responsibility question in LTC

  1. Hi,
    I'm a new grad, and I accepted a two day a month position in an alzheimers unit, in a LTC facility. ( This is in addition to a full time job)

    I will be the RN, the other nurse is an LPN, there are two hallways on this unit, I take one, she takes the other.

    My basic understanding is that the RN is ultimately responsible for all of the LPNs clients. This is what I was taught in school.

    So is what I was taught in school correct? The LPN can pass meds, and do treatments, but in the end I am the one responsible?

    I asked this question of the RN/retention coordinator that hired me, and she said "not necessarily,it's not like at the hospital".

    I still don't know what she meant. I know what is required of the RN as far as Ohio's nurse practice act goes, and I guess once I get in there and start working, I'll have to look up something in the facility manual.

    Any advice would be appreciated.
    Thanks in advance.
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  3. by   sassynurse78
    I don't know about Ohio, but here in Indiana, as an LPN we take responsibility for whomever we take report on. The DON is responsible. We LPN's and RN's work side by side on diffrent hallways and even have the same job description. All nursing is considered "Licensed Staff" verses "non-licensed staff" such as CNA's. The only thing LPN's cannot be responsible for at my facility is accessing an infusaport, but once it is accessed we can deal with it from there. So where I am, you would not be responsible for the LPN's pts. only your own unless you were hired as a charge nurse. I would ask if you would be responsible, I think that would be the only way too know for sure. Best of Luck!
  4. by   Talino
    Sassynurse is correct.

    This clause from the NY Board of Ed applies to both RNs and LPNs...

    Nurse-Patient Relationship
    A nurse-patient relationship begins when the nurse accepts responsibility for providing nursing care based upon a written or oral report of patient needs. A nurse-patient relationship ends when that responsibility has been transferred to another nurse and a report of patient needs has been communicated.

    Hence, you will not be responsible for the actions of the LPN towards his/her patient.

    You as an RN may be asked to perform tasks beyond the qualifications of the LPN. By accepting that responsibility, you will be liable for that action.

    You may want to get a copy of the description of your duties and responsibilities -- the one you signed and agreed upon during inital employment.
  5. by   Jayne LPN
  6. by   LauraF, RN
    The LTC facility I work at if there is an RN onsite they are ultimately responsible. Mostly for things like call-ins, they are suppose to act as the "shell answer man". I was unable to find exact info on what more the RN is responsible for. I did note in one of the websites I found, RN's are required to be on duty form6am to 5pm. Does not have to be the same one all day, but one has to be present for medicaid reimbursement. You can also contact your state board of nursing.
  7. by   TinyNurse
    Thanks for your replies! I will definitely ask to be sure.
  8. by   Sue RN GNC(C)
    There is a phrase - Scope of Practise" - and LPNs must work within their own. If an LPN were to expand out of her scope of practise, the RN is responsible to take whatever action is warranted.
    You are no more responsible for her actions than you would be for the actions of another RN, LTCA or what have you.
    LPNs function within their own guidelines and have their own licensing body. They have accountability for their practise, must know what lies within their scope of practise and provide care accordingly.

    Don't let yourself be snowed into assuming that responsibility. That just adds way too much stress to an already stressful area of practise.
    Good Luc!!