RN's signing LPN Charts - page 2

At our facility in VA, we are told we have to sign all the charts and orders for the LPNs, we are doing team nursing on days so that it is automatically done. The RN assess's and does all the... Read More

  1. by   shelynch
    thanks, that's pretty much the way i understand it. i think the change paper will be to make the RN get off of her butt and do the admission assessments. in our LTC facility, the LVN does ALL the admissions, sometimes 2, 3, or 4 admissions in an 8 hour shift. that is a prescription for disaster. we feel like we put our license on the line every time we do an assessment. maybe if we quote the NPA, they will realize they are assigning something to us that is out of our scope of practice. even the admission form says INITIAL NURSING ASSESSMENT. you have helped me make my decision. thanks a gazillion!
    shelynch
  2. by   RN34TX
    Quote from shelynch
    thanks, that's pretty much the way i understand it. i think the change paper will be to make the RN get off of her butt and do the admission assessments. in our LTC facility, the LVN does ALL the admissions, sometimes 2, 3, or 4 admissions in an 8 hour shift. that is a prescription for disaster. we feel like we put our license on the line every time we do an assessment. maybe if we quote the NPA, they will realize they are assigning something to us that is out of our scope of practice. even the admission form says INITIAL NURSING ASSESSMENT. you have helped me make my decision. thanks a gazillion!
    shelynch
    LTC can be tricky and the rules a bit different, not sure. I never worked LTC in TX, only in other states.
    I know that in acute care if LVN's take an admission I always had to get an RN to co-sign my initial assessment. Or other facilities did not allow me to fill out the initial assessment part of the admission and gave that part to the charge nurse.
    I know what you mean, all through LPN school we were told we couldn't assess, then went to work upon graduation and performed one assessment after another filling out all of those pages, no RN in site to help.
  3. by   JHUBRAIN
    Quote from RN34TX
    LTC can be tricky and the rules a bit different, not sure. I never worked LTC in TX, only in other states.
    I know that in acute care if LVN's take an admission I always had to get an RN to co-sign my initial assessment. Or other facilities did not allow me to fill out the initial assessment part of the admission and gave that part to the charge nurse.
    I know what you mean, all through LPN school we were told we couldn't assess, then went to work upon graduation and performed one assessment after another filling out all of those pages, no RN in site to help.

    At our hospital in OKC we have to have the RN sign off on all LPNs Physical assessments (not orders) - It says in the LPNs state laws that they may contribute to the Physical assessment - Prior we let the LPNs do there own -Then we got hit by the State on that one and they read us the riot act and ticked us for it. The LPNS were not very happy about it, I mean we have some great LPNS - but neither were the RNS - Good Luck - GP
  4. by   GN1974
    In LPN school I was taught that LPN's collect and record data and RN's assess patients. In the hospital I just started working at, the initial assessment is to be completed by the RN, but the LPN can do it after that. I just finished an ADN program and really think if I am expected to sign off on LPN assessments that I must validate it. I will not put myself at risk for taking the word of another. If my name goes on it...I will validate it. Honestly, I learned much of my assessment skills and patient care while working as an LPN. I think all the science courses and more in depth nursing courses also made me see the differences between the two types of practice and the responsiblities each carries. I also think there are lazy LPN's and RN's but it rather bothers me when I see LPN's say "get the RN off her butt to do this or that", maybe the LPN should see that they may be busy co-signing and checking things! Really laziness abounds in both practices but it is more often that I hear LPN's saying this about RN's and I don't think it to be completely accurate!
    Karen
    Last edit by GN1974 on Mar 8, '05
  5. by   shelynch
    Quote from GN1974
    In LPN school I was taught that LPN's collect and record data and RN's assess patients. In the hospital I just started working at, the initial assessment is to be completed by the RN, but the LPN can do it after that. I just finished an ADN program and really think if I am expected to sign off on LPN assessments that I must validate it. I will not put myself at risk for taking the word of another. If my name goes on it...I will validate it. Honestly, I learned much of my assessment skills and patient care while working as an LPN. I think all the science courses and more in depth nursing courses also made me see the differences between the two types of practice and the responsiblities each carries. I also think there are lazy LPN's and RN's but it rather bothers me when I see LPN's say "get the RN off her butt to do this or that", maybe the LPN should see that they may be busy co-signing and checking things! Really laziness abounds in both practices but it is more often that I hear LPN's saying this about RN's and I don't think it to be completely accurate!
    Karen
    don't be offended by the "off her butt" bit. i apologize for that if it upset you. i can only speak for the RN in my facility. i will be an RN in a couple of months and i hope i am not the kind of RN that is referred to as she is. my point was that the LVNs are being forced to do something that is out of their scope of practice, corporate knows it, the RN that accepted the responsibility as DON knows it, LVNs probably don't realize it because they haven't been to a higher level of education to learn it (how many LVNs do you know that are familiar with the NPA?) and it's a prescription for disaster. someone could lose their license behind that if something vital is missed in an initial assessment. in my facility, the only time the RN (which by the way the only 2 RNs in the building are the DON and the ADON/Medicare coordinator) assesses anything about a patient is if the LVN brings something to her attention that is grossly out of scope of practice.
  6. by   diablo
    Quote from shelynch
    don't be offended by the "off her butt" bit. i apologize for that if it upset you. i can only speak for the RN in my facility. i will be an RN in a couple of months and i hope i am not the kind of RN that is referred to as she is. my point was that the LVNs are being forced to do something that is out of their scope of practice, corporate knows it, the RN that accepted the responsibility as DON knows it, LVNs probably don't realize it because they haven't been to a higher level of education to learn it (how many LVNs do you know that are familiar with the NPA?) and it's a prescription for disaster. someone could lose their license behind that if something vital is missed in an initial assessment. in my facility, the only time the RN (which by the way the only 2 RNs in the building are the DON and the ADON/Medicare coordinator) assesses anything about a patient is if the LVN brings something to her attention that is grossly out of scope of practice.
    how many LVNs do you know that are familiar with NPA?
    A little condescending??

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