? LPN as a medicine nurse

[djb727]

Just recently started at a new facility. This facility has one LPN whom only comes in to work to give out all the medicines to all the patients on the floor. My question is, am I, the RN, responsible for making sure that my patients medicines are given; and if and when to hold certain meds such as BP meds, etc. Is this setup a delegating process. In other words, if the LPN went ahead and gave a BP medicine without checking a persons blood pressure on graphics, before you could tell the LPN to hold the BP med verbally (probably because as soon as the LPN comes in to work, they automatically start giving out am meds before the RN has even entered the room to do pts vitals, assessment, etc.) Am I responsible as the RN if a pts. BP is bottomed out because the LPN didn't check the graphics or know that pts BP beforehand? Of course I think I am. In other words, the LPN is not using their nursing skills by not checking BP. And if you so happen to be checking BP after the LPN has already given it while making your rounds, and you realize that there needs to be a med put on hold and you go to your MAR - guess what the med was already given before you could even delegate not to give this so and so med.

[debroh1]

I'm an LPN at a large facility. I rotate between charge and giving meds. However our doctors write in the orders if we are to check the BP and hold for parameters set by the DR. If I fail to check the BP before giving meds than I have done a med error and not the charge nurse, RN coordinator etc...LPN's are governed by BON just as RN's are and are responsible for their own actions. This is not delegating duties under your license unless you ask her to get the BP's prior to administering meds(such as it is your job to do the VS, but you delegate it to the LPN to do-which is reasonable since it is in their scope of practice)If a bp drops too low as a result of getting the med then it needs to be brought to the md's attention to evaluate the med. Either way, unless they are required to get the bp prior to giving the med and ignore that part of the order than it falls on their head and not yours.

[pagandeva2000, LPN]

i'm an lpn at a large facility. i rotate between charge and giving meds. however our doctors write in the orders if we are to check the bp and hold for parameters set by the dr. if i fail to check the bp before giving meds than i have done a med error and not the charge nurse, rn coordinator etc...lpn's are governed by bon just as rn's are and are responsible for their own actions. this is not delegating duties under your license unless you ask her to get the bp's prior to administering meds(such as it is your job to do the vs, but you delegate it to the lpn to do-which is reasonable since it is in their scope of practice)if a bp drops too low as a result of getting the med then it needs to be brought to the md's attention to evaluate the med. either way, unless they are required to get the bp prior to giving the med and ignore that part of the order than it falls on their head and not yours.

i am applauding your comment!! this definitely needs to be cleared up because many make this error of thinking...the rn is the delegator of care, however the lpn holds her own license and we learned the same things regarding medication administration...parameters should be checked, allergies, the 5 rights, etc... and should the lpn neglect any of those duties, it is her license that is at risk, not the rn. lpns are taught how to do vital signs, know that certain medications should not be administered without checking them first, even without the exact direct order from an rn, and we can also verify with the physician if an order needs clarity.

[HouTx, BSN, MSN, EdD]

My goodness - Team nursing is popping up again, huh?

We (oldies) are pretty comfortable with this care delivery model, but I realize how difficult may be to convert a primary care system back to team nursing.

Here in TX, we have very clear language in our nurse practice act & by our BON that differentiates "Assignment" from "Delegtion". I am sure that most other states have this also. All licensed people are accountable for meeting their own standards of practice. When you have an LPN med nurse, you are not delegating anything -- she is responsible for her own performance. You can only delegate to unlicensed people -- or in some cases, those who are operating outside their scope of practice and are therefore considered unlicensed such as an EMT.

[CHATSDALE]

the lpn is responsibile for taking v/s, bs befoe giving meds

this is a serious d/t harm that can come to patient

taking pulse when giving dig, checking b/p on pts before giving hypotensive drugs should be a second nature for the nurse giving meds and should not be delegated to another person wether that person is rn in charge or an cna doing routine v/s

[nghtfltguy, BSN, RN]

yeah....

they are all right....

look @ it this way... the lpn giving meds ALSO has a nursing license... they are responsible for their actions just as well as you... if you think that lpns are not capable of giving meds... then you don't know that many lpns.... *THEY ARE NURSES TOO*.....

don't ever forget that...

[akanini, MSN, RN]

I would prefer to take my own vitals and not depend on someone elses anyway. I have my BP machine in my pocket AT ALL TIMES. I would never think that the RN should be held accountable, especially if I'm giving the med.

[Ginger's Mom, MSN, RN]

The LPN is responsible for their own practice and mistakes. As RN you are responsible that they are given an assignment that matches their credentials The LPN or RN can make the same practice issues.

[pagandeva2000, LPN]

I really get a bit emotional about this, because LPNs are NURSES, TOO!! We may not have been trained as in depth, but medication administration is a fundamental task. Now, the scope of practice may be different (for example, in my state, I cannot hang central lines or do IV push), but the basic facts of medication administration is the same for both types of nurses.

A licensed nurse, may it be LPN or RN would probably be responsible legally if a certified medication aide made an error, however (which is why I don't like working in places that have them for the most part), but the individual nurse is responsible for her/his own practice.

[pagandeva2000, LPN]

My goodness - Team nursing is popping up again, huh?

We (oldies) are pretty comfortable with this care delivery model, but I realize how difficult may be to convert a primary care system back to team nursing.

Here in TX, we have very clear language in our nurse practice act & by our BON that differentiates "Assignment" from "Delegtion". I am sure that most other states have this also. All licensed people are accountable for meeting their own standards of practice. When you have an LPN med nurse, you are not delegating anything -- she is responsible for her own performance. You can only delegate to unlicensed people -- or in some cases, those who are operating outside their scope of practice and are therefore considered unlicensed such as an EMT.

So, to clarify (because I always had a hard time fine-lining the difference between assignment and delegation), an RN can assign an LPN to do a certain task, but because she is licensed as well, she (that LPN, I mean) is ultimately responsible for the performance of that task, but an LPN or RN can delegate a task to an unlicensed employee, but that they (the LPN and RN) are responsible for the outcome of that task...am I correct? Thanks.

[txspadequeenRN, BSN, RN]

let me clarify a texas rule here. lvn's do not delegate that belongs to the rn.

so, to clarify (because i always had a hard time fine-lining the difference between assignment and delegation), an rn can assign an lpn to do a certain task, but because she is licensed as well, she (that lpn, i mean) is ultimately responsible for the performance of that task, but an lpn or rn can delegate a task to an unlicensed employee, but that they (the lpn and rn) are responsible for the outcome of that task...am i correct? thanks.

[pagandeva2000, LPN]

let me clarify a texas rule here. lvn's do not delegate that belongs to the rn.

okay, so when an lpn is a charge nurse on a unit, say like ltc, then, is she making an assignment? this is where i get confused...i still can't get that together!