LPN"s and telephone triage

tutusandfrogs · Jan 25, 2006

I don't really have much to add...but wanted to say, I am taking the lpn course in Canada, and there definitely is training for critical thinking. It is the main focus of the whole "nursing arts"

ETA: I am not taking the course yet... oops the last quote sounded as if I am!

DusktilDawn · Jan 25, 2006

I was an RPN/LPN in Canada for over 10 years, and yes I was trained to critical think. I will say this though, I don't agree with LPNs triaging, JMO.

What about the RN's that make mistakes? Is it okay for them to make mistakes just because their title is RN? I know many RN's that are terrible nurses (many that are good too) and really shouldn't be in the field!

LPNs and RNs both are accountable for their actions. Being an RN does not make it okay to make mistakes. Acquiring a license as an RN does not give one immunity.

oh2beinxtc · Jan 31, 2006

I am an LPN in Tn and was trained very well in pediatric phone triage,It was difficult at first,the office had 6 peds drs, but there was another nurse an LPN there with me while I trained.Our office had a peds triage book that the phone nurse always has access too,and the phone nurse is never alone if we needed a dr they were always there as were the nurse manager.I feel I am a wonderful triage nurse because of the correct training I received.

ojoson · Feb 1, 2006

It all boils down to your LPN, do they have critical thinking skills and WILL they go to an RN or MD for advice in a complex situation. In Wash. State LPN's cannot assess, complex situations are out of their scope of practice.They are allowed to gather info and educate. Don't get me wrong I know some very good LPN's but the law is the law.Why put them in that situation?

kids · Feb 16, 2006

In Washington state, LPN's cannot assess pt's only gather data and educate. Once you pick up the phone and hear the complaint and respond to it you are assessing. LPN's are not taught critical thinking. I was one for 10 years before becoming an RN many many years ago

I am also in WA.

I questioned this at a clinic I worked at. Per the P&P manual and as documented by a letter in the manual from the BoN... LPNs working in telephone triage are not performing assessments if they obtain the data from the patient and respond with specific, pre-established protocols based on the data supplied.

wincha · Feb 16, 2006

I am also in WA.
I questioned this at a clinic I worked at. Per the P&P manual and as documented by a letter in the manual from the BoN... LPNs working in telephone triage are not performing assessments if they obtain the data from the patient and respond with specific, pre-established protocols based on the data supplied.

its might say that but they are assessing over the phone and that wouldn't hold up in court if there was a lawsuit.

ojoson · Feb 16, 2006

I have removed our LPN from triage. Because she is allowed to educate I am developing a program that will enhance our monitoring program, and she will be doing the teaching of our patients and gathering data for the triage nurse.Again, the minute you pick the phone up and discuss your pt's symptoms you are assessing, you also are assessing which protocol to use to treat the patient. I don't want to lose my LPN so I will develope the program that is within her scope of practice.

blynn · Mar 3, 2006

This thread has got me worried. I work for a clinic that only hires LPN's and MA's. We don't have any RN's employed at our facility. We are each assigned one doctor to work with, and we handle all of the patient calls for our assigned physician. We collect information from the patients, and relay that info to the MD. Then we call the patient back and relay to them the MD's advice/orders/instructions/what have you. But not every phone call is something that you need to talk to an MD about. Sometimes it's something simple, like yes, you do need to be NPO starting midnight before your surgery, or yes, I can phone in a prescription for the sample medication that the doctor gave you to try. (His dictation will always very clearly state 'patient is to call for RX after trying samples) Am I out of my scope of practice here? Things are not always so cut and dried as the examples I've mentioned. I am in the habit of documenting all of my phone conversations, and I will have the MD sign off on my notes, particularly if it's regarding a patient being non compliant or something of that nature. I feel confident in my abilities, and if something comes up that is questionable I will always run it by the doc, but I worry that maybe the clinic shouldn't just have LPN's and MA's doing all of this.

ojoson · Mar 4, 2006

It is excellent for you to document. You said patients call and you relay the message, and he gives you direction on what to do, then you have him sign -off on your notes, I hope I understood you correctly. I believe at that point you are not assessing you are giving the info to the MD and he is making the decisions, you are under his direct supervision. I believe this is OK. Do you make decisions without him? It doesn't sound like it to me. Make sure you continue to document and cover yourself with his signature. Good Luck

lb1991 · Sep 23, 2006

In the state of CA two things apply: 1) it is not within the scope of practice for an LVN to perform an assessment; 2) there was a law passed in 2001 that states only an RN (or MD) can perform telephone triage.

Be careful - if it's not within their scope, the managing RN could be held accountable.

icugirl33 · Sep 24, 2006

I am an RN and work telephone triage 2 weekends a month. In the company's manual, the duties of the LPN and RN are different. However, on the call center floor, everyone does what they choose. All of the nurses work very hard. I recently saw the pay difference between the RN and LPN this place, and it was $12 an hour difference. These companies protect themselves by having each employee sign something stating they will stay within their "scope of practice".