Is this right, using LPN's delegating abuse

  1. I have a few questions, I work at a nursing and rehab center. The few nurses we have working there believe that we are being delegated tasks that are not within our license peramiters.

    Are LPN/LVN's to be filling out ACUTE CARE PLANS, ex:s/t's, falls, abt's?


    Are LPN/LVN's to be filling out MDS's?

    The facility I work at, has a new MDS coordinater, new ADON, that have come here with their own ideas on how things are to be done. They are delegating their work to us, for the simple fact they dont know the residents well enough.

    Yet they are able to do stand up with the day nurses, specifically and know detailed information on each resident, neither one will work the hall, or go and physically examine a resident.

    The quarterly year summaries were delegated with the excuse, "Each of these are supposed to be done on every resident, every 3 months, it would take me 3 months to do one of them, because, i am new, and have no idea what these people are like, you guys know them like the back of your hand."

    The paper work has become so outrageous, that we are there on average 3-4 hours after each shift. Here is a list of things that I am referring to:
    Inc Rep:
    fall assessment form
    inc rep form
    acute care plan form
    neuro check form
    change of condition form
    investigation form

    Our new admits have been changed from 72 hour documentation to 14 days documentation Q shift.

    We now have to chart on every lab draw, every UA, that they are drawn, pending, faxed to doctor and then wait for new orders. As many of you know this can take weeks.

    We then are told that we can not go into overtime.

    If anyone can tell me about this, do you think that the delegating is being abused I dont wish to lose my license for doing things that I am not trained or licensed for.

    And if i am doing mds coordinators job I WANT HER PAYCHECK! he he, I can dream can't I.

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  3. by   kjmta57
    LVNS/LPNS cannot do assesments.And if these plans affect the overall dx of the patient I would want a RN to co-sign evryone of them.Good luck
  4. by   lpnandloveit1
    just a couple of thoughts. Lpn can do assesments. check your policy and procedure manual. this spells out exacly who is responsible for what. Check out your nurse practice acts for your state. note that the lpns role changes from state to state and from hospital to ltc to home care.
  5. by   rncountry
    I think being an LPN has to be very difficult. The roles that one play change from facility to facility.
    I will say that in answer to your question I have found that the assessments that you are questioning should be done by the MDS coordinator. As you know the MDS must be done q 90 days. Each of the other assessments that are required as well should be put on the same schedule as the MDS's and be done by the MDS coordinator. The data gathering done the week prior to the assessments should be put out and the charge nurse, LPN or RN should be ensuring that the paperwork for that is filled out. Asking the floor nurses to do anything more than that is ridiculous. What the floor nurses do is already more than one persons job. I will tell you that for new admissions the charting has to be done every shift now for medicare rules, that has actually been in place for a couple years now. I also think that any nurse manager that is unwilling to pull a cart when it is needed, or to do an actual physical assessment on a patient is entirely useless. Having worked in management in a couple nursing homes I can tell you the paperwork requirements that a nurse manager is responsible for is immense, but it is their responsibility, not yours. It is a team that has to make sure that it is done, and the floor nurse as well as the CNAs are very important to make sure that all information is given to the nurse manager, but the actual doing of the paperwork is theirs to do. That is why they are there. The MDS also has to be signed by an RN. In Michigan the MDS can be done by an LPN, but it has to be gone over by an RN and that RN must sign it as the RN Assessment Coordinator.
    After having worked in LTC for 5 years, I would not go back to that environment unless that was the only way I could feed my kids. Your problem is only one of the reasons I feel that way.