Are Lvn's Allowed To Do Initial Assessments??

Nurses LPN/LVN

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I was interviewed for a job at a nursing recently. After the normal routine questions in the interview with the DON (Director of Nursing), I was given an opportunity to ask questions. I asked who would be doing the initial assessments on their admissions to the facitlity and I was told that I would be doing them.:crying2: I have no problem doing assessments but I need to know if this is right. In school we were taught that it is the RN that does the initial assessments and I do not want to put my license on the line by doing things that are not within my scope of practice.:confused:

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
An RN should be doing the initial assessment.
This is not the case in the state where the OP resides (Texas). She is legally allowed to complete her own initial assessments if she is working in a nursing home or other long term care setting (assisted living center, skilled nursing facility, etc.).

What an LPN/LVN is permitted to do is very state-specific. I am also licensed in California, which tends to be one of the most restrictive places for an LVN to practice.

Specializes in Mother-Baby, Rehab, Hospice, Memory Care.
An RN should be doing the initial assessment.

Exactly what Commuter said... Read my first reply, it includes the exact response from the BON. The OP resides in our state of Texas where he/she is permitted to do so in certain settings. Enough said...

Specializes in Psych, Med/Surg, LTC.

LPN's can in PA, in hospitals, too. There isn't much an LPN is not allowed to do.

Specializes in A little of this & a little of that.

It is definitely state specific. I believe that the OP's question was answered by the quote from the TX BON for her situation. I have worked in states where it is the RN only and where it can be the LVN/LPN. Just an FYI, though, Medicare regs require an RN co-signature on LVN/LPN admission assessments. This does not affect any other admissions. Its very much like the MDS situation, LVN/LPN's can do them but an RN has to co-sign before they are submitted. There are facilities that have their own policies against LVN/LPN's doing admission assessments because of this. This has made some nurses believe it is illegal even when it is not. What I am saying here refers only to skilled nursing facilities not hospitals.

An RN should be doing the initial assessment.

And again, I reply...it depends on the state. Maybe in your state, the BON is restrictive. Mine however, isn't.

Specializes in LTC, Urgent Care.
LPN's can in PA, in hospitals, too. There isn't much an LPN is not allowed to do.

In LTC though, the RN has to co-sign the initial assessment. At least that's the way it was in the facility I worked at.

Specializes in LTC.

I too work in a ltc facility and we do the initial assessments...we even have to do initial care plans which is just a stupid flow sheet that the mds uses to do the real care plan...we do everything with an admission or discharge....really aside from mgmt nurses who never do anything to do with the floor or our paperwork if they can get out of it....we only have 2 rns who will help with an admission if needed.

Specializes in Psych, ER, Resp/Med, LTC, Education.

I have to say that as an RN I don't quite understand how this can vary from state to state. How does one state feel an LPN doesn't have the education and training to do an assessment at all....some say yes they can do this and are qualified in LTC but not Acute care........or they can do assessments but not the first or they can assess anytime anywhere?????? I don't get the HUGE inconsistency.

Specializes in Mother-Baby, Rehab, Hospice, Memory Care.
I have to say that as an RN I don't quite understand how this can vary from state to state. How does one state feel an LPN doesn't have the education and training to do an assessment at all....some say yes they can do this and are qualified in LTC but not Acute care........or they can do assessments but not the first or they can assess anytime anywhere?????? I don't get the HUGE inconsistency.

I think most of of LPN/LVNs feel the same way... There seems to be huge variances in our scope of practice from state to state and it's not just for assessment. I'm all for finding some consistency....

Specializes in Knuckle Dragging Nurse aka MTA.
I was interviewed for a job at a nursing recently. After the normal routine questions in the interview with the DON (Director of Nursing), I was given an opportunity to ask questions. I asked who would be doing the initial assessments on their admissions to the facitlity and I was told that I would be doing them.:crying2: I have no problem doing assessments but I need to know if this is right. In school we were taught that it is the RN that does the initial assessments and I do not want to put my license on the line by doing things that are not within my scope of practice.:confused:

In california we can't do ANY assessments.

I've only been working as an LPN for 2 weeks and have done 2 admission assessments and a re-admission assessment already. lol

I guess it just depends on where you work.

I am a LVN in California and I work in a acute care hospital and I assess my own patients. I can assess a patient just as well as a RN can maybe even better. I have worked on med/surg, post-partum,telemetry,peds,burn unit,icu, and currently have a position in ccu.I have been doing my job for 28 years ,so I've had lots of practice. All the RN's that I work with trust my assessments and I always confer with them when a there is a problem/question/decision to be made.I've been told by many RN's that they trust my judgement more than a lot of RN's that they work with. I take care of my patients to the best of my abilities. And when you work in a critical care unit, you must be continously watching their BP's, HR's, rhythms, O2 sats,RR's and observing any subtle changes .And I don't mean just looking at a screen, you must be looking directly at the patient ,interacting with the patient. Touching the patient is his skin clammy or dry?Is he symptomatic or not, is he dry/wet ,is he making any urine? what's his labs? When you suddenly notice your patient's tachy and earlier he wasn't you need to investigate and find out why, is he febrile? is he dehydrated? in pain? To me if you are not an investigative nurse with a "gut feeling or intuition" you are not taking care of your patient . If you don't pay attention and ignore or don't notice subtle or obivous changes in your patient it could have serious or fatal consequences! Even if you notice something with someone else's patient make their nurse aware. And always make sure your IV is good, and put a double extension on your IV or better yet put in another line because you never know what could happen. Because, you don't want to be fumbling to start an IV when your patient is crashing. Well. maybe LVN's aren't suppossed to assess patients initially but I do because how else are you going to know your patient? How can you properly take care of them if you don't assess them? Hey, I've told RN's when I'm floating admiting their patients,and assessing them that they can either co-sign my assessment or they can rip it up and do it themselves! I have never had anybody rip up or redo the admission data base yet! I think it is stupid to say that an LVN can't assess a patient. They teach you that in school. It's like sometimes people think that if you have LVN after your name that you are "on the low end of the IQ scale"or that your vision is poor or you're just plain stupid.

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