lpn supervising RN!!!

[masry123]

I am very confused, my facility just hieared 2lpn to supervise day shift during weekday and weekends. we do have more than 6 RN {new grad} on diffrent floors. my question is 'is it possible for lpn to supervise RN if she have mor exp":idea:?

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[PatMac10,RN, RN]

can the lpn,since she is in charge,delegate tasks to the rn?

well what kind of tasks? i know that the lpn can assign certain nursing tasks to unlicensed assistive personnel , but as far as the lpn delegating such tasks to the rn i'm not really sure because i think that this would fall under clinical supervision. now if the lpn is going to be assigning which halls to do and such tasks as that i think that is permitted since they are the nurse in charge. but, it is like i said earlier, i've never seen a rn work under the supervision of an lpn, not that i don't think lpn's aren't qualified, but the bon says "supervision of an rn by an lpn is beyond their scope of practice" it doesn't specify what type if not all supervision. you can take a look at

the ncbon website at www.ncbon.com

heres a link to the page that has list of the clarification on the role of the lpn and rn http://www.ncbon.com/content.aspx?id=682

scroll down the subject list and look at the different subjects and color comparison chart. compare it to your state it is clarified much better and is very interesting and informative.

[StayLost, BSN, RN]

I don't want to sound ignorant, but I didn't know that an LVN could be a charge nurse. I thought to be charge you would need to make assignments for others, which I thought was out of the LVN's scope. Am I way off?

[TheCommuter, BSN, RN]

I don't want to sound ignorant, but I didn't know that an LVN could be a charge nurse. I thought to be charge you would need to make assignments for others, which I thought was out of the LVN's scope. Am I way off?

LVNs/LPNs are almost always employed as charge nurses in the long term care setting (a.k.a. nursing homes).

As I've said before, an LPN can supervise an RN administratively, but not clinically. Staffing and creating assignments are administrative tasks, so the LPN can function as a staffing director or staffing coordinator over a unit of RNs. Remember that making assignments and dealing with staffing issues are not exactly the same as delegation.

[PatMac10,RN, RN]

i don't want to sound ignorant, but i didn't know that an lvn could be a charge nurse. i thought to be charge you would need to make assignments for others, which i thought was out of the lvn's scope. am i way off?

the ncbon lists a charge nurse as an rn who supervises and manages care and a "nurse-in-charge" as an lpn who is put in charge to make sure that the care plan or system set up by the rn is implemneted.

http://www.ncbon.com/uploadedfiles/practice/position_statements/nurse%20in%20charge%201-2010.pdf

also look at this link about the comparison of the lpr and rn roles, looks towards the bottom where it says management of care:

http://www.ncbon.com/uploadedfiles/practice/position_statements/scopecomparisonchart.pdf

but it does say it is beyond the lpn scope practice to assign nursing tasks to the rn and supervise the rn when it comes to patient care.

[APRN., DNP, RN, APRN, NP]

The RN is not only responsible, but accountable for delegating tasks. Just because a task in in the scope of practice for a particular license, it does not mean you would be delegating the task appropriately to someone who, for whatever reason, was unable to competently perform the task. (e.g.- had not been signed off as competent to use the accucheck/glucometer and wound up missing a critical sugar level) If something bad goes down, you can bet your sweet bupkus that your RN license will be on the line. I'm not joking either. You may consider yourself as working as an RN despite the job title of LV/PN. You may tell prospective employers that you participated in an LP/VN job description, but was required to provide a level of care required of an RN by such examples as; IV's, assessments, etc.

[Asystole RN]

this must be a ltc facility.

and yes, lpn's can supervise an rnadministratively, but not clinically.

this is very, very common.

leslie

Very important key words here.

In my State of Arizona it is illegal for a LPN to delegate a task to a RN, although there are LPN supervisors.

[classicdame, MSN, EdD]

experience has nothing to do with it. Scope of practice per your state's nursing practice act is all that should be considered. It is probably online.

[NRSKarenRN, BSN, RN]

north carolina bon has good info on role within their state:

[color=#004478]color - rn and lpn scope of practice components of nursing comparison chart

[color=#004478]nurse in charge assignment to lpn

issue:

in non-acute health care settings, the licensed practical nurse (lpn) may participate in assuring the implementation of the established health care plan(s) for a specified number of clients as assigned and supervised by the registered nurse (rn). this participation in assuring plan of care implementation may be carried out by the lpn in the capacity of a "nurse-in-charge" role (differentiated from a rn charge nurse) as long as the following criteria are met:

(1) time limited - restricted to a specific assigned tour of duty which shall not exceed the usual 8-12 hours within any 24-hour time frame;

(2) geographically limited - restricted to a geographically-defined unit or clinical area within an institutional setting or for a group of clients within a specified program or service area of an agency;

(3) client acuity limited - restricted to the care of clients whose health status would be expected to change only over a period of days and weeks, rather than minutes and hours; and

(4) rn is continuously available, on-site when necessary, for notification of significant changes in client status and consultation regarding further evaluation and care planning decisions.

definitions:

charge nurse - an rn who supervises and manages patient care delivery settings or groups of clients, usually for designated time periods.

nurse-in-charge - the assigned role and responsibilities of an lpn who participates in assuring the implementation of established health care plans for a designated number of clients under rn supervision

and [color=#004478]lpn scope of practice - clarification: position statement for lpn practice

the lpn also participates in implementing the health care plan by assigning nursing care activities to other licensed practical nurses and delegating nursing care activities to unlicensed personnel qualified and competent to perform such activities providing certain essential criteria are met. these criteria are listed in the attached lpn rules in paragraph (d)(2) and include:

1. assuring that competencies of personnel to whom nursing activities may be assigned or delegated have been validated by an rn;
   
2. continuous availability of a registered nurse for supervision;
   
3. participation by the lpn in on-going observations of clients and evaluation of client’s responses to nursing actions;
   
4. accountability is maintained by the lpn for responsibilities accepted, including care provided by self and by all other personnel to whom care is assigned or delegated;
   
5. supervision provided by the lpn is limited to assuring that tasks have been performed as assigned or delegated and according to established standards of practice.
   

it is beyond lpn scope of practice to assign nursing responsibilities to rns.

please note: managing the delivery of nursing care and administering nursing services

are not components within lpn scope of practice. supervision by lpns is limited to the assuring that tasks have been performed as assigned or delegated and according to established standards of practice as stated in paragraph (d)(2)(e) of the attached lpn rules.

therefore, it is beyond lpn scope of practice to be responsible for the following activities: nursing unit management, nursing administration, performance appraisal, orientation and teaching of nursing staff, validation of competence, or nursing staff development.

in ltc settings, nurse in charge role is often seen. in smaller facilites 100 beds or less, "nursing unit" is considered entire facility and don/ adon functions as unit manger delegating assignment to scheduler/lpn for shift responsibility but total unit mgmt -- highlight blue functions above, is their responsibility.

[RN_Canada]

This points out that the issue of scope of practice is not well understood, by employers and nurses.

In Canada scope of practice is NOT about "tasks" it is about depth and breadth of practice.

Generally the higher level functions of supervision, assignment, delegation etc are applicable to the LPN scope of practice only to workers with a lower level of education and narrower scope of practice.

This would be consistent with the information posted by NRSKarenRN.

A nurse can report to a non-nursing administrator as part of the organizational hierarchy but this is not direct supervision. Technically RN's do not need supervision as they are self regulating and should be seeking out direction and supervision when it is needed, from the most appropriate person to provide that supervision or direction.

However, in organization hierarchy there should be a supervisor designated so an RN knows who to go to when seeking that supervision.

If an LPN works in an administrative position and a nursing credential is NOT required for that position then technically a RN could report to that administrator BUT they would not be reporting to an LPN because the license is not required.

Most nursing laws (not all) in Canada define nursing scope of practice for the LPN as "under supervision" or "under direction" of a registered nurse so a LPN cannot supervise an RN.

It would be poor practice in any organization to have supervisors and other administrators in the organizational hierarchy with less education than the front line workers. Having said that it does happen because experience sometimes trumps education.

There are many LTC facilities in Canada where there are no degrees among the administrators but the nurses looking after the clients all have university degrees. It provides for some interesting dynamics in the workplace!

Just wanted to point out my comments are directed to supervision here not leadership - all people and organizations need leadership.

Registered nurses should not require supervision (technically) but leadership is always needed and good leadership contributes to a good quality practice environment.

[island40]

I have had all types of administrative supervisors - MBA, BA, BS, non-nursing and even one really great CNA with a BA in business. They made my schedule, were able to correct me if my uniform was not right, if I was late or talked smack to another employee or client. They were not there to judge my clinical skills, or competency. They were ADMINISTRATORS and did a great job of managing work flow, personnel and fire drills.

[caliotter3]

I worked at a LTC facility where the house supervisor at night was an LVN. We had one or two RNs on the night shift who were new grads. I was told the LVN was in charge because of his years of experience and also because of his special relationship with the DON. There was never any friction or problems because of this. On the other hand, I have worked at facilities where brand spanking new grad RNs are put in charge whether they could handle the job or not. It is sink or swim for them.

[annacnatorn]

How about a CNA showing an LPN what to do!................She couldn't even take a rectal temp!......

Does that get you or what!