I wish RN schools would quit teaching the RN students LPN's can't do anything!

[Wannabeeinscrubs, ADN, LPN, RN]

I am getting so frustrated with some RN students in these NCLEX review groups. They keep saying that LPN's can't do any assessments, they can't do any patient teaching, or evaluations, that it is illegal. I think it is important that RN understand the real scope of practice of the LPN. To hear them talk LPN's are no different than medication aids. It makes me sad that they are taught to think so little of our education and training.

[lost soul]

In BSN school we were taught nothing about LPNs. We just know that each type of nurse can do what their practice act says they can.

[Bbett, MSN, NP]

I think the problem is we aren't taught anything at all. We never even talked about LPNS in our program 😣

[Fiona59]

You've got to remember that students only learn what their instructors know. In my province the RN governing body and union are both anti-LPN and dit comes across in their education.

More than a few have been shocked and dismayed to find out they are "buddied" with an LPN for part of their floor time during their placements. Unit Managers quickly set them straight.

[Raviepoo]

It was illuminating for me to complete an RN bridge program after working for a few years as an LPN. I really came to understand the distinctions between what an LPN can and cannot do.

LPNs cannot do assessments. They can gather data for an assessment, but an RN always ends up signing off and taking responsibility. LPNs cannot do primary education. They can reinforce education delivered by an RN. In other words, the first person to teach a new colostomy patient how to change their appliance should not be an LPN.

In practice this is not always followed. Care planning is supposed to be done by an RN, but at my facility the LPN often add items to the care plan. There is a distinction though. Final approval of the care plan lies with people higher on the food chain, and not with the LPNs who work the floor.

The RNs are right. LPNs will seem to have more autonomy in an LTC setting, but in fact it is always an RN who signs off on everything.

[caliotter3]

My BSN program didn't even teach me the basics of medication administration, I might have had a conniption if they had instructed on the scope of practice differences between RNs, LVNs, and CNAs.

[Fiona59]

It was illuminating for me to complete an RN bridge program after working for a few years as an LPN. I really came to understand the distinctions between what an LPN can and cannot do.

LPNs cannot do assessments. They can gather data for an assessment, but an RN always ends up signing off and taking responsibility. LPNs cannot do primary education. They can reinforce education delivered by an RN. In other words, the first person to teach a new colostomy patient how to change their appliance should not be an LPN.

In practice this is not always followed. Care planning is supposed to be done by an RN, but at my facility the LPN often add items to the care plan. There is a distinction though. Final approval of the care plan lies with people higher on the food chain, and not with the LPNs who work the floor.

The RNs are right. LPNs will seem to have more autonomy in an LTC setting, but in fact it is always an RN who signs off on everything.

In your state, perhaps.

In my province you are so far off the mark it's funny. LPNs are independent nurses. Nobody signs off my work. The only person I and my fellow LPNs report to is the Charge, just like the RNs I work alongside.

[anh06005, MSN, APRN, NP]

When I was in the hospital an RN would have to put in an assessment on a patient assigned to an LPN. In home health LPNs cannot do the Medicare paperwork (the OASIS).

My state obviously has some distinction too. Despite that I'd like to throw in I have worked with some awesome LPNs and horrible RNs.

[nolanurse88]

The only thing the RNs do for me are the iv pushes and spiking the blood.. Everything else is my responsibility including initial teaching and assessments. No one signs off after me.

[Fiona59]

Heck, I'm certified to push most IV meds. I've been told by my provincial body that we'll be spiking blood within the next two years. I've never understood why I can do the two nurse verification of the patient, the blood bands, the bag, sign the form and then watch the RN spike the bag, walk with me to verify that we are hanging blood on my patient and then monitor the patient while they transfuse and decide to terminate the transfusion if I observe adverse reactions. I don't call an RN to verify that my patient is reacting.

That only leaves Travisol in the spiking domain of the RN.

[tokmom, BSN, RN]

I do believe every state is different. When I was an LPN, in the 80's (yes, I'm OLD), we did everything but blood and IV pushes. Nobody looked over me except the Charge, like she did everyone else. Nobody signed off on my charting.

However, I do know in my state they have tightened up what an LPN can do. It's really too bad because they are not used to their full potential.

[jadelpn, LPN, EMT-B]

It was illuminating for me to complete an RN bridge program after working for a few years as an LPN. I really came to understand the distinctions between what an LPN can and cannot do.

LPNs cannot do assessments. They can gather data for an assessment, but an RN always ends up signing off and taking responsibility. LPNs cannot do primary education. They can reinforce education delivered by an RN. In other words, the first person to teach a new colostomy patient how to change their appliance should not be an LPN.

In practice this is not always followed. Care planning is supposed to be done by an RN, but at my facility the LPN often add items to the care plan. There is a distinction though. Final approval of the care plan lies with people higher on the food chain, and not with the LPNs who work the floor.

The RNs are right. LPNs will seem to have more autonomy in an LTC setting, but in fact it is always an RN who signs off on everything.

Depends on the state in which you live.

If one really looks at the scope on a BON website for their state, the only thing that LPN's can 100% not do in most of them is clinically direct an RN. Otherwise, it is up to each individual facility to determine what can and can not be done per policy.

There is language regarding showing competencies, otherwise, clinical skills and care planning and implementation is facility based.

The real issue is that it is a feather in the cap of more than one manager to have a BSN only staff. LPN's are cost, especially those who have worked acute/sub acute care for multiple years. Why pay an LPN when you can have a BSN and a CNA and even a medication aide--and still pay them collectively less than an LPN who has multiple years on the job and is paid accordingly?

As much education as one can is not a bad thing. However to completely discount a group of nurses who have done their job well for a long period of time is not right. But it happens. Every day.

http://www.lpnboard.state.wv.us/scope.pdf