Quote from CapeCodMermaid
My question....I practice in the state of Massachusetts in a SNF. I have always been under the impression that an RN "outranks" an LPN and therefore an LPN cannot supervise an RN. Does anyone know where I can find the regs? I tried the state website and this issue wasn't addressed. (and please, don't think I care what initials are after someone's name. I've worked with some outstanding LPN's)
Long term care regulations vary from state to state, however, Federal Regulations apply to all states, and each state must have regulations equal to or above this set standard.
Federal regulations state that a LPN may supervise, other LPN's, and un-licensed personal(such as a Nursing assistant). LPN's may take charge of the entire facility after normal business hours, as long as there is a RN on call 24 hours per day. ( usually the Director of Nursing is this RN, as their license is listed as the person responsible for the nursing care for that facility) Federal regualtions also state that the Director of Nursing for a long term care facility (SNF) must be a RN. (Under special circumstances the facility may apply with the federal govermant, that there is a severe shortage of a qualified RN to take this role, and request that a LPN hold this position...This is extremely rare, and the facility must prove, that after a aggressive recruitment search, no RN's are available and also must continue to actively recruite a RN). LPN's may hold Administrative positions, where they are indeed in charge over other LPN's, CNA's and RN's. Keep in mind that this is strictly on a Administrative level. ie- LPN that holds the title of Assistant Director of Nursing, Assistant Administrator, etc. ( I have held these type of positions myself). The RN who is the Director of Nursing would be responsible for the clinical coordination and supervision of the nursing staff. As far as a LPN supervising a RN on a ward/unit/floor; NO, A RN's clinical practice cannot be supervised by a LPN. I am not one who puts much emphasis on someone's title. I have worked with outstanding nurses, both LPN's and RN's. Remember WE ARE ALL NURSES. However, we still must follow the regulatory process.