Having come from a little larger hospital(200 beds) I was told in staff meetings that by a Doctor office giving a telephone order to an LPN and then the LPN giiving that order to an RN, it was a violation of the nurse practice act. Example: Dr. J./Office Person/ Sally LPN/Jane RN. Now I am working at a critical care access facility and they tell me it is not. Can someone explain to me why the same rules do not apply in both situations. Are all states this way?
Jan 18, '12
by Meriwhen, ASN, BSN, RN Senior Moderator
IMO, based on how you wrote the situation I can't see how it's a violation of the nurse practice act. Also, a LVN telling a RN about what a doctor ordered for a patient doesn't necessarily qualify as delegation either.
Look at it this way: the LVN happened to be the one who took the orders from the doctor on the telephone, and in several states that's perfectly legal for her to do. Now, those orders need to be carried out on the patient and in all honesty, the doctor doesn't care if Nurse X or Nurse Y or Nurse Z does it, as long as his orders are implemented. So does it matter if it's the LVN who took the telephone order that implements them, or if the RN who didn't answer the phone does them?
(It goes without saying that scope of practice will dictate what the LVN can and can't do as far as the actual orders).
So unless I'm missing something and/or you forgot to add a key piece of info, I really don't see what the problem is.
Last edit by Meriwhen on Jan 18, '12