Documenting for another nurse?

[Barnstormin' PMHNP]

Feel free to correct me if I am wrong on this. A friend of mine works at a snf that wants the RN's to document on the LPN's patients, even though they do not work on that unit and don't even see those residents during the shift. I told her that that is a really bad idea, I personally think it's a legal nightmare waiting to happen. What's worse is that her DON is on board with it.

[CaringGerinurse525]

At the LTC facility I work at the RN is the supervisor and therefore is responsible for all the residents in the building. The LPNs are in charge of each hall and chart on their patients. The RN charts on falls, incidents (they all must be followed up for 72hrs). The RN also charts any deaths or change in condition that they assess. There are many other circumstances in which the RN would chart on a resident. I don't think it is ridiculous to ask your friend to chart on patients. Obviously she should know the patient or assess their condition before doing so.

[classicdame, MSN, EdD]

It is against the law in Texas. Each license carries its own authoirty, responsibility, and accountability. You cannot document what you did not witness. We are not allowed to "sign after" an LVN, student or anyone else, unless we witnessed the event.

[Barnstormin' PMHNP]

Classicdame, that is exactly the concern I have for her. She doesn't even see these people, there are forty beds on each unit as well as her own. She is supervisor of the three units weekends and when needed, the only residents she is actually familiar with are her own. She can't even place names with faces on the other units. How can you be expected to chart on patients without actually caring for them?

[classicdame, MSN, EdD]

someone needs to look at the nurse practice act or call the BON for clarification. The LVN has a license to protect too.

[chare]

What exactly is your friend being asked to document?

[xoemmylouox, ASN, RN]

What do they expect her to document? She may have to get to know ALL of the residents at that facility to document safely and legally. Such is the joy of being an RN sometimes.

[MomaNurse]

What do they expect her to document? She may have to get to know ALL of the residents at that facility to document safely and legally. Such is the joy of being an RN sometimes.

Or the joy of being an RN supervisor. If your friend is a supervisor on the weekend covering 3 units, yes she can, and should, cosign the lpn documentation (incident reports, admissions,etc). If she is the only RN in the building on her own floor doing a med pass and someone she doesn't know two units down falls and fractures a hip, I don't think she's required to document that situation inasmuch as taking responsibility for it under her license.

[ak2190]

This reminds me of the days when I "supervised" my LPN supervisor in a SNF. She had about 35 years of experience, I had 2 weeks.

[DedHedRN]

Uggg, I worked at a facility that wanted me to do all the charting on all the wounds, even though we had a RN who was the wound nurse and I have 30+ pts and rarely saw the wounds. Management can be pretty stupid sometimes.

[BrandonLPN, LPN]

I'm betting your facility is engaging in unecessary and redundant documentation policy. Whoever makes the policy there ought to check with the BON on this. LPNs can complete their own documentation.

I've worked in skilled nursing for nearly four years now, and I've never once had to have a RN document anything for me.

This reminds me of some book I read about hospitals in the sixties where the RNs would stay over to "chart" on patients cared for by practical nurses. And the RNs in question never even saw these patients. All because charting was considered a "RN only" task.

Terribly inefficient. There are some things a RN an do that a LPN cannot. Charting is not one of those things.

[proud nurse, BSN, RN]

When I was an LPN, the only time my RN supervisor charted on my patients was when I called her about a change of condition of a patient. She would come to my unit, assess the patient, and document. Most of the time it was very redundant, like the previous poster said. I would chart my own assessment, then she'd come and observe the same findings and chart her assessment. The patient didn't change that much and she did the same type of assessment that I did. I'm guessing it is done as proof that the protocol of assessment and documentation is followed.