LPN doing assessments Mn

Rexie68 · Mar 11, 2008

sometimes when i hear this from lpns, i can't help but get a little peeved when they state they are nurses and therefore they can do things an rn can do.

well, you certainly opened that can of worms!! last time i looked, my license said "licensed practical nurse" and when i'm done with school and pass nclex-rn it will say "registered nurse."

looks like both are nurses, but with different titles and responsibilities, at times.

Rexie68 · Mar 11, 2008

the rn owns the nursing practice and process. it can be shared with an lpn but the lpn can not independently own it.

perhaps it might be more accurate to say that you're the major stockholder or ceo, but can't "own" it alone....without lpns, cnas, pcts, feeder aides, etc......nursing would be in a world of hurt!!!

(yes, you touched a hot spot)

jjjoy, LPN · Mar 11, 2008

rexie68,

the poster wasn't saying that she gets peeved when lpns say they are nurses but "when they say they are nurses and therefore they can do things an rn can do." it's the "and therefore" part she objects to.

kimmiekoo72,

i don't see that pointing out the differences in scope of practice amounts to 'discounting the education of lpns.' the point isn't whether lpns are capable of doing one thing or another but that certain roles aren't defined in their scope of practice as dictated by their state bon.

unfortunately, there are major gray areas between the job roles of rns and lpns and i think that's a good part of what contributes to the tensions and defensiveness.

pepperann35 · Mar 12, 2008

In all honesty I do not understand why it is a touchy subject. It is what it is. Is there some disconnect between what is taught vs. how it really is? Sometimes I wonder why there has to be this "walk on eggshells" type of feel to this. For example...let's kick it up one notch... I do not hear RNs saying there are upset because they can not do things that an advanced practice RN can do. It's the law and has to do with scopes of practice.
Why is it wrong for RNs to say to LPNs that they can not do assessments? As an RN if someone was trying to practice within the scope of RN who is not an RN, then it needs to be discussed. This isn't about "I am better than you" but it is, I am credentialed to practice professional nursing and LPNs are not. Again...it is what it is.
Sometimes when I hear this from LPNs, I can't help but get a little peeved when they state they are nurses and therefore they can do things an RN can do. Please do not do this because really it is discounting the education of RNs. I can't help but think if one wants to be in the role of the RN, then go to school to be one. I wish to do things as an APRN so I will need to go back to school. But I do not harbor bad things against APRNs while I am only an RN.
With that being said... I do feel that LPNs are a valuable member of the nursing profession. LPNs do have their own license and are allowed to practice practical nursing. However, it does have to be under the supervision of an RN or MD. Should an LPN want to practice in the higher level of nursing then the LPN should be returning to school and getting an RN degree. If the LPN does not want to do this...then please accept the constraints of the present degree and credentials. The RN owns the nursing practice and process. It can be shared with an LPN but the LPN can not independently own it.

The truth is, the education we receive in school (whether for LPN or RN) is basic. Most of what we learn is learned through experience and continued education. I have been a LPN for 19 yrs. I work as a LTC supervisor at night. I do, and or check most of the admissions that come through our doors and we get over 500 admits per year to our facility. This includes complete head to toe assessments, verifying and writing up all the orders, going through all information sent from the hospital to make sure nothing is missed. Some patients may need follow-up appts that were not on admission orders or may have had abnormal labs or chest x-rays in the hosp. that need followed up, etc. Then, I leave a note for the Dr. to review my concerns when she comes in. :nurse: Anyway, it all comes with experience, not just your title. As long as my state and my facility says it's ok, then it is and that is that. It should not be an issue of ego, really.

jjjoy, LPN · Mar 12, 2008

The truth is, the education we receive in school (whether for LPN or RN) is basic. Most of what we learn is learned through experience and continued education.

So true!

PsychNurseWannaBe, BSN, RN · Mar 12, 2008

rexie68,
the poster wasn't saying that she gets peeved when lpns say they are nurses but "when they say they are nurses and therefore they can do things an rn can do." it's the "and therefore" part she objects to.

jjjoy that is exactly what i was trying to say...it's the and therefore part. thank you for taking the time to read the post correctly and getting what i was trying to say.

PsychNurseWannaBe, BSN, RN · Mar 12, 2008

As I mentioned and as the OP said, it was the and therefore part. Other than that...it's all good. If LPNs are getting RNs to review things or to sign off things or if they are contacting an MD, then the LPN is doing things correctly and there is no problem.

As I stated prior this wasn't and still isn't about one being "better" than the other. It was about scopes of practice.

LPNs, are valuable members of nursing and should not be discounted. Which I stated in my original post. I would like to add, so are CNAs, Med Techs, NATs, etc. They perform very hard and very time consuming tasks and are stretched very thin.

I actually got to work with 2 great LPNs and really they are the ones that trained me while I was doing my orientation. With many years of experience, they demonstrated outstanding nursing practice and taught me A LOT! And while we worked together, if something major came up, they got me to do the assessment or went over their assessment with me and we had great discussions as to what we should do. It was a team effort which really benefited the patient. And as they taught me things, I was able to teach them more in depth things as well, like pathophys. It was quite fantastic. I have a lot of respect for those 2 ladies and what stinks now is that I work opposite shifts from them. I never get to see them L.

I know that there is this tension but I don't think there needs to be. I am thinking that for the past many years, LPNs were kicked around or told that they are less than, and I truly do not believe LPNs should be treated this way. I think that because of the past and present, LPNs are trying to maintain their autonomy in nursing and sometimes what is said comes across in a way that really takes away from the role of the RN.

The sandbox is big enough...there is more than enough room for both to play.

noc4senuf · Mar 14, 2008

It all comes down to what the laws of nursing are that are listed with the BON's. I know and have seen that LPN's perform many assessments, it doesn't make it right and i have also seen state surveyors cite for the exact same thing. I guess it depends on how tight the regs are followed where you practice.

I have worked with some wonderful LPN's over the years and **** poor RN's (and vice versa). Now.... everyone take a deep breath and remember that we are all in this together and need to continue to stick together for the betterment of our residents.

I am licensed to work in both MN & WI, no difference with the laws regarding RN's and LPN's.

lpnflorida · Oct 12, 2008

I just want to impart on one part of the BON. It is the teaching part. I teach my patients something everyday whether is what the purpose, possible side effects or food drug interactions might be on each and every medication I give them. I also teach patient how to self cath, or teach their loved how to do catherizations. This is with full knowledge of the RN/s above me. I now have to question, am I suppose to not tell a patient anything about their medications, or about self care such as how to cath.. I am truly wondering. Not being a smart alleck about BON and what my Scope of Practice is versus reality. I am being honest, that is all.

lpnflorida · Oct 12, 2008

oh shoot, I just realized this is an old thread, well if anyone happens to read it. I would love their thoughts on it.

pagandeva2000, LPN · Oct 12, 2008

I do a great deal of teaching for patients in my clinic, at health fairs and on the floors. I teach about the disease process, how to manage common illnesses like DM, HTN, CHF, etc...medications, health management. I cannot see how anyone-may they be LPN or RN be a nurse without teaching. Even if the BON limited that, I wouldn't do it, because I would not appreciate it if it were not done for me.

Thornbird · Oct 12, 2008

I think that part about teaching was from NCLEX. Anyways, if unsure, check with your own Board regs. LPN scope of practice varies a great deal from state to state. In CT where I live, assessment is an RN only thing. All those forms that say "assessment" on top have been deemed to be "data collection" by the state. Teaching is in the LPN scope and is expected. Teaching is considered to be one of the defining differences between LPN's and Medical Assistants here.

In MA, where I have also worked, the LPN is responsible for her/his own practice and may be supervised by an RN or an MD and supervision may be indirect. In just the same way an RN must be supervised by an MD directly or indirectly. LPN's perform "basic" assessments on chronic or stable patients. There may not be an RN anywhere on the premises and the LPN then calls the MD if a significant change is occurring.

For people to make global statements about LPN education, training or scope based upon personal experience is unfair and confusing.

LPN's are trained in assessment at the level necessary for them to practice. All this emphasis on the semantics of "assessment" have come about since I went to school. I was taught that what differentiates a nurse from others is the ongoing use of the nursing process and nursing judgement. For example, I was taught that nurses don't "take" vital signs, they "assess" vital signs and that one never gives a prn med or does a treatment without "assessing" before, after and with treatments during. I really don't know how else to function nor can I understand why this whole semantics issue has come about. BTW, I went to school in CT and learned all this in a state where assessment by LPN's is not allowed now.