Is this within my scope?

[idasavealife]

I have a question about LPN "scope of practice". Is it in the scope of practice of a Licensed Practical Nurse to be the first one to do an assessment on a client being received to a group home? I was told to do a head-to-toe assessment on a client who is coming for the first time on my shift. I am aware that RN does all initial assessments but what exactly does this mean? I will receive this patient and she will come the following day to do the initial assessment. I was told LPN receive and do assessments on clients all the time in the nursing home. I have never done this and I do not want to do anything outside of my scope of practice. I have contacted nursing board for a possible answer but was basically told to figure it out on my own. Please any advice.

[idasavealife]

I really wish this were the case here. I emailed them and got the response that I told you. Not sure why my question couldn't just get answered. Evidently, I don't see it in their which is why I asked. I've called my previous instructor fr the program and waiting for her to call me back. The message before last looks like we are authorized to do assessment but it does not specify initial assessment

[Kooky Korky, BSN, RN]

You would search for LPN Scope of Practice on your state's BON website. It will be laid out for you there.

In my last state, I was allowed to do first assessment as an LPN, and did it daily. I was also allowed to educate, admit, and discharge.

Once I moved to my new state, none of these things were allowed.

It's up to the individual nurse to make sure they know their scope of practice in the state they're licensed.

Good luck!

She is trying to know, but says the BON basically told her to figure out on her own what her SOP is. What the $#%^$#&$*!!????

OP, what do your Policy and Procedure Manuals or other Manuals say? What does the DON say? The Administrator?

[Kooky Korky, BSN, RN]

A google search found

Rules and Regulations of the State of Georgia

Rule 410-10-.02. Standards of Practice for Licensed Practical Nurses

(1)The practice of licensed practical nursing means the provision of care for compensation, under the supervision of a physician practicing medicine, a dentist practicing dentistry, a podiatrist practicing podiatry, or a registered nurse practicing nursing in accordance with applicable provisions of law. Such care shall relate to the promotion of health, the prevention of illness and injury, and the restoration and maintenance of physical and mental health through acts authorized by the board, which shall include, but not be limited to the following:

(a)Participating in patient assessment activities and the planning, implementation, and evaluation of the delivery of health care services and other specialized tasks when appropriately educated and consistent with board rules and regulations;

Pretty general, it circles back on itself a few times, doesn't specifically answer OP's question. It also does not specifically say she can't do initial assessment.

Perhaps the accrediting bodies can answer the question. JCAHO, CMS, Medicaid come to mind. Department of Senior Services, Dept. of Health (state and federal).

OP, is there a form the RN fills out when doing initial assessment? I hope there is and I hope you use it. It would be like an H & P form.

[Kooky Korky, BSN, RN]

My state Board provides answers to nurse questions regarding scope of practice. As a matter of fact, I seem to remember that on the website, they list a separate office to send such questions to. Often the Board will also write a position paper and publish that position on the website. One example that I remember reading in the past was about the RN responsibility to oversee the use of unlicensed assistive personnel. I find it unacceptable that the OP's Board said for her to "figure it out". Send them a written request anyway. Nobody will remember talking to you on the phone. Let's see if they send you a written reply over a signature to "figure it out".

Yes, do that. In fact, send the same letter to several Board members. Address one to each person you are sending it to. Somebody needs to get off their duff in Georgia and give you a straight, complete answer.

Whoever told you to figure it out for yourself needs to lose their job because he or she is being paid to be lazy and unhelpful. Let your State Senators and Congressmen/women know.

[idasavealife]

I ended up calling to the BON again and spoke to a representative that says she can not give me legal advice but she showed my in the practice acts where it states that LPN can only participate in assessment and where it says RN do assessments. I sent that to the owner of the company, RN, house manager and told them I am not going to do the initial assessment because its against the law and my scope of practice. I was asked if I would come in and just not do the assessment wth?? I've been so stressed about this my body is shaking on and off, headaches and loss of appetite. I could loose my job for telling them no but I will not break the law for anyone nor practice outside of scope and potentially loose my license. I'm upset that I would even be asked such a thing. Its a very stressful situation.

[idasavealife]

Thank you all so very much for you input. I feel like i'm not alone trying to figure all this out.

[Lunah, MSN, RN]

Georgia is just one of those states. Where I have worked in Georgia, RNs had to do any initial assessments or co-sign for an LPN.

[TBohmRN, RN]

In Iowa, the LPN scope does not allow an LPN to perform an INITIAL admission assessment in LTC. Once the initial is done, if the LPN has taken the supervisory course required by the Iowa Board of Nursing, then they can perform skilled assessments. Not sure if there would be a difference between a LTC facility and a group home though. Sorry your state BON wasn't more helpful.