LPN scope of Practice

TheCommuter, BSN, RN · Sep 3, 2015

Here in the States, LPN scope of practice varies from state to state. Each state has its own Nurse Practice Act, and nurses who are licensed in a particular state are bound to practice in accordance with it.

For instance, I am in Texas, a state with a wide scope of practice where LVNs are permitted to perform whatever skills their employers have trained them to perform. Therefore, my LVN coworkers practice to their full scope: they have ACLS certification, give medications via IV push and IVPB, and maintain PICC lines.

However, LVNs in a state with severe practice restrictions such as California are not allowed to administer IV medications, and ACLS certification would be pointless since they'd be disallowed from pushing any of the cardioactive meds.

quiltynurse56, LPN, LVN · Sep 16, 2015

I live in Iowa. There are two things I am not allowed to do here. They are, 1) IV and IV meds and 2) Initial assessments upon admission.

After we work a certain number of hours, we can take and IV administration class and become certified in that area.

jadelpn, LPN, EMT-B · Sep 22, 2015

I also live in a state that allows LPN's to do whatever a facility allows them to, and they show competency in. What is a major component in all LPN practice acts is that they are not allowed to clinically direct an RN. (But many in sub acute are in supervisory roles, as administrative roles, and not clinical roles)

However, one would be hard pressed to find a facility that will allow an LPN to do what "classically" is themed as what an LPN can't do: ie: blood products, IVP, PICCS. ect.

Most have LPN policies. And that will outline exactly what you can and can not do.

And as far as ACLS--in the facility I worked, LPN's could not, by facility policy, do IVP meds. Additionally, one can not clinically direct an RN. So that left recording only for a code.

The RN nursing unions were often to "blame" for LPN's and their limited scope. It took one RN to dig up the "working under my license" myth, and bring it to the union, and then all bets were off.

Get malpractice insurance. Back up your scope with the facility policy. And be sure that you have a copy of your signed competencies. Protect yourself, OP, as you can be fairly certain that if you make an error, the facility can and will claim they had "no idea" you were working to such a scope in the ER....Interestingly, this will also include your charge nurse claiming ignorance.....

Make sure that you are able to back everything up. With all that being said, I see you are a Canadian nurse...which I think your scope is really different than that of the US.