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

BuckyBadgerRN, ASN, RN · Jan 11, 2015

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.

In my state LPN's may NOT do initial assessments. These things can differ from state to state you know. What one RN is saying about what an LPN can do may absolutely be correct from where s/he lives. For instance, in my state, an LPN may NOT call themselves a "nurse" as a stand alone term. They HAVE to say LPN. I know of no other state that the BON has verbage like this.

beckyboo1, BSN, RN · Jan 11, 2015

According to the Missouri Practice Act, LPNs cannot do teaching, including discharge teaching, cannot do admissions and cannot do the initial assessments. I was an LPN in a hospital for 20 + years before our hospital realized it. We had been doing those things all along. Then we found out differently and those things were taken away from us.

Raviepoo · Jan 11, 2015

Yes, it's true. Different states have different scopes. In my state an LPN cannot hang IV meds (unless they recieve an additional certification for IV meds), cannot hang blood, cannot complete assessments, and cannot do IV push meds under any circumstances. There are a few other items on the "Cannot" list as well.

The thing is, NCLEX is a national test. For the brief time you spend at PearsonVUE completing your test you are not in your state. You are in NCLEX National Utopia Land where everything is uniform, you have all the supplies and assistive personnel you need and all of the options you have to choose from already have a practitioners order. No matter what your state's LPN practice act says about the LPN scope, NCLEX assumes that there are a number of things LPN/LVNs cannot do. It's in your best interests to learn what they are. You can forget them as soon as you pass your boards, but until you get your license it's a good idea to know them. If you get delegation questions on your test you must assume that you can't delegate certain things to the LPN/LVN.

Wannabeeinscrubs, ADN, LPN, RN · Jan 11, 2015

That is true. I didn't think about it that way, as far as the NCLEX was concerned. They have to cover all of the bases, I know in Virginia, LPN's have a wide scope of practice.

Yes, it's true. Different states have different scopes. In my state an LPN cannot hang IV meds (unless they recieve an additional certification for IV meds), cannot hang blood, cannot complete assessments, and cannot do IV push meds under any circumstances. There are a few other items on the "Cannot" list as well.
The thing is, NCLEX is a national test. For the brief time you spend at PearsonVUE completing your test you are not in your state. You are in NCLEX National Utopia Land where everything is uniform, you have all the supplies and assistive personnel you need and all of the options you have to choose from already have a practitioners order. No matter what your state's LPN practice act says about the LPN scope, NCLEX assumes that there are a number of things LPN/LVNs cannot do. It's in your best interests to learn what they are. You can forget them as soon as you pass your boards, but until you get your license it's a good idea to know them. If you get delegation questions on your test you must assume that you can't delegate certain things to the LPN/LVN.

eroc · Jan 11, 2015

I understand you feel short changed for the value of your work. And I appreciate all of my peers from CNA's to the chief medical officer.

But as you progress in your education you begin to research questions. Your posts are incorrect on the scope of practice for a LPN. Here, Virginia Board of Nursing - Laws and Regulations, you can see that all actions of a LPN are the responsibility of the registered nurse (RN). And all actions must be approved by the RN. And it is illegal for the RN to delegate; assessment, education, care plans, etc. to a LPN or anyone else.

And you really have to read and understand the definition of what is considered an "unlicensed person." The BON even states "regardless of title".

With that stated, I respect everyone that is excellent in their practice, regardless of their restrictions.

IrishIzCPNP, MSN, RN, APRN, NP · Jan 11, 2015

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

It is first up to the BON what an LPN can do. The facility can limit it more if they want. If you spend the time to look at the practice acts at the BON many end up surprised at the limitations that are placed on the LPN because "they always did that before". An important note is that "always did it before" won't hold up in a law suit.

In my state an LPN cannot do an assessment among other things.

ThePrincessBride, MSN, RN, NP · Jan 11, 2015

Well, it IS for the NCLEX. EVERY NCLEX review I have taken has stated that RNs should NOT delegate (initial) assessments, (initial) teaching and never evaluation or anything related to IVs. It is nothing personal, but the LPN scope of practice is not the same as the RN scope of practice.

Remember, this is NCLEX nursing. Not real life nursing. In real life, LPNs do have more independence, but for NCLEX purposes, the board doesn't want the RN to over-delegate to LPNs as the RN assumes responsibility AND accountability for the patient and outcomes.

NurseSpeedy, ADN, LPN, RN · Jan 11, 2015

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.

Same here. In my state there is little difference between what an LPN and an RN can do. I worked in a hospital and no one signed off my assessments. I also worked in a long term care facility. I did admissions. I did assessments. The director of nursing was an LPN. The only person who was an RN was the regional manager and I can guarantee you that she did not sign off on any care plans and we did our own assessments.

Nienna Celebrindal · Jan 12, 2015

Oh I sooooo agree with this post.

I was utterly SHOCKED by the nclex. I repeatedly got LVN questions wrong in practice. I figured out why in Kaplan. You can't answer them based off real life, even the Kaplan instructor agreed. So I started picking the stupidest option and got them all right. I was livid! No wonder RNs treated me like dirt, they have no clue what LVNs do. It's sad. I think this is also why being an LVN doesnt really help LVN to RN new grads get their first job.

It's really sad

soulRN · Jan 12, 2015

I know good LPNs that are better than a lot of RN's, they need to be respected a little more...my 2 cents;)

akulahawkRN, ADN, RN, EMT-P · Jan 12, 2015

I was taught in school that the scope of practice of an LVN and an RN can be nearly identical but never will be entirely equivalent. As an RN, an LVN cannot be my clinical supervisor. While each state does set the scope of practice for each type of provider, typically an LVN can not do initial education, initial assessment, or initial teaching. This doesn't mean that this is always true. An LVN may or may be allowed to do Nusing Diagnosis or may or may not be able to initiate a nursing care plan independently.

What really makes things interesting is that individual circumstances may result in the practical equivalence of the two. As a new grad RN, I'd be happy to learn stuff from seasoned LVNs as they've learned some things from experience that I've not learned yet. That doesn't absolve me from evaluating what I've been taught to determine if it's actually OK to do and it doesn't mean that the LVN is allowed to delegate things to me.

The point is that every place is different and it's incumbent upon everyone to determine what their actual scope of practice is, to whom one may delegate to, and the like. You don't want to inadvertently be functioning outside your authorized scope... it could be bad for your license.

eroc · Jan 12, 2015

Same here. In my state there is little difference between what an LPN and an RN can do. I worked in a hospital and no one signed off my assessments. I also worked in a long term care facility. I did admissions. I did assessments. The director of nursing was an LPN. The only person who was an RN was the regional manager and I can guarantee you that she did not sign off on any care plans and we did our own assessments.

Just out of curiosityâ€¦ what state is that? And do you have a cite for that information?