allowed to transcribe verbal/telephone orders from a physician?
3. Are we allowed to flush PICC lines? We have a resident with a PICC line and we flush it q 12 hrs using saline and heparin.
4. Are we allowed to hang new IV antibiotics or monitor the IV without prior training?
5. Also, we do not always have an RN on site to supervise activities on off-shifts (2nd and 3rd shifts). Is this permissible?
Thanks for any info. I will be calling the State Board of Nursing tomorrow, but I just wondered if anyone could give me a heads-up in the meantime.
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- Sep 16, '08 by juan de la cruzThe State of Michigan is one of those states that do not go into much detail when it comes to its Nurse Practice Act. We actually no longer have a nurse practice act per se but the Michigan Public Health Code is the law that defines the practice of nursing in Michigan. This law also creates the Board of Nursing for our state.
As far as LPN's the Michigan Public Health Code merely states, “Practice of nursing as a licensed practical nurse” or “l.p.n.” means the practice of nursing based on less comprehensive knowledge and skill than that required of a registered professional nurse and performed under the supervision of a registered professional nurse, physician, or dentist. (see http://www.legislature.mi.gov/(S(uts...=mcl-333-17201). Pretty darn simple isn't it?
Anyway maybe I can take a shot at your questions but do talk to someone at the BON so you can get the definitive answer.
1. Technically, yes. You have learned pharmacology in your program so you should be able to pass oral meds.
2. Yes, the law states that LPN's are under supervision of a physician (or an RN or a dentist as the law states) so if the physician orders something, an LPN is qualified to transcribe and carry out the order written or verbal.
3. Now, I do not know if IV flushes and IV meds are part of the competencies included in an LPN program. I always thought they are not. However, I think that is where NAPNES comes in. I believe NAPNES offers IV lines and drug management courses for LPN's and that's how they can practice IV lines and drug management.
4. Same answer as number 3.
5. There is no definite language in the law that states that on-site supervision is the requirement.
- Sep 16, '08 by happynewLPNThanks for the reply. I know that some LTCF's require NAPNES certification before they will even hire a new LPN, so apparently this might be optional?...
Being that I've received no formal IV training, I do not feel comfortable flushing PICC lines, manipulating drip rates, etc. Granted, I'm getting exposure to that during my clinical time right now, but that is as a 'student', not an 'LPN'.
I'll be sure to post an update when I talk to the BON tomorrow.
- Sep 17, '08 by Sirena922Welcome Happy, where did you go for your LPN and what school are you attending now for your RN?
- Sep 29, '08 by happynewLPNI am currently attending Mott CC for my ADN.
I'll be finished on Dec 18th!!!
- Sep 30, '11 by William VanOrden LPNLicensed Practical Nurses may:These are the Job Duties listed on Michigan.gov pageJOB DUTIES
Assist in the development and modification of patient plans of care
Take and record temperature, pulse, blood pressure, respiration rate, height, and weight
Dress wounds, draw blood samples, and give tube feedings
Give enemas, douches, irrigations and catheterizations
Apply compresses, ice bags, or hot water bottles
Observe patients and chart and report reactions to registered nurse or physician in charge
Sterilize equipment and supplies, using germicides, sterilizers, or autoclaves (a pressurized, steam-heated vessel)
Give prescribed medication or start intravenous fluids when authorized by a licensed physician, dentist or registered nurse
Assist patients in activities of daily living, such as eating, exercising, bathing, oral hygiene, and making beds
Assist with teaching patients good health habits
Perform simple diagnostic tests
Turn patients in bed, position, and help them walk
Record the intake and output of food and fluids
Care for mothers in labor and after childbirth
Feed infants and newborn babies
Provide emotional support for patients and families
Provide post-mortem care for patients who have died
Provide pre-operative and post-operative care
Care for patients in isolation, in casts, or in traction
Observe patient monitoring equipment
Supervise care delivered by nurse aides as delegated by a registered nurse