LPN goin beyond scope of practice - page 5

by SweetheartRN

7,753 Unique Views | 46 Comments

LPN was doing assessments and discharges on patients. This is beyond her scope of practice but no patients have been harmed as a result of this so if reported the BON will most likely just "tap her on the hand" right? Nursing... Read More


  1. 2
    In our state, LPNs are allowed to do assessments and discharges, as long as an RN cosigns the paperwork with them. At our hospital, we utilize the help of the LPNs and don't complain when one steps up and says, "it's okay, I've done that assessment," or, "don't worry, I'll handle that discharge." I don't want to sound rude, but I feel like it's a little ridiculous to consider reporting this to the BON. However, I do admire the fact that you are so concerned with patient safety and correct procedure. The best advice I can give is to Google state policies and procedures for whatever state you live in and find out for sure what the scope of practice for an LPN is. If you do that, there won't ever be another question about whether an LPN is doing something outside the scope of their practice. Also, like you said in your post, no one was harmed so the LPN, or LPNs, involved obviously know what they are doing. I say just relax, let it go, and look up the scope of practice.
    mehitabela and JacknSweetpea like this.
  2. 2
    Where I live I can do assessments, discharges, admissions, and initiate care plans. In some facilities I can also initiate wound treatments. An RN has to sign off on them, and I pass them off per protocol, but it's not my fault if the RN doesn't get to them when they should. Why report the LPN for that?

    Why would it be necessary to even report the RN when they're probably up to their earlobes in paperwork and are unable to stay on top of every little thing that they should be doing?

    If the LPN is doing these tasks and the State BON says it outside the scope of practice, my first concern would be that the fault lies in the facility that is making LPNs practice outside their scope and is then not making it possible for the RN to follow up.

    That then puts both the RN and the LPN at risk when they are just trying to do their jobs to the best of their abilities in a facility that doesn't give a crap.
    makes needs known and Start2 like this.
  3. 2
    I have no opinion on the OP topic.

    What I do have strong feelings on are the statements that this is none of the OPs business.

    Under the ANA Code of Ethics this would fall under:

    3.5 Acting on Questionable Practice
    6.2 Influence of the Environment on Ethical Obligations
    6.3 Responsibility for the Health Care Environment

    Not to mention the OP almost certainly has a legal obligation under her NPA to question and report perceived questionable practice by a fellow nurse.

    Every nurse has the legal and ethical obligation to monitor and report any perceived questionable acts of practice, I give kudos to the OP for having the courage to ask her cohorts what their advice is knowing full well that she would not receive favorable attention from many.
  4. 4
    SweetHeartRN-

    Normally I don't read prior posts but in your case I did, which details the history of your employment with the hospital and all the politics and your resentment of this person because you basically feel she got hired for the job you felt entitled to have. You commented about how because you were hired as a nurse's aide, you were upset because you were "stuck doing vitals", and how she can't even get meds without help" etc. You talked about the "underhanded maneuvering".

    You've called the employee helpline, talked to numerous other nurses and ascertained their feeling that an RN was a better choice because this particular person can't do all the things you would be able to do. I would be upset, too if two more RNs were hired while all of this was going on and you had worked there as a unit secretary and as an NA.

    Now you and your family are (or want to) talk to the Public Relations Department of your hospital because of the injustice you feel has occurred here that "reflects badly on the hospital". So I respect what Systole and others have said, I don't think this is simply an objective case because you are concerned someone might be harmed by this individual. They might not see it as courageous at this point if your facility is the same gossip mill that every place I've worked for has been to some degree.

    I hope things get better for you and that you can be hired as a new grad RN someplace and that you got a raw deal from the hospital. ...
    Last edit by nursel56 on Mar 25, '11
    TheCommuter, marthyellen, *Posh*, and 1 other like this.
  5. 0
    Quote from ladybuglouRN
    In my state(NY) LPN's are absolutely not allowed to assess or discharge patients. They are allowed to collect data and consult with the RN about what they have collected but the RN has the final say.
    Yikes, that sounds like a tech/ nursing assistant job.
    I feel bad that people go to college, become an LPN, and can't get hired/get pigeonholed into nursing assistant roles. We should either let them do everything they are trained to do or get rid of LPN training programs all together. Just feels like a bait and switch.
  6. 1
    Quote from Asystole RN
    I have no opinion on the OP topic.

    What I do have strong feelings on are the statements that this is none of the OPs business.

    Under the ANA Code of Ethics this would fall under:

    3.5 Acting on Questionable Practice
    6.2 Influence of the Environment on Ethical Obligations
    6.3 Responsibility for the Health Care Environment

    Not to mention the OP almost certainly has a legal obligation under her NPA to question and report perceived questionable practice by a fellow nurse.

    Every nurse has the legal and ethical obligation to monitor and report any perceived questionable acts of practice, I give kudos to the OP for having the courage to ask her cohorts what their advice is knowing full well that she would not receive favorable attention from many.
    I concur.

    Doing a full assessment on a patient and signing "LPN" behind it - in and of itself - does not constitute gross negligence or incompetence. The fact that the employer took that assessment as final and complete is not the fault of the LPN.

    HOWEVER.....

    If the LPN willfully and knowingly performed functions that were limited to the RN scope of practice in the state that the LPN is practicing in, is this going to be the consensus of this forum to state that the OP is going overboard in questioning this practice and to turn a blind eye to this incident since the employer decided to remove their blessings from the practice in question?
    SweetheartRN likes this.
  7. 0
    Quote from nursel56
    SweetHeartRN-

    Normally I don't read prior posts but in your case I did, which details the history of your employment with the hospital and all the politics and your resentment of this person because you basically feel she got hired for the job you felt entitled to have. You commented about how because you were hired as a nurse's aide, you were upset because you were "stuck doing vitals", and how she can't even get meds without help" etc. You talked about the "underhanded maneuvering".

    You've called the employee helpline, talked to numerous other nurses and ascertained their feeling that an RN was a better choice because this particular person can't do all the things you would be able to do. I would be upset, too if two more RNs were hired while all of this was going on and you had worked there as a unit secretary and as an NA.

    Now you and your family are (or want to) talk to the Public Relations Department of your hospital because of the injustice you feel has occurred here that "reflects badly on the hospital". So I respect what Systole and others have said, I don't think this is simply an objective case because you are concerned someone might be harmed by this individual. They might not see it as courageous at this point if your facility is the same gossip mill that every place I've worked for has been to some degree.

    I hope things get better for you and that you can be hired as a new grad RN someplace and that you got a raw deal from the hospital. ...
    Thankyou Nursel56:heartbeat
    Edited to say I forgot to say I have been working with PSA because that is all I could find plus its kiddies so that part of it is nice.
    Last edit by SweetheartRN on Mar 26, '11


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