The newsletter is entitled boards revise scope of practice and delegation models for RN/LPN. I just do not get what the questions mean? I never delegate some issues to a LPN or CNA, even when there is a protocol to cover it, some patients needs assessed by the RN and frequently. If in the course of doing their usual duties either the LPN or CNA notice a issue then I expect them to report it to the RN. It talks about current skills, reasonable and prudent acts, and etc. Some of this is just not clear to me. Maybe I am out of touch, but certain issues are always the responsibility of the RN and certain ones fall to LPN or CNA's. I NEVER leave meds at bedside. I NEVER take the word of the CNA if she reports a elevated temp or BP. I always check myself. That way we each have a back up. I was taught so much in school and learned so much when I first started in nursing, maybe I expect the same of new nurses. If they don't know then I expect them to say they don't know and get help, guidence, practice from the staff. Why anybody would proceed in unsafe situations is beyond me. I just don't understand what they are going for. While I will admit to bending a few rules, I have stayed within National Nursing Standards. Like applying 02 when I have no order but pt is having chest pain, getting an EKG, and putting in a IV med lock for possible use. I will get a CBC, blood culture and Urine culture if a patient spikes a temp and then call for orders. these are just two situations I can think of off the top of my head. I have also made a patient NPO when they start projectile vomiting, called doctor for orders. I usually put an IV med lock in them too. Check emesis for occult blood. Stool too. Little things. I do glucose checks if a patient starts complaining of feeling shakey and has a family hx of DM. I guess I just think a nurse should be doing certain things to insure patients are getting all the care they need. If anybody gets the gest of this newsletter, please advise me. I am lost.
Nursing News