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

cinlou, BSN, MSN, 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?

that is why I also made the statement "So indeed if PA does not state that and AZ does then that is another state to state issue of non-standardization."

cinlou, BSN, MSN, 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?

You will also find the delegation responsibility of all states at the following site, most state the person delegating know the ability and scope of practice of the person they are delegating a particular task too.

http://www.healthlawyers.org/Events/Programs/Materials/Documents/LTC11/lightfoot_nurse_delegation_annotated_citations.pdf

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 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.

I found it interesting with all the statutes and research (such as the one that put out the research on mortality related to BSN) that comes out of PA that they are one of the few states who do not have a statement on delegation in their statutes.

HazelLPN, LPN · Apr 21, 2014

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.

This one of the BIGGEST misconceptions that new RNs have. The LPN is responsible for her/his scope of practice. It is the responsibility of the RN to know what that scope of practice is and to cover what is outside of that scope. If the LPN scope is restricted, this can give a lot of work for the RN to have to do. Let's say that when an LPN gives a potassium bolus, she/he has to check it with an RN before she starts the pump. They check the dose and the rate, but the pump is set wrong and the bolus infuses too quickly and the patient codes, both the LPN and the RN are at fault in this case and both can be disciplined by the BON. However, if the LPN has a patient with an IV that is infiltrated and she assesses the patient and fails to note it and lipids are running into the tissue causing a case of cellulitis requiring an extended hospital stay and that LPN is responsible for her own shift assessments and maintaining all IV access, she alone is responsible, not the RN who only covers what is outside of that scope.

Lets say that an LPN is restricted from drawing off an arterial line and has been assigned a patient who needs gasses drawn q2. The RN covering that LPN is responsible for drawing those gasses and must remember to do that. The LPN should reminds her to, but the RN is accountable. If the RN fails to draw that gas and the LPN fails to notice, than the RN is held accountable, not the LPN. In this case, it wouldn't be a good idea for an LPN to care for this patient, because it is too heavy a burden on the covering RN.

Best to you,

Mrs H.

Philly_LPN_Girl, LPN · Apr 21, 2014

It might help financially however, there are certain things that an RN can do and not LPN. I live near Philadelphia and all of the major hospitals want BSN nurses nothing less. The LPNS have been grandfathered in however they are not hiring LPNs as nurses but in outpatient for coordinated care, etc. Now the suburban hospitals still hire LPNS. I'm an LPN and IMO, it makes more since to have all RNs in a hospital because of the scope of practice.

smartnurse1982 · Apr 24, 2014

This one of the BIGGEST misconceptions that new RNs have. The LPN is responsible for her/his scope of practice. It is the responsibility of the RN to know what that scope of practice is and to cover what is outside of that scope. If the LPN scope is restricted, this can give a lot of work for the RN to have to do. Let's say that when an LPN gives a potassium bolus, she/he has to check it with an RN before she starts the pump. They check the dose and the rate, but the pump is set wrong and the bolus infuses too quickly and the patient codes, both the LPN and the RN are at fault in this case and both can be disciplined by the BON. However, if the LPN has a patient with an IV that is infiltrated and she assesses the patient and fails to note it and lipids are running into the tissue causing a case of cellulitis requiring an extended hospital stay and that LPN is responsible for her own shift assessments and maintaining all IV access, she alone is responsible, not the RN who only covers what is outside of that scope.
Lets say that an LPN is restricted from drawing off an arterial line and has been assigned a patient who needs gasses drawn q2. The RN covering that LPN is responsible for drawing those gasses and must remember to do that. The LPN should reminds her to, but the RN is accountable. If the RN fails to draw that gas and the LPN fails to notice, than the RN is held accountable, not the LPN. In this case, it wouldn't be a good idea for an LPN to care for this patient, because it is too heavy a burden on the covering RN.
Best to you,
Mrs H.

In NJ lpn's are restricted to the point that we could not access Picc lines and Central lines.

I am not a new Rn either,been one for 6 yrs,but i do not work in the type of setting that requires delegation.

smartnurse1982 · Apr 24, 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.

I still have a big problem with this statement.

mfigueroa22 · Apr 24, 2014

I still have a big problem with this statement.

There are a lot of RNs that will tell you that CNAs just can't do enough to really help them. I'm a CNA, I have been one for 3 years and I love my job. I'm soon to be an lpn. CNAs can't help nurses with anything except for dressing and maybe prime IV tubing. That's it. They can't pull meds, give meds, call the doctors... I live in nc where LPNs can do quite a bit. Except for blood products and care plans we can pretty much do what a RN can do. So, I'm sure that most RNs out there are 1. Delegating already because you have CNAs under you. And 2. They would love the help of an LPN when they have 4 patients calling out for pain meds at one time when they still have to chart or have a lot on their plate. And by the way even though the LPN works under the RN, the LPN is still responsible for their actions and scope. I don't see any reason why LPNs can't work in a hospital setting, they did for many years and the only reason why they still aren't is because of magnet.

mfigueroa22 · Apr 24, 2014

It clearly states"accepts responsibility for self" under RN and LPN. So that means the LPN is responsible for what they do. An RN delegates and LPN follows through. It is up to the BON weather that LPN or RN is competent to do that task. And as long is that LPN is practicing with in their scope they can do what they need to and accept full responsibility.

Esme12, ASN, BSN, RN · Apr 24, 2014

There are a lot of RNs that will tell you that CNAs just can't do enough to really help them. I'm a CNA, I have been one for 3 years and I love my job. I'm soon to be an lpn. CNAs can't help nurses with anything except for dressing and maybe prime IV tubing. That's it. They can't pull meds, give meds, call the doctors... I live in nc where LPNs can do quite a bit. Except for blood products and care plans we can pretty much do what a RN can do. So, I'm sure that most RNs out there are 1. Delegating already because you have CNAs under you. And 2. They would love the help of an LPN when they have 4 patients calling out for pain meds at one time when they still have to chart or have a lot on their plate. And by the way even though the LPN works under the RN, the LPN is still responsible for their actions and scope. I don't see any reason why LPNs can't work in a hospital setting, they did for many years and the only reason why they still aren't is because of magnet.

This maybe true in North Carolina....but not in all states.

There are states and facilities that hire LPN's in acute care but they are very few scattered in a very few places. LPN's in most states have been phased out of acute care.

Have you thought of working a LTACH one you graduate from a school?

Esme12, ASN, BSN, RN · Apr 24, 2014

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It clearly states"accepts responsibility for self" under RN and LPN. So that means the LPN is responsible for what they do. An RN delegates and LPN follows through. It is up to the BON weather that LPN or RN is competent to do that task. And as long is that LPN is practicing with in their scope they can do what they need to and accept full responsibility.

Of course the LPN is responsible for themselves....within their scope of practice.

mfigueroa22 · Apr 24, 2014

Of course the LPN is responsible for themselves....within their scope of practice.

My point was that in almost all cases the LPN is responsible for an error not the supervising RN which another post suggested otherwise.