Can a LPN delegate to RN?

[roxs752]

We have a new manager on the LTC unit. She is a LPN. She has been delegating to me and another nurse who is a RN. Is this even legal? How can she delegate tasks that are out of her scope of practice.

[Gabby-RN]

To the OP, could you provide some examples of what was delegated? This is an interesting topic.

[AdamantiteEnigma]

I would be curious as well. OP, could you please share some specifics if you can. This is a topic of interest to me as I often find myself in charge of the floor or facility (with Medical Director/Director of Nurses on speedial) as an Agency LPN.

In fact, I had a new grad RN go nuclear on me yesterday saying similar things. I'd only come in through the door and introduced myself. It was very odd to me...

[jadelpn, LPN, EMT-B]

Which brings up another question. As an LPN there are some facilities that allow LPN's to obtain ACLS, PALS, NALS. Not many, but they are there. If the LPN can not push IV meds, then that is not something that they can participate in as part of a code. The LPN can not direct an RN clinically, (which seems to be the major part of every state's LPN scope) therefore, can't lead the code. So one could assume that the only thing that an LPN could do in a code is record. Which can be done regardless if there's the above certifications on board or not.

With that being said, there are not a whole lot of full codes in LTC. (there are some moreso than others, but generally speaking). However, there are some. It would be situations such as that which would be needing some well worded policy if there's a charge LPN and RN's in the mix.

[KenH]

If the OP is concerned about scope of care, they need to conduct the BON, I would say there is only about 5% difference between what a RN and LPN can do. The LPN is the manager and they can delagate anything they want as long as it follows the policy of the facility they work in.

That said, I have worked with a lot of LPN/LVN who ran circles around many RNs

[Bruceh]

I am a CNA and worked at a place where a LPN was a ADON and one of the best nurses I have worked with. She also directed the RN always fair I don't understand why people have such a power trip if the home thinks she can run the place go with it

[roser13, ASN, RN]

"I am a CNA and worked at a place where a LPN was a ADON and one of the best nurses I have worked with. She also directed the RN always fair I don't understand why people have such a power trip if the home thinks she can run the place go with it."

The simplest answer to your power trip accusation is that you are way off base about a power trip. Don't worry - you're not alone. Way too many folks get hung up on perceived animosities between the 2 types of nurses.

It's about conforming to the requirements of your profession's governing board. It's about legal compliance and a desire to practice your profession within the boundaries of the law. It's about protecting your license.

If you were working under a professional license that you had earned, you would likely understand more fully.

[vintage_RN, BSN, RN]

In my province (Ontario) every nurse is governed under the same college of nurses and is responsible and accountable to their own practice. An RN never delegates to an RPN (unless that nurse is charge) and an RPN never delegates to an RN. On my floor we take the same patients and do the exact same job. We work together as a team and I've never had to ask an RN to do anything for me. I work on a very acute surgical floor...the main thing here is patient assignment. There is no real difference in skills But RPNs are suppose to have stable, predictable patients. Unfortunately on my floor at least that never happens...I still get pts from icu and pts going to icu...but I have a lot of support around me and a lot of experienced nurses. We work together to care for a very acute patient...If I'm not comfortable or don't know what to do for a patient I just ask a more experienced colleage. I like the way we do it. Interesting to see different scopes of practice.

[feelix, RN]

This is not about bitterness. This is a legal question. Better safe than sorry.

My understanding is that this particular LPN is not in a clinical role, she is in a managerial role. If she is in a clinical role, please refer the question to your board of nursing who will be able to guide you better.

Remember, you cannot delegate what is beyond your scope of practice. What you delegate is still your responsibility. This can become a real problem if the nurse is delegated something he/she is not trained for, because it is the responsibility of the delegator to ensure the delegatee is properly trained for the task. Which you cannot know if you are not trained yourself. A good example is pediatric dosing.

[Bruceh]

Feelix but are the LPN trained to handle the role Don't they have to be trained to handle this take extra training? I would think so why would a facility risk the danger you have peoples lives to think about

[Alex Egan, LPN, EMT-B]

This is not about bitterness. This is a legal question. Better safe than sorry. My understanding is that this particular LPN is not in a clinical role she is in a managerial role. If she is in a clinical role, please refer the question to your board of nursing who will be able to guide you better. Remember, you cannot delegate what is beyond your scope of practice. What you delegate is still your responsibility. This can become a real problem if the nurse is delegated something he/she is not trained for, because it is the responsibility of the delegator to ensure the delegatee is properly trained for the task. Which you cannot know if you are not trained yourself. A good example is pediatric dosing.[/quote'] That's a very bad example feelix. I shall immediately inform all my pediatric patents I can no longer dose their meds... Let's say central line care, or a TPN infusion, or hanging blood. I'm my state then yes this is so you cannot delegate what you cannot do yourself.

[Isis Phoenix]

In the long term care setting Lpn's are also supervisors,however policy states that a RN must be on the roster.

[Isis Phoenix]

'Can a LPN delegate to RN?' Let us call to mind that most long term care facilities operate for profit,and as such each owner/operator has a model for the business. What we are taught in nursing school is not the same when we make the transition to the real world;most long term care facilities use LPN's who have several years of experience as unit managers,and supervisors,however they are micro managed by RN's. As per health care policy each facility should employ a certain number of RN's,LPN's,and CNA's,and each shift should also be staffed by Rn's,Lpn's as well as CNA's;and from what I learned a nursing home can never operate with just the director,LPN's,and CNA's.....welcome to the real world....theory and practice differs!