Are LPN's going to be phased back into the hospital settings?

smartnurse1982 · Apr 17, 2014

One last thing,but if hospitals are phasing out Adn Rn's too.

i do not understand why hospitals will hire lpn's over Adn Rn's?

We are all in LaLa land with this one........they ONLY want BSN now.

So we both are in the same boat.

smartnurse1982 · Apr 17, 2014

Why won't they just keep them. It makes sense financially for hospitals to pay an LPN to do a lot of what RN's do and a cheaper salary. Not that I mind working LTC facilities I'd just like to have options.

You can't be serious. They are 2 different scopes.

Once you go back to school,you will see that there is a BIG difference,esp regarding critical thinking.

If that is the case,why pay an lpn when a Cna can do it for a cheaper salary?

They can be taught Iv insertion,tube feedings,and other "nurse skills" in my former state of SC.

As a former Lpn,i understood immediately that if i wanted options,i NEEDED to go back to school to become an RN.

Now,6 yrs later,i NEED to go back to school to earn a BSN,because my options as an Adn are limited.

When i was a CNA i did not understand why nurses made so much more than me when i cleaned all the poop,yet when i became an lpn it was a different story.

BuckyBadgerRN, ASN, RN · Apr 17, 2014

Why do you say this? If the LPN is acting under the scope of her own license and practicing within the limits of what she's allowed to do, the med error is hers alone. I work in LTC/Rehab and at times am the only RN in the building. If the LPN on the other side gives two Tylenol instead of one, that is HER med error, not mine.

I guess you guys did not get the memo that if something happens the Rn is responsible for what the lpn does wrong?
Say if the lpn makes a med error....the Rn goes down with her too.

Alex Egan, LPN, EMT-B · Apr 17, 2014

I guess you guys did not get the memo that if something happens the Rn is responsible for what the lpn does wrong?
I agree, LPNs are not going to storm right back on the hospital floors tomorrow. However as reimbursement falls, pendulum is going to swing if for no reason than reimbursement. Within the next 10 years, I predict increase job opportunities in the hospital for LPNs. Hospital job still won't comprise a bulk or even a a large part of LPN jobs, but there will be increased utilization I believe.
Say if the lpn makes a med error....the Rn goes down with her too.

This is not true at all. LPNs are licensed staff who are disciplined by the Board of nursing as individuals. I would love to see one case, where an RN received a disciplinary action, based solely on LPNs error. Lawsuits, another matter entirely. Malpractice attorneys, will name anyone possible in a suit, if they think it helps a payout.

smartnurse1982 · Apr 18, 2014

This is not true at all. LPNs are licensed staff who are disciplined by the Board of nursing as individuals. I would love to see one case, where an RN received a disciplinary action, based solely on LPNs error. Lawsuits, another matter entirely. Malpractice attorneys, will name anyone possible in a suit, if they think it helps a payout.

So i guess the Rn has to make sure the lpn is competent to perform certain skills before she delegates?

Alex Egan, LPN, EMT-B · Apr 18, 2014

No more so then you make sure other RNs are competent. You are delegating to another NURSE who has passed the NCLEX PN. There would be no reason to assume your coworker is in need of you declaring them competent. My state an RN must be available in person or electronically in case a concern arises or the pts condition changes. I am responsible for my assignment and practicing within the limits of my scope of practice. Part of that is having an RN, MD, or DDS available to "supervise". So long as you are delegating a task within the LPN scope of practice it is entirely on the LPN to complete that task, and seek assistance if they have an issue.

cinlou, BSN, MSN, RN · Apr 18, 2014

So i guess the Rn has to make sure the lpn is competent to perform certain skills before she delegates?

Actually that is true. Check out your state board statutes.

Alex Egan, LPN, EMT-B · Apr 18, 2014

Actually that is true. Check out your state board statutes.

Im extra familiar with mine, and there is no requirement of competency demonstration in the code as I have read it. Could you point me to the specific section.

049 Pa. Code Â*21.145.Â*Functions of the LPN.

we may be expearencing state variation. The RN would be responsible to make sure all tasks are completed just like when delegating to ANY other team member, but I can't see how you would see or document that the LPN is comped in each skill, by each RN they ever have to work with.

smartnurse1982 · Apr 19, 2014

This is something i will have to ask on the general board.

cinlou, BSN, MSN, RN · Apr 19, 2014

Im extra familiar with mine, and there is no requirement of competency demonstration in the code as I have read it. Could you point me to the specific section.
049 Pa. Code Â*21.145.Â*Functions of the LPN.
we may be experiencing state variation. The RN would be responsible to make sure all tasks are completed just like when delegating to ANY other team member, but I can't see how you would see or document that the LPN is comped in each skill, by each RN they ever have to work with.

This the Arizona BON for both the delegation by the RN to LPN or UAP and LPN to UAP, both state that the person delegating must know the persons scope of practice and maintain accountability. They also state that the RN or LPN are accountable to their own actions. Someone questioned this point earlier. So indeed if PA does not state that and AZ does then that is another state to state issue of non-standardization.

ARTICLE 4. REGULATION

R4-19-401. Standards Related to Licensed Practical Nurse Scope of Practice

E.

A LPN assigns and delegates nursing activities. The LPN shall:

1. Assign nursing care within the LPN scope of practice to other LPNs;

2. Delegate nursing tasks to unlicensed assistive personnel (UAPs). In maintaining accountability for the delegation, the LPN shall ensure that the:

a. UAP has the education, legal authority, and demonstrated competency to perform the delegated task;

b. Tasks delegated are consistent with the UAP's job description and can be safely performed according to clear, exact, and unchanging directions;

c. Results of the task are reasonably predictable;

d. Task does not require assessment, interpretation, or independent decision making during its performance or at completion;

e. Selected client and circumstances of the delegation are such that delegation of the task poses minimal risk to the client and the consequences of performing the task improperly are not life-threatening;

f. LPN provides clear directions and guidelines regarding the delegated task or, for routine tasks on stable clients, verifies that the UAP follows each written facility policy or procedure when performing the delegated task;

g. LPN provides supervision and feedback to the UAP; and

h. LPN observes and communicates the outcomes of the delegated task.

R4-19-402. Standards Related to Registered Nurse Scope of Practice

D.

A RN assigns and delegates nursing activities. The RN shall:

1. Assign nursing care within the RN scope of practice to other RNs;

2. Assign nursing care to a LPN within the LPN scope of practice based on the RN's assessment of the client and the LPN's ability;

3. Supervise, monitor, and evaluate the care assigned to a LPN; and

4. Delegate nursing tasks to UAPs. In maintaining accountability for the delegation, an RN shall ensure that the:

a. UAP has the education, legal authority, and demonstrated competency to perform the delegated task;

b. Tasks delegated are consistent with the UAP's job description and can be safely performed according to clear, exact, and unchanging directions;

c. Results of the task are reasonably predictable;

d. Task does not require assessment, interpretation, or independent decision making during its performance or at completion;

e. Selected client and circumstances of the delegation are such that delegation of the task poses minimal risk to the client and the consequences of performing the task improperly are not life-threatening;

f. RN provides clear directions and guidelines regarding the delegated task or, for routine tasks on stable clients, verifies that the UAP follows each written facility policy or procedure when performing the delegated task;

g. RN provides supervision and feedback to the UAP; and

h. RN observes and communicates the outcomes of the delegated task.

. Accept responsibility for individual nursing actions, decisions, and behavior in the course of registered nursing practice;

BuckyBadgerRN, ASN, RN · Apr 19, 2014

You're certain that EVERY state/commonwealth has verbage within the laws that govern nurses? I'm willing to bet my firstborn that that's not accurate across the board...

Actually that is true. Check out your state board statutes.

BuckyBadgerRN, ASN, RN · Apr 19, 2014

So that's AZ's laws. You do know that we're a pretty diverse group representing far more than just AZ, correct?