My hospital is breaking the law...

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Specializes in Paramedic 15 years, RN now.

My employer is breaking the law asking me, on med surg, and all other RNs to accept 10 patients. They give us an LVN and say that the LVN has "their patients" and I have mine. However, I am still expected to give all IV meds. If I give ANY med am I not therefore, assessing that patient thereby making him/her "my" patient? What should I do? I KNOW its illegal and fear that I may make an error an will have no one to back me up.

Advice?

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I don't know where you work, but unless the ratio is mandated by law, it isn't illegal to give you 10 patients. Do all of the patients have IVs? And just because you are asked to give a med doesn't mean you need to do a head-to-toe assessment.

I would hope that the LPN is forthcoming with any information you need.

Best wishes!!

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Also pretty sure this is legal. Even in states that do have mandated ratios, if 5 of those patients are the LVN's it doesn't matter that you're the one giving the IV meds. They still don't count as your patients. I'm assuming you're in CA since you're saying "LVN" and not "LPN".

This is directly from the CA gov web page.

"Licensed vocational nurses may constitute up to 50 percent of the licensed nurses assigned to patient care on any unit ...

Nothing in this section shall prohibit a licensed nurse from assisting with specific tasks within the scope of his or her practice for a patient assigned to another nurse. "Assist" means that licensed nurses may provide patient care beyond their patient assignments if the tasks performed are specific and time-limited."

Completely legal by CA staffing laws.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I KNOW its illegal and fear that I may make an error an will have no one to back me up.
What your hospital is doing is very legal. It is called team nursing. Even though California has legally mandated nurse/patient ratios, it is still legal to assign an RN and an LVN to a group of 10 patients. You have five primary patients, and the LVN has five primary patients. Although you're hanging IV meds for the LVN's patients, they are still his/her patients.
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Specializes in Paramedic 15 years, RN now.

Interesting...thanks for the info!!!! Never knew it was legal..but I tell you, I feel very uneasy giving an IV med and simply waliing away and trusting the LVN to monitor the pt I just gave something to. Seems very shady to me even though it may be legal. I feel, perhaps incorrectly, that if I do ANYTHING to a pt I am therefore responsible for any outcome of my intervention, and by being responsible, I would therefore need to assess and monitor...but, as you have pointed out, I guess I am incorrect. Anyhow, thanks guys!

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Specializes in Acute Care, Rehab, Palliative.

Why wouldn't they just have the LVNs give their own meds?

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Specializes in Pediatric/Adolescent, Med-Surg.
Why wouldn't they just have the LVNs give their own meds?

Because in some states (such as the OP's state) LPN's can not give IV meds or IV push meds.

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Specializes in Hospital Education Coordinator.

I know this will start a controversy, but LPN/LVN's should not be doing bedside care if they are not allowed to do the bedside care.

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Specializes in PACU, OR.

I can understand that meds are supposed to be administered by an RN if it's outside an LPN's scope of practice, but why should the OP fear leaving an LPN to monitor a patient after administration? I regard my ENs as being more than capable of doing that, and they're approximately the equal of an LPN....

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Specializes in PeriOp, ICU, PICU, NICU.
I know this will start a controversy, but LPN/LVN's should not be doing bedside care if they are not allowed to do the bedside care.

In my place of employment the charge nurse is the one who pushes the IV meds and hangs the blood. It just works better for everyone on the floor to keep the charge nurse out of staffing and she can follow the LVN's, co-sign their assessments. Admit a pt and transfer care to them etc that the LVN having to 'find' an available nurse who will not grunt to push a med of hers. Works for us and no one ever complains to be honest.

These nurses have been there for decades and very inteligent women. The hospital no loger hires LVN's though.

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I think the only state that cares is California. Def no laws like that where I live, I had 10 patients on med surg by MYSELF with no LVN. I would have loved to have the help. I have worked with some great LVNS that taught me a lot.

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Specializes in Med-Surg/Oncology.

I typically have 12 patients assigned to me, and an LPN (to give meds to the 12 patients) and sometimes a CNA (to do patient care on the 12 patients). Not only do I trust my LPN -and- my CNA to "watch" my patients for me, I usually depend on them to do so, as I cannot be in 12 places at once for 12 hours. Your LPNs (LVNs) have received enough schooling and almost always have enough experience (most of my LPNs are more experienced than me) to be able to safely help you monitor your patients, and know the signs and symptoms of a patient going into some kind of distress. Unless one of them gives you a reason not to, trust them!

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