Can LPNs make assesments??

[carlolpn]

Hello,

I am an LPN from the province of Quebec. however, here in Quebec we call LPNs` Registered nursing assistants(RNA), kinda of weird name. I don`t know how it is in the USA, or the rest of Canada, here in Quebec the RNs`pretty much dominate nursing care. Especially, when it comes to making a nursing assesments. RNAs`or Lpns`s (whatever you want to use) in Quebec, can only implement the Nursing care plan. Everything else is done by the RN. For example if a patient complains of a headache, before giving a tylenol from a standing order, an RN has to asses a patient. If a patient is complaining of a cough, and soar throat, again the RN has to asses. Any small changes in the patient`s status, the RN must be notified, and asses the situation. I think it is stupid. The adminstrators of our professional order(LPN board, known as the OIIAQ), do not have the courage enough to argue this point with the professional order of the Registared Nurses in Quebec. My question, is it the same practice elsewhere? Do RNs` have to asses everything before and LPN can use an intervention.

[AntFlip7395]

I can only speak from my experience. I was an LPN for 10 years and when I worked telemetry, I did my own initial assessments and an RN was to co-sign. In addition, an RN was required to do an assessment every 24 hours, so this meant that an LPN could not pass her patients to another LPN on the next shift. As far as focused assessment, which you are referring to, it depends on the relationship between the LPN and the RN in question. Many times, if I needed morphine, dilaudid, or an IV nitro bolus given, I would give a detailed description of the problem, including the vitals, and the RN would just go give the medicine. There are some that would do their own assessment and that was just fine too. In LTC, LPNs are far more independent as there are usually no RNs on the premises, and if there are, they are administrators who don't know the patient. In other words, what I am saying is that it is "understood" that the RN in charge has given the LPN the authority to assess the patient to collect the data and then implement whatever orders are given, unless it is something that an LPN is prohibited from doing by his/her scope of practice. If my patient had pain that I could alleviate on my own, I never went to any RN to get the ok or ask them to assess my patient. I can't see how patient care is done very efficiently if you have to ask an RN to assess every little status change when you are quite capable of doing it yourself. Believe me, I was glad when I got my RN because it was enough of an inconvienence to ask them to give my IV meds.

[TheCommuter, BSN, RN]

As an LPN, I am allowed to do the initial assessment in a non-hospital setting such as a skilled nursing facility, nursing home, rehab center, long term acute care facility, or subacute floor. However, I am not allowed to do the initial assessment in an acute care hospital without an RN's signature.

[Fiona59]

Carol:

are you looking for an international or Canadian viewpoint?

I work in Alberta, I assess and I dispense prns on my own. I can't pronounce death, but I've certainly told my charge RN that there are no signs of life in a patient.

Every province is different. As is every facility in the same province. I've worked in facilities where I couldn't inject medication because they deemed it an RN's responsibilty even though I did the accucheck for blood sugars, charted the entry and noted the amount per the sliding scale. Next month we do our own IV starts and meds.

You need to check with your provincial college of PNs for what you can and cannot do.

[BuffaloNurseAmy]

Hi all ! First post here ! Well, as for LPN's making "assesments"...I recently worked in LTC where we were told LPN's could not document the word "assesment". We were told our scope of practice is as a "data gatherer." We charted on a computer & did "D.A.R." charting & under "response" we used to be able to write "No change in assesment". When we were told we could no longer write that, I began typing "No change in DATA GATHERING." The other nurses got a big kick out of that!

[lvlissl2ebecca]

I am a new nurse in West Virginia and I work in a LTC. In our facility it is often required of us to do "assessments". For example, if we get an admission into our facility on evening shift, often times there is no RN supervisor present and the LPNs must do the oodles of assessments and paperwork for that admission and the DON must sign off upon completion. If we get notice of this admission they will TRY to get an RN in there to help with the admission, however, we often get an admission without enough notice.

[Mycherry05]

I am a new nurse in West Virginia and I work in a LTC. In our facility it is often required of us to do "assessments". For example, if we get an admission into our facility on evening shift, often times there is no RN supervisor present and the LPNs must do the oodles of assessments and paperwork for that admission and the DON must sign off upon completion. If we get notice of this admission they will TRY to get an RN in there to help with the admission, however, we often get an admission without enough notice.

This is more like what I am used to...Where I have worked in the past few years, or forever, I have always done assessments. BUT, I always feel like I am not good at it. I can't imagine having to have the RN check everything I do. I have worked in places where someone passed away and there was no RN to pronounce the body. It's pretty obvious. I don't think we need help in that dept although I know it's a law.I had this RN(she had to take her boards twice she was so dingy) ask me if I was sure when I informed her that my patient had passed. I sat with him and watched him take his last breath. I think that it"s not always the title, but your skills. Some LPN's are much more skilled that some RN's I know.Enough said.