PA Board refuses to answer skills question - page 2

a debate arose at work regarding the legality of performing of a specific skill. staff nurses and nursing directors were not in agreement. i contacted the pa state board of nursing to get the answer.... Read More

  1. by   jimthorp
    I have not given up and am using another avenue.
  2. by   PANurseRN1
    Quote from jimthorp
    a debate arose at work regarding the legality of performing of a specific skill. staff nurses and nursing directors were not in agreement. i contacted the pa state board of nursing to get the answer. in one response the respondant provided an opinion but could not cite any part of 49 pa code to support it. i disagreed with the respondant's opinion and cited parts of 49 pa code to support my opinion. the respondant then replied with the following quote; "the board has no authorization to offer you opinions, legal advice or interpretations of the professional nursing law and regulations" and "we suggest that you consult with your own legal counsel..."

    this response from the regulatory body of nursing in pa was quite a shock.

    has anyone here had problems getting anwers from the pa board of nursing?

    jt
    oh yeah. repeat after me: the pasbon is not your friend. they won't answer your questions, but as sure as gun's iron, they will go after your license like jaws goes for chum if you wind up messing up.

    in 22y i have had to contact the pasbon three times. each time, i was met with indifferent, if not outright rude staff. the system needs a major overhaul.

    sorry i can't offer you a better answer, but i did wind up getting my own atty. to interpret an issue regarding licensure for me because i got the same drivel from the board that you did. it's ridiculous that they will not explain the statutes they hold us to.
  3. by   suni
    I believe you also need to check your employer's policy. You definitely need education and training on the job and I believe that LPN's must have yearly training to continue to hang IVAB, and draw labs. Not sure but will see if I can track that info down in the next few days.
  4. by   jimthorp
    Quote from suni
    I believe you also need to check your employer's policy. You definitely need education and training on the job and I believe that LPN's must have yearly training to continue to hang IVAB, and draw labs. Not sure but will see if I can track that info down in the next few days.

    I have already checked with my facility and no document has been provided. However, the DON told me that no boundaries exist for LPN practice other than the PA-NPA.
  5. by   RN34TX
    Quote from jimthorp
    I have already checked with my facility and no document has been provided. However, the DON told me that no boundaries exist for LPN practice other than the PA-NPA.
    So that means that your employer mas not made any additional restrictions or stipulations for LPN practice at your facility.

    I've been reading this thread but have not commented on it previously because my info might be outdated.

    But for what it's worth, I worked as an LPN in PA in the 90's and experienced some of the same confusion.

    When I first received my PA LPN license, along with the PA rules and NPA booklet, I also received an insert that specifically dealt with LPN's and central lines because they had gotten so many recent calls inquiring about this.

    "In the opinion of the board...." (yawn) it was considered to be within LPN scope of practice to administer meds that LPN's are allowed to administer, flush, change the dressings, etc.

    The facility where I was working at the time was going crazy because they didn't specifically mention whether or not LPN's could draw blood from central lines and the board just wouldn't clarify or expand upon their previously issued statement.

    I learned later that the vagueness was not unique to PA many years later when Hurricane Rita struck.

    Many nurses bombarded the TX BNE with questions about what is considered to be patient abandonment as many of us were threatened with this by our employers during the time following Hurricane Rita.

    Of course the TX BNE's only response was the usual vague "Case by case basis" baloney which only means that it leaves them open to interpret the NPA and laws however they want to with respect to each licensure hearing/complaint and they can twist and bend their interpretations to fit their desired outcome and decision of each licensee.

    They don't want to be put into a position where the nurse in question followed the NPA and letter of the law to the point where the BNE couldn't touch them because they followed their specific rules and regs.

    As long as they leave it vague and open to multiple interpretations, they always have an "out" to snag a nurse in any situation and control the outcome of disciplinary action.
  6. by   RN34TX
    I'd also like to add that this may inspire me to work toward someday getting a job at a state board.

    They seem to have a corner on the market being the only nursing jobs where you are literally not responsible or held accountable for the things you say and do.

    That is, if you say or do much of anything at all during your 8-4 work day.
  7. by   Havin' A Party!
    Quote from RN34TX
    I'd also like to add that this may inspire me to work toward someday getting a job at a state board.

    They seem to have a corner on the market being the only nursing jobs where you are literally not responsible or held accountable for the things you say and do.

    That is, if you say or do much of anything at all during your 8-4 work day.
    Hahaha! :chuckle
  8. by   jimthorp
    Quote from rn34tx
    when i first received my pa lpn license, along with the pa rules and npa booklet, i also received an insert that specifically dealt with lpn's and central lines because they had gotten so many recent calls inquiring about this.

    "in the opinion of the board...." (yawn) it was considered to be within lpn scope of practice to administer meds that lpn's are allowed to administer, flush, change the dressings, etc.

    the facility where i was working at the time was going crazy because they didn't specifically mention whether or not lpn's could draw blood from central lines and the board just wouldn't clarify or expand upon their previously issued statement.

    apparently the confusion and uncertainty exists even at educational institutions. a nurse i work with graduated about 4 years ago. she was told in school she could not touch a picc line.

    i did not recieve anything in the mail with my license but upon graduation the school provided me with a copy of "professional nursing law and practical nurse law."

    of course the tx bne's only response was the usual vague "case by case basis" baloney which only means that it leaves them open to interpret the npa and laws however they want to with respect to each licensure hearing/complaint and they can twist and bend their interpretations to fit their desired outcome and decision of each licensee.

    they don't want to be put into a position where the nurse in question followed the npa and letter of the law to the point where the bne couldn't touch them because they followed their specific rules and regs.

    as long as they leave it vague and open to multiple interpretations, they always have an "out" to snag a nurse in any situation and control the outcome of disciplinary action.
    my feelings exactly and rather disappointing indeed. i am 99.9% certain i have the correct interpretation and simply wanted the bon to remove the remaining doubt.

    it's interesting that at first they provided an opinion which disagreed with mine. the bon said that; "section 21.145(f) of the lpn regulations stand, which refer to peripheral iv lines only, not picc lines". when i questioned where it says this and pointed out that specific vad's are not mentioned anywhere in the pn law they suddenly came back with; "the board of nursing is not authorized to offer advisory opinions or give advice" and told me i had to get my own attorney. nowhere in the law does it say the bon cannot give advice or opinion regarding the law.

    the regulatory body of hunting and trapping in pa is the pennsylvania game commission and just like the bon they do not make the laws but regulate and enforce them. i have never had a problem getting a definitive answer from the pgc regarding interpretations of the game law. likewise for the batf.


    i am pursuing another avenue for the answer. if it produces the same result i will certainly pressure my state assemblymen to change this.
  9. by   RN34TX
    Quote from jimthorp
    Apparently the confusion and uncertainty exists even at educational institutions. A nurse I work with graduated about 4 years ago. She was told in school she could not touch a PICC line.
    I don't know of any RN who had much of any education regarding LPN's and their scope of practice in nursing school.

    The frightening thing about this is so many RN's end up in jobs working with, or even supervising LPN's. Many rely on the first thing an instructor told them in school or go by what their first job's policies were regarding LPN's, even though the facilty or state where they are currently working is entirely different.

    When I was an LPN and this scope of practice stuff came up, my biggest complaint was always the same:

    Ask 4 RN's at work what an LPN is allowed to do and you'll get 4 different answers.

    The ambiguous policies written by the facilities often added to the confusion but it still disturbs me today how many of my supervisors, managers, DON's, etc. so often would stutter and be so perplexed at what an LPN was allowed to do and could never give me a straight answer.

    This occurred at every LPN job I ever had in every state I worked in the 7 years of being one.

    Another frightening thing that I remember specifically about PA when I lived there was a job interview I had in Philly at a pediatric long term vent facility.

    The DON (as she referred to herself) who was interviewing me and was actually a respiratory therapist, not an RN, informed me that part of my LPN responsibilites at this job would be hanging TPN.

    I pointed out that the PA NPA specifically states that LPN's were not allowed to hang TPN.

    Her response was that even though the state forbids it, she allows it at "her" facility and has the authority to override the state.

    Dead wrong on so many levels, but then again, how does a respiratory therapist with no RN license or education become a director of nursing in the first place and be in a position to supervise LPN's and RN's for that matter?
  10. by   withasmilelpn
    I know that I read the same thing about being able to change dressings for PICCS but I never saw specifically any mention of what type of IV we were allowed to do, PICC vs Central vs peripheral, just no TPN, no antineoplastics, no blood products or titrated meds. I know I have that picc policy somewhere as I am a packrat - where- that is the question! But I remember being trained to do it many moons ago.
    The fact that the board keeps things so vague limits our effectiveness, our job opportunities, and puts our licenses in jeapordy. Can we sue them? Just kidding- sort of!
  11. by   withasmilelpn
    Quote from RN34TX
    I'd also like to add that this may inspire me to work toward someday getting a job at a state board.

    They seem to have a corner on the market being the only nursing jobs where you are literally not responsible or held accountable for the things you say and do.

    That is, if you say or do much of anything at all during your 8-4 work day.
    me too!
  12. by   deehaverrn
    Originally Posted by RN34TX
    I'd also like to add that this may inspire me to work toward someday getting a job at a state board.

    They seem to have a corner on the market being the only nursing jobs where you are literally not responsible or held accountable for the things you say and do.

    That is, if you say or do much of anything at all during your 8-4 work day.


    yeah but I think you need a lot of extra letters after your name before you can do that
    i tried contacting the state board to ask about regs since i was on light duty (only able to lift 20 lbs, and no squatting or kneeling..etc), and my employer was assigning me to work in our PACU (post cesarian) or in our OB triage area --both alone but "you can call for help if you need it", i maintained that this was unsafe but was TOTALLY unsuccessful in finding anything to back up this assertion, and of course the state board was no help at all. No wonder Nursing is in such dire straits, we can't even do this right!!
  13. by   withasmilelpn
    Just had a similar issue concerning a PCA pump. It states in the practice act that RN's deliver and monitor pain meds given by epidural caths or devices... I was taught that LPN's can't do PCA pumps in schools and that this specific part and also the fact that it delivers a bolus as well is why. I brought this in to work. However, some of the RN's say that we can "under their direction". I say no. Where does it say we can do things outside our scope "under their direction"! I am reluctant to contact the BON because of the issues raised above. The BON states it's primary purpose is protecting patients. How much more basic is clarifying these regs in order to ensure adherence to safe nursing practice?

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