LPN scope of practice

[Quark09]

I realize this can vary a bit from state to state, but in general, I thought that in a hospital setting, an LPN/LVN cannot do an initial assessment, hang blood, do IV pushes, or do initial patient education (they can reinforce it though).

In light of this, I was a bit surprised to come across an ad for a hospital seeking an OB LPN; duties to include the following:

Obtain initial health data of patients with a wide range of specialized medical and surgical conditions. Provide educational service to patients and their families for health promotion, prevention and/or detection of disease. Conduct initial interview, provide appropriate referrals and lab panels per protocol for new maternity patients. Perform electronic fetal monitoring as needed. Document patient information in record, computer, and log as appropriate.

The ad called for a year of experience r/t the field. Regarding the obtainment of initial health data and conducting the initial interview, is this the norm in some of the places you've worked? I've been on med/surg, OB, ICU, and PACU, and while LPNs worked in med/surg and OB, they didn't do initial interviews or assesments.

[SweetBabyLPN]

Well, in my state, LPN's can do initial interviews and assessments but we can't call the assessment an "assessment" but must refer to it as data collection. As long as there is an RN assessment within the first 72hrs or prior to discharge, this is okay.

We can also do IV pushes as long as the medications are non-narcotic and we can hang blood with an RN co-signature.

Hope that helped.

[prettyinblu]

I work in the hospital and my first 9 months there we were allowed to do assessments with an RN to cosign the assessments but they recently changed that rule. So now I cannot do the assessment or admissions I can hang blood but an RN must start it, and i havent heard we couldnt do the intial patient education? hope this helps?

[prettyinblu]

Wow! Where I work LPN's cant do any IV push drugs

[sevensonnets]

LPN's do not hang blood.

[SweetBabyLPN]

Prettyinblu: Really? Where I am is pretty liberal as far as skills are concerned. The only skills that an RN can perform that an LPN can't are PICC and Midline insertions, Push IV narcotics and access medports although once a line is in, we can use them to hang IV fluids and meds.

LPN's can hang blood here as long as it's with an RN but since an RN has to be the one to monitor the pt for the first 15min anyway, usually an RN is assigned this duty and the LPN cosigns if another RN is unavailable.

[realnursealso/LPN, LPN]

NYS Nursing:Consumer Information

Licensed Practical Nurses:

•Administer medications as directed,

•Provide bedside nursing care, including services requiring sterile techniques,

•Observe, measure, record, and report indications of patient health status,

•Perform more specialized tasks routinely, such as catheterizations and suctioning and others sparingly, such as IV therapy, with additional training,

•Administer blood and blood products, with additional training and may assist in dialysis in outpatient centers that provide dialysis to chronically ill end stage kidney patients.

[Miller86]

Where I work LPN's do pretty much everything a RN does except being in charge and a few things here and there. They hang blood, do IV initiations, Picc line management, all types of assessments and data collections. And the duties are changing and increasing as as well. It's a bit of a fuss at our hospital as compensation is not being met with the additional tasks. Completely unfair since the hospitals just want to take advantage of LPNs and not pay them for doing the additional work.

[Sun0408, ASN, RN]

In my state and LPN can not do any IV pushes, access a PICC or TLC,port a cath, initial education or hang blood.. I know from past hospital experience an LPN can not do the initial assessment.. An RN would have to do that if they got a new admit.. At my current hospital an LPN can not sign the initial plans of care but can after they have been established.

[Quark09]

Thanks much for the replies, all! I knew scope of practice varied from state to state; I just wasn't sure if this institution was basically trying to hire an LPN to fill duties that would normally be fulfilled by an RN, and subsequently pay less for the same service.

[freetopayattention]

Often it is facility policy that keeps LPN's from practicing to their scope. It makes it more difficult for the RN's to organize as long as LPN's can do so much of what they want as a job description especially for their 2-yr RN's. LPN's are being forced out totally or the job content changed. If any LPN's are in unions watch carefully; I feel like my union sold me out and worked with management to remove the LPN's from all departments (except LTC [so far]). Some of the posts on here sound a little too pat to be true, like maybe it's a fishing expedition...

[mentalhealthRN]

Not for nothing but I don't get how the training/prep/schooling is not the same and yet it sounds like in some places LPNs are doing the same things as an RN.....just putting this out there as a thought but for those out there trying to push that all nurses should be RN/BSN--when they let LPNs do whatever an RN can do why would they bother? It certainly doesn't make it so that one would feel limited enough as an LPN to feel like they needed to go back for an RN let alone a BSN. And me personally I don't like the idea that the law says LPNs can't assess so they go ahead and assess and just call it something else to get around the law. When something is missed and the LPN did the "observation" isn't that a huge liability for a facility if the patient/family decides to sue.

--As far as OB in NY--when I worked in L&D they didn't hire LPNs. Too much working independently and assessing constantly to have LPNs and have to get stuff co-signed.

--when I worked on an inpatient medical floor we had a few LPNs and they couldn't do anything with PICCS unless they were already running NS they could piggy back.

--Blood they couldn't hang but could be a second check (all blood had to be checked by 2 nurses, at least one being an RN)

--they couldn't do IV pushes either--of any med.