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LPN Scope of Practice By State

Posted

Hi, I would appreciate honest replies from real LPNs or RNs that used to be LPNs. I am trying t figure out which states have the broadest scope of practice for practical nurses. Which states have the most limited scope of practice?

I know the scope is not as broad as that of aRN but I also know it varies by state. One thing I think pertains to ll states is that only RNs can do assessments right?

Thanks in advance for clarifying what your role is as an LPN!

There are some variable in the scope of practice, What you learn in RN school makes LPN not as useful as RN, and yet in LTC, LPN does everything exception on IV ABT, TPN for picc, medi port, central line or so. Now in LTC- LPN can do assessment, admission, call Dr, report labs, manage his or her section well-independently. In Hospitals where LPN left, Like where I work at Kindred, we have many LPN and they are damp good. Experiences counts so much. In Hosp LPN doesn't call MD, no admission there for no assessment, No IV of course, they do treatments-wound, PO meds, G-tube+NG-tube meds, their assignment is more at time, but RN covers for all IV meds, call MD in LPN behalf if needed. Depends where nurses are. In IL any LPN took IV certification can start IV for fluid, monitor lines strictly PIV lines only. Not sure LPN can hang IV-ABT. Sorry that all I know. Hope that help!

LadyFree28, BSN, RN

Specializes in Pediatrics, Rehab, Trauma. Has 10 years experience.

These scope of practice can be broad enough the the difference between the nurse and LPN is that RNs do assessments and teaching; LPNs "data collect"-translation no initial assessments or initial teaching- and no chemotherapy infusions. That is the scope in my state; LPNs just got the green light to administer blood products.

I was IV therapy certified; meaning I got to access ports, draw labs off of Central Lines; etc; however, not every facility had policies in place to honor the full scope that the state allows; that is the draw back of being a LPN; in addition, one cannot be recognized as an expert in their specialty unless they are an RN; so I couldn't get certified in the specialties that I worked in, that was a HUGE reason why I became an RN: full scope without limitations on practice, and the ability to become certified in every specialty that I work in.

Archerlpvn, LPN, LVN

Specializes in Home health, Addictions, Detox, Psych and clinics.. Has 9 years experience.

I think kansas has one of the the broadest scopes for sure. They can IV push certain meds out there. In terms of IV in California, LVNs can start PIV and administer fluids for hydration and piggyback certain vitamins but no medications whatsoever at all, though we can administer blood and blood products. They cannot touch a central line except for assessing superficially. Where I'm practicing in colorado LPNs scope is nice we can start PIVs, administer fluids, and infuse antibiotics into PIVs and PICCs as well draw blood on both. No administering blood in colorado for LPNs.

Texas is a great place for experienced LVNs to work. Every hospital has their own policies but some are very good. State law forbids us from doing initial assessments, inserting PICCs, but that about all if you have been independently trained. You also can't supervise an RN relating to nursing judgement.

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience.

Adding to the Tx info... LVNs can only practice under the supervision of an RN, APRN, PA, Dentist, Podiatrist or Physician. The person supervising is the one that makes the decision about what the LVN does (with the exclusion of the above-mentioned areas). The degree of supervision (direct & immediate or not) depends upon the environment & the patient's needs. LVNs participate in the assessment process by collecting data & (at the direction of the supervisor) conducting "appraisals" or focused assessments of a specific facet of the patient's physical condition or situation... e.g., check reaction to diuretics, evaluate patient's ability to perform glucometer tests, etc. Comprehensive assessment is limited to RNs.

If a hospital has formal training programs, they can expand their LVN's scope for IV therapy, central line care, or other 'advanced' tasks... but hospitals have to answer to their insurance carriers, and many of them take a dim view of this, particularly if there have been any claims due to problems in those areas.

Archerlpvn, LPN, LVN

Specializes in Home health, Addictions, Detox, Psych and clinics.. Has 9 years experience.

Adding to the Tx info... LVNs can only practice under the supervision of an RN, APRN, PA, Dentist, Podiatrist or Physician. The person supervising is the one that makes the decision about what the LVN does (with the exclusion of the above-mentioned areas). The degree of supervision (direct & immediate or not) depends upon the environment & the patient's needs. LVNs participate in the assessment process by collecting data & (at the direction of the supervisor) conducting "appraisals" or focused assessments of a specific facet of the patient's physical condition or situation... e.g., check reaction to diuretics, evaluate patient's ability to perform glucometer tests, etc. Comprehensive assessment is limited to RNs.

If a hospital has formal training programs, they can expand their LVN's scope for IV therapy, central line care, or other 'advanced' tasks... but hospitals have to answer to their insurance carriers, and many of them take a dim view of this, particularly if there have been any claims due to problems in those areas.

in any state lpns are to be supervised by any of the aforementioned prescribing clinicians.

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

In NC, we are less limited than other states. But our education reflects that as well.

We can do IV pushes, most IV meds, etc. while many states are very strict about that. We can't do an initial assessment, we can't spike for blood transfusion but we can sign and monitor them. We can't give a handful of meds, most being meds for OB or for codes. We can do assessments after the initial even though its the same assessment. We can't write care plans, but we can assist RNs with writing them and we can assist with changes to the care plan.