Jump to content

As an RN, am I responsible for the actions of an LPN?

Nurse Attorney   (1,396 Views 9 Comments)
by Lorie Brown RN, MN, JD Lorie Brown RN, MN, JD (Advice Column) Writer Expert Nurse Verified

Lorie Brown RN, MN, JD has 30 years experience .

11 Followers; 8 Articles; 5,921 Profile Views; 102 Posts

As the only RN on a mixed Med-Surg/Peds unit, taking 5 to 6 of my own patients (with no tech on most days), am I responsible for the actions of the LPN? We are not completing team nursing, just each of us individually takes our own patients. With this being said, I am unable to "follow" the LPN to ensure that she is completing her job duties.

We have had several incidents, including late medications (10 plus hours), not placing physicians orders into the computer, not calling critical labs to the physician, etc. Management is aware and only states that it all comes back to the RN on duty, as it is ultimately the RN's responsibility and the RN's license on the line. Also, this nurse is not open/honest about the items not being completed; always stating that she is "fine" when asked if she needs assistance with anything.

Any advice would be greatly appreciated. I have been nursing 24 years on this unit and would like to keep my license in good standing.


Dear Am I Responsible,

An RN is responsible for the actions of an LPN.  An LPN cannot work independently although an LPN can take their own patient assignments. LPNs rely on the expertise of RNs for patient assessment or changes in condition.  It is your license. If you don’t feel comfortable being responsible for an LPN, you should talk to your supervisor. As the RN on duty, you are ultimately responsible.

I know you like your job but you can always find another one. However, you can’t always get another license.  Hopefully, you’ll be able to work out matters with your employer so that you can feel comfortable supervising this LPN.

Good luck with getting this resolved

Lorie

Share this post


Link to post
Share on other sites

TriciaJ has 38 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

12 Followers; 3,335 Posts; 34,602 Profile Views

Your management has a performance issue on their hands that they're not addressing.  It sounds like they're hoping to throw you under the bus when the LPN messes up badly enough.

Check with your board of nursing to see if they have any information on just how responsible you are for this person's work.  Are you considered her supervisor?  Do you have the authority to discipline her?  Probably not.

I would complete an incident report for every reportable occurence.  That includes real incidents like late medications, and near misses, like doctor's orders not being entered.  Since your manager is happy to let it be in your lap, you need to do end runs around her; stack up enough incident reports and she has to answer to her higher ups.

In addition to incident reports, keep a notebook at home.  Write little summaries about the LPN's mess-ups, your conversations with the LPN and your conversations with your manager.

Once you have a bit of a paper trail established, you can file a complaint with the board of nursing yourself due to an established pattern of unsafe practice.

Good luck.

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

4 Followers; 1,476 Posts; 7,186 Profile Views

With your job set up, you cannot possibly supervise the errant LPN to the degree that is apparently required.

If you have already notified management, and they haven't done anything, it's probably time to dust off the resume.

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

3 Posts; 617 Profile Views

In Massachusetts, each licensed nurse (RN or LPN) is wholly responsible for the care he or she delivers. The regs that describe functions and responsibilities of RN’s and LPN’s include “communicate, collaborate, and cooperate to insure quality and continuity of care.” There is no “direction” or “supervision” required by law or regs. That’s what licensure means. 

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

1 Follower; 473 Posts; 11,372 Profile Views

On 3/10/2019 at 12:44 PM, Lorie Brown RN, MN, JD said:

As the only RN on a mixed Med-Surg/Peds unit, taking 5 to 6 of my own patients (with no tech on most days), am I responsible for the actions of the LPN? We are not completing team nursing, just each of us individually takes our own patients. With this being said, I am unable to "follow" the LPN to ensure that she is completing her job duties.

We have had several incidents, including late medications (10 plus hours), not placing physicians orders into the computer, not calling critical labs to the physician, etc. Management is aware and only states that it all comes back to the RN on duty, as it is ultimately the RN's responsibility and the RN's license on the line. Also, this nurse is not open/honest about the items not being completed; always stating that she is "fine" when asked if she needs assistance with anything.

Any advice would be greatly appreciated. I have been nursing 24 years on this unit and would like to keep my license in good standing.


Dear Am I Responsible,

An RN is responsible for the actions of an LPN.  An LPN cannot work independently although an LPN can take their own patient assignments. LPNs rely on the expertise of RNs for patient assessment or changes in condition.  It is your license. If you don’t feel comfortable being responsible for an LPN, you should talk to your supervisor. As the RN on duty, you are ultimately responsible.

I know you like your job but you can always find another one. However, you can’t always get another license.  Hopefully, you’ll be able to work out matters with your employer so that you can feel comfortable supervising this LPN.

Good luck with getting this resolved

Lorie

If this is true, why does an LPN hold a state issued license?

If everything they do, is in fact, under an RN license, they should be treated as unlicensed staff, no?

 

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

127 Posts; 3,719 Profile Views

I hate this question, it's call Scope of Practice.  If my license says I can do it, I can and I will be responsible for my actions not you.

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

127 Posts; 3,719 Profile Views

Furthermore if your cna takes someone to the bathroom and they break their hip are you responsible.  No, you will have a lot of paperwork but you will not loose your license.  True story, my uncle 25 yrs ago was an LPN in CA,  he had just come back from vacation and was working with an RN who told him to do something the wrong way.  He admitted in open court he knew this was wrong, the RN admitted in court she told him to do it ( Pt. old with dementia died as a result).  My uncle lost his license the court and BON found that since this was WITHIN my uncle's SCOPE OF PRACTICE it did not matter what the RN said ( she never touched the Pt).  Unless an LPN does something out of her scope of practice that is when you can be held responsible.  I give the wrong med. and the Pt dies it's not coming back on you.  I DON'T WORK UNDER YOUR LICENSE I WORK UNDER MY OWN 

Share this post


Link to post
Share on other sites
Are you a credible source? Add your Credentials, Experience, etc.

1 Follower; 473 Posts; 11,372 Profile Views

9 hours ago, muffylpn said:

Furthermore if your cna takes someone to the bathroom and they break their hip are you responsible.  No, you will have a lot of paperwork but you will not loose your license.  True story, my uncle 25 yrs ago was an LPN in CA,  he had just come back from vacation and was working with an RN who told him to do something the wrong way.  He admitted in open court he knew this was wrong, the RN admitted in court she told him to do it ( Pt. old with dementia died as a result).  My uncle lost his license the court and BON found that since this was WITHIN my uncle's SCOPE OF PRACTICE it did not matter what the RN said ( she never touched the Pt).  Unless an LPN does something out of her scope of practice that is when you can be held responsible.  I give the wrong med. and the Pt dies it's not coming back on you.  I DON'T WORK UNDER YOUR LICENSE I WORK UNDER MY OWN 

Thank you. Your response makes perfect sense because an LPN is a licensed professional, with a Scope of Practice.

Share this post


Link to post
Share on other sites

kbrn2002 has 25 years experience as a ADN, RN and specializes in Geriatrics.

2,958 Posts; 29,090 Profile Views

An LPN is covered under their own license, they do not "work under" the license of an RN.  Any screw-up that LPN does is strictly their own.  I am a little surprised at the responses. Are there actually states where an RN supervisor can held accountable by the BON if an LPN messes up?  

Your employer on the other hand can pretty much do what they want and if they choose to put the responsibility of ensuring the LPN's do their work on a charge RN rather than a nurse manager or even farther up the chain of command I suppose they can.  So while your job may be in jeopardy if they are looking for an excuse I highly doubt your license is.

Share this post


Link to post
Share on other sites
×