From the California Code of Regulations:
TITLE 22. Social Security
Division 5. Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies
Chapter 1. General Acute Care Hospitals
Article 3. Basic Services
70215. Planning and Implementing Patient Care
(a) A registered nurse shall directly provide:
(1) Ongoing patient assessments as defined in the Business and Professions Code, Section 2725(d). Such assessments shall be performed, and the findings documented in the patient's medical record, for each shift, and upon receipt of the patient when he/she is transferred to another patient care area.
(2) The planning, supervision, implementation, and evaluation of the nursing care provided to each patient. The implementation of nursing care may be delegated by the registered nurse responsible for the patient to other licensed nursing staff, or may be assigned to unlicensed staff, subject to any limitations of their licensure, certification, level of validated competency, and/or regulation.
(3) The assessment, planning, implementation, and evaluation of patient education, including ongoing discharge teaching of each patient. Any assignment of specific patient education tasks to patient care personnel shall be made by the registered nurse responsible for the patient.
(b) The planning and delivery of patient care shall reflect all elements of the nursing process: assessment, nursing diagnosis, planning, intervention, evaluation and, as circumstances require, patient advocacy, and shall be initiated by a registered nurse at the time of admission.
(c) The nursing plan for the patient's care shall be discussed with and developed as a result of coordination with the patient, the patient's family, or other representatives, when appropriate, and staff of other disciplines involved in the care of the patient.
(d) Information related to the patient's initial assessment and reassessments, nursing diagnosis, plan, intervention, evaluation, and patient advocacy shall be permanently recorded in the patient's medical record.
Hospitals are cheating the patients and nurses by unsafe staffing levels. Any RN who does not collaborate with an LVN on the team is a fool.
Assessment includes not only data collection, including such sophisticated data as lung and heart sounds. Assessment is the analysis and synthesis of data to come up with a plan of care.
An LVN being licensed is responsible for nursing care assigned by the RN. The RN is responsible for effective supervision. Hospitals have staffed in such a way as to put the license of the LVN and the RN at risk. The RN MUST be available to all patients.
They do this yet do not PAY the LVNs for this added responsibility! Not even one cent more much less what they pay an RN. Shame on them!