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Discussion

Breaking the law?

I just started working at and adult day care. I'm a new LPN. It's come to my attention that I'm being supervised by another LPN.?!! Isn't this a violStion of the Nurse Practice Act? There are no RN or DR's working at the facility and the supervising LPN works off site as well?!

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    • Experts

    Check with your state's Board of Nursing. It seems that your clinical practice should be supervised by an RN or MD, even if off site.

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    Adult day care is very low acuity. I do not think it is heavily regulated. They might not even be required to staff with any licensed nurses at all. I know there are assisted living facilities that do not have a single RN on staff, so it is not surprising there are adult day care centers without any, too. Likely the reason they hire LPNs at all is to be able to put "licensed nurses on staff" in the brochures.

    I do not know the legal ins and outs, but if an assisted living facility can function without a RN or MD on staff, it would stand to reason that so can an adult day care center.

    And a LPN can most definitely supervise another LPN in an administrative capacity. If push comes to shove, you are working under the direction of the PCPs of your clients. Any medications or treatments you may administer were ordered by a provider one way or another.

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    • Experts

    Check the state licensure regs for adult day care. They will specify what the requirements are for licensed staff in those settings.

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    • Experts

    Most state nursing practice acts allow LPNs to supervise other licensed nursing staff in an administrative capacity. This essentially means that, in a healthcare setting such as adult day care, the LPN supervisor is permitted to oversee other nurses for administrative issues such as attendance, misconduct, insubordination, client abuse, and a wide repertoire of issues.

    LPN supervisors, however, are forbidden from supervising other nurses in a clinical capacity. The LPN supervisor can give clinical direction under the direction of a remote offsite manager (RN, midlevel practitioner, or physician).

    If you think about it, anyone can supervise any employee administratively. Most hospitals and other healthcare facilities have non-nursing administrators with no healthcare backgrounds who are are allowed to manage licensed nurses in an administrative capacity. They are not, however, allowed to manage licensed nurses in a clinical capacity.

    Administrative versus clinical direction is the main difference.

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