LVNs in Acute Care-PLEASE HELP!

[klmb318]

I work for a small rural hospital in California. Until about 3 years ago our adc was 3, staffed with one RN and one CNA. The administrators have pushed for an increased census, now it is 6 (as high as 9 at times). Their response to the staffing for the increased workload was to add an LVN. The burdens this has placed on the RN have been overwhelming. When the state ratios are brought up by the RN, we are told that we have a "waiver" and the ratios only call for licensed nurses, not necessarily RN's. The hospital has no policy for the use of LVN's. I have reviewed the state Nurse Practice Act for the RNs and LVNs as well as title 22 and cannot find any information on the use of LVNs as primary caregivers in acute care. Does anyone have a policy for this? Or can someone point me in the right direction to write a policy? Additionally, we do not have a charge nurse or relief for breaks. Please help me!

[KrysyRN, BSN]

Just a thought..try writing your state's BON to see if LVNs can provide primary care.

Annecdotally, when my unit (not in CA) switched from team nursing to primary care, the RN had to do one assessment on a patient every 24 hours and the initial assessment of newly admitted patients. I don't know if that was a BON stipulation or floor policy. The LVN provided the rest of the care, minus any RN duties, such as IVPs, IV admixture, hanging blood products, discharge teaching.