Am I doing my job within my scope as a Nurse?

[downsouthlaff, LPN]

There's a lot of shady areas about LPNs like myself being in charge and acting as primary nurses in the nursing home environment. If your workplace is anything like mine as the floor nurse you will be doing

*Admit assessments. Admit paperwork. Putting in place appropriate nursing interventions for the dx.

*Administering meds. (P.O.) per PEG, IM, Sub q, rectally, etc.

* Assessing lab values and intervening appropriately.

* Communicating with physicians, and taking telephone orders.

* performing trach care.

* managing wound vacs.

* completing nurses notes on skilled residents for Medicare reimbursement.

* assessing residents c/o and intervening appropriate, ex ER transfer, PRN med etc.

As LPN floor nurses we do a lot. But I often wonder if State board would pay a nursing home a visit and observe a LPN at work like myself doing all these things and like assessments, how'd something like that would go? Anyone else?

[Rose_Queen, BSN, MSN, RN]

This is why each and every nurse should be familiar with their state's nurse practice act. Find yours- may be available online for free or to be mailed for a fee. Each state has its own NPA, so if you work in more than one state, make sure you know them all.

[downsouthlaff, LPN]

I actually am familiar with my states nurse practice act for LPNs. The BON in my state believes that outlining limits on LPN practice is unachievable and limits practice. We may not initiate blood transfusions, or chemotherapy, under RN delegation, but other than that I'm not certain. I know however that nursing homes sometimes utilize RNs for a signature on careplans, assessments, etc. while LPNs technically carry out the whole process.

[quiltynurse56, LPN, LVN]

As has been stated, it all comes down to your State's NPA. This would be a question to ask those in the know of your facility as LTC are inspected annually. If you are passing inspection and not being dinged on these things, then it would be okay in your state, especially with such a vague NPA.

[vintagemother, BSN, CNA, LVN, RN]

Re: "As LPN floor nurses we do a lot. But I often wonder if State board would pay a nursing home a visit and observe a LPN at work like myself doing all these things and like assessments, how'd something like that would go? Anyone else?"

As an LVN, I performed all of the above duties at work and/or in clinicals.

In my state, LVNs may not hang blood or do IV pushes.

I believe there is some sort of regulation that says that an RN must sign off on these tasks. However, in my own experience, the RN wasn't even on site. I performed these actions independently for the most part.

I don't think it's illegal for an LVN to perform these duties independently. I do believe, however, that some people are led to believe an LVN world alongside an RN who supervises her physically.

This was not the case for me, and I don't think the letter of the law requires this.

I do think that an RN must be available by phone and must sign off later.

[vbarger28, BSN]

your scope varies state by state, the thing you have to be careful of is the word "assess" that is a major NO NO for ALL Lpns, that differentiates us between RNs.

I work in urgent care, and triage, which is assesing, but we are technically 'monitored closely' by the RN staff, so we are not techinically assessing.

[downsouthlaff, LPN]

your scope varies state by state, the thing you have to be careful of is the word "assess" that is a major NO NO for ALL Lpns, that differentiates us between RNs.

I work in urgent care, and triage, which is assesing, but we are technically 'monitored closely' by the RN staff, so we are not techinically assessing.

Again I know I'm the one who asked the question , and I do understand where your coming, on the FAQ page of my BON's website, it does say that LPNs may assess residents condition. And looking through license revocations of LPNs in my state, many nurses have had there licensed revoke for the reason of failure to assess and intervene for a detororiating residents condition. So how can it be illegal for all LPNs to assess a patient ?

[BuckyBadgerRN, ASN, RN]

In my state, LPN'S can't do INITIAL assessments. Ongoing can be done by any nurse

Again I know I'm the one who asked the question , and I do understand where your coming, on the FAQ page of my BON's website, it does say that LPNs may assess residents condition. And looking through license revocations of LPNs in my state, many nurses have had there licensed revoke for the reason of failure to assess and intervene for a detororiating residents condition. So how can it be illegal for all LPNs to assess a patient ?