LPN assessment in LTC

Hi everyone, I am new to posting, done a lot of reading though.

My question is I'm an LPN in LTC, I work the sub acute/rehab floor, I read in another tread that LPN's could not do initial assessments on new admits. We are required to. Am I endangering my license?

Thanks for any info.

Where I work, LPN's are not allowed to assess/document lung or bowel sounds.

[Brownms46]

Only if your state practice act doesn't allow it, but as far I have read, and I'm guessing you're Fl, there isn't anything that says you can't. What your place of employment says, and what the BON says are two differnt things, but I have rarely seen a facility go beyond what the state says. Usually facilities are more restrictive, not less.

Thank you both for replying, I'm currently trying to find a copy of the Florida LPN Scope of Practice. Do you suggest the BON or is there somewhere I can go online?

[Brownms46]

I suggest you call, email or write your board for a copy of the practice act. And you're very welcome. :). And you're a very wise person, to find out about what restrictions your state places on you. Your state board of nursing is the only source, that should be consulted when you're in doubt about what you do under your license. As you're the one who will be accountable to them, if you step beyond it.

[LaShell]

Hi, I work subacute too and do admissions. We have the typical packet and forms we fill out when people are admitted. I do a full head-to-toe and skin assessment when they come in and I document my findings. We always have a RN on duty in case something I assess is not normal or when I need another opinion. I feel like I am gathering information, not deciding the plan of care or goals, etc.

Thanks to all of you. This discussion board has been of great help to me. I find it very educational. Lots of smart nurses out there. I'm glad you guys are here.

[nursedawn67, LPN]

where I work I do the admit, as well as the other nurses. We have a packet of forms to fill out and there is always the unit managers that review the charts and are there for any of us nurses to go to about anything. I document lung sounds, and bowel sounds.

Here in New York, LPNs are not allowed to assess. According to the scope of practice, LPNs take and record data - it is the RN who assesses the data.

In New Mexico LPN's can do the same job as RN's as far as assessments and documentation goes. LPN's can start IV's, set vents, draw blood, administer any med via any route. They can pronounce if certified (whole other thread here isn't it?).

-Russell

I currently do PRN for a LTC facility in North Carolina. At this facility we (LPNs) complete the assessments and admission paperwork. When I first graduated from LPN school, I worked there and was surprised by this. If I find any irregular findings, I always have an RN sign off on the admission packet with me.

i am sorry to hear that in nm. whenever another profession takes on the responsibilities of an rn it devalues the role of the rn. why hire an rn when you can get the lpn for less. this is politics.

The initial assessment can be done by an LPN, but must be co-signed by the RN present. Need to know what is the policy of the facility,and the Nurse Practice Act within that State. Please protect your license.

Is this legal !! The Board of Nursing in New Mexico is aware of this practice.

I always have done my own assessments. We usually don't even have an RN in the building on the pm shift. I think the RN has to sign the care plan but the LPN can do it. I don't do care plans we have a careplan nurse who does it during the day.

I still do belive it all comes down to the policy of the facility, and the Nurse Practice Act for LPN"s within the State. I urge you to protect your license.

From the NM nurse practice act:

I. Standards for licensed practical nursing practice. Licensed practical nurses practice in accordance with the definition of licensed practical nursing in the NPA [61-3-3, G. NMSA 1978].

(1) LPNs may assume specific functions and/or perform specific procedures which are beyond basic preparation for licensed practical nursing [61-3-3,G. NMSA 1978] provided the knowledge and skills required to perform the function and/or procedure emanates from the recognized body of knowledge and/or practice of nursing, and the functions or procedure is not prohibited by any law or statute. LPNs who perform procedures which are beyond basic preparation for practical nursing must only perform these procedures under the supervision/direction of a RN.

(2) LPNs may perform intravenous therapy, including initiation of IV therapy, administration of intravenous fluids and medications, and may administer medications via the intraperitoneal route provided the LPN has the knowledge and skills to perform IV therapy safely and properly.

(3) When assuming specific functions and/or performing specific procedures which are beyond the LPN's basic educational preparation, the LPN is responsible for obtaining the appropriate knowledge, skills and supervision to assure he/she can perform the function/procedure safely and competently.

J. Educational program criteria. Educational programs preparing either RNs or LPNs to perform specific functions and/or procedures that are beyond basic educational preparations should:

(1) prepare the nurse to safely and properly perform the function and/or procedures.

(2) prepare the nurse to recognize and respond to any complication(s) which may result from the procedure, and

(3) verify the nurse's knowledge and the ability to perform the specific functions and/or procedures.

K. Nursing practice advisory committee. Board of nursing may appoint a minimum of a 7-member advisory committee to assist the board in regulating the practice of nursing. The committee shall assist and advise the board in the review of issues related to the practice of nursing.

Rustyhammer, I think it's wonderful that the NM BON recognizes the abilities of the LVN and don't just see us an "assistant" to the RN. I'm not devaluing an RN's knowledge but it's time the States recognize that LVN's can be trained to perform more than perfunctory duties or work as a clerical assistant with the extra fun of administering medications. Hurrah!

Forgive my cynicysm....it comes with years of experience. :)

Thanks for the written proof from the NM LVN scope of practice guidelines.

Oh yes, and for those who still question, please be sure to note in the guidelines that an LVN must be trained and certified to perform the duties and is also under the supervision/direction of an RN. This really frees up the RN to perform many of the duties they otherwise don't have time for which, in my humble opinion, increases the quality of care.