I'm confused with the LPN's responsibilities...Please help!

[KulRN]

Hello, fellow Californians!

I'm a fairly new RN and have only been working for a year and a half. I work on a med-surg floor. We do team nursing once in a while (RN-LPN-CNA), we have 8-10 patients. I feel like when I have a team, my work doubles or I get even more exhausted at the end of the day. I am responsible for patients assessments, IV pushes, charting, talking to patient and families and Doctors...I guess my question is, what does LPN do that is within their scope of practice? I sometime get to work with an LPN who has excuses for everything.....starting an IV, inserting foley/NG tube and discharges....to the point where I don't even bother asking anymore and just do it myself...

[ginger58, ASN, RN]

http://www.bvnpt.ca.gov/factvn.htm

This has some vague facts on what LVN's do in CA and then it also depends on your facility. In all honesty, having an LVN does feel like double the work. As an RN we're supposed to see the patients of the LVN ourselves, do initial assessments, hang or push certain meds, sign off charts. Ours do talk with the docs and family. Sounds like you're working with a dud! If her passing off stuff to you continues I'd talk with my manager. It's hard enough getting our own work done.

[toeleah]

in alabama the only thing an lpn can not do is hang blood but they can monitor it and do iv pushes.they have there own patients just as the rn. they do their own assessment, talk to the doctor and everything else that goes along with being a nurse.AND U DO NOT NEED TO BE IV CERTIFIED BECAUSE THATS TAUGHT IN SCHOOL. THE STATE OF ALABAMA HAS ALSO ENCORPORATED IN COMMUNITY COLLEGES THAT LVN AND RN TAKE THE SAME CLASSES THE FIRST TWO SEMESTERS MAKING IT EASIER FOR U TO GO LPN TO RN.

[caliotter3]

When I worked in LTC, LVNs and RNs had their own assigned residents/areas. Each charge nurse took care of her/his own residents and only went to other nurses for help or questions of some kind. There were RNs with supvr resp if things came up that required that kind of intervention. The team you describe really sounds like you (and the LVN) are being misutilized. There should be a better division of labor. That is the fault of mgmt. What is written in the job descriptions? You should go to your supvr and get a better clarification. There is no reason why your LVN can't carry her own pt load and only have to rely on you for those few things that are really legally your resp. Is she IV certified? If you are working in an acute care setting there is no excuse for her not to be doing IV skills that are within the LVN scope of practice. Of course, a lazy person is a lazy person. At the LTC fac I worked at there were charge nurses that did less than others, and some who were so lazy they should have to answer to a higher power for their lack of care. Falsifying nursing actions in the chart is not nursing. But, this occurs best when there is not closer supvr oversight. To alleviate your work imbalance, talk to your supvr, ask to see the job descriptions, ask questions, maybe you can get a change where your LVN starts to earn more of her paycheck. A good question: are you responsible to conduct her performance review? Maybe she only does all of this shirking of work b/c she has been getting away w/this beh for so long and nobody is really aware of it. Good luck. I know how morale busting it can be to be around a co-worker who is allergic to work.

V