NCLEX: Specific tasks to delegate to LPN? Charge Nurse role?

missnurse01, MSN, RN · Jun 12, 2012

this is a hard question to answer b/c in some ways you are asking for your specific state and also hosp policy. what lpn/lvn can do varies widely based on location. however the nclex is a national test-so guidelines are more generalized. when they talk about a stable pt they are looking at things like VS and assessment findings within normal parameters-and you do not expect and quick deterioration. there should be some information given to guide you as to typical delegation questions for the nclex...but it's been a little while since I took it so don't remember! I know I personally didn't have any of delegation questions, altho I had a ton of 'which pt is more sick' type questions. In many areas d/c planning and also admission/triage are typically not given to lpn/lvns. different states allow giving IV meds so you can't really depend on that one.

yes I would think the d/c person could wait.

charge role usually must be an expert in their field, and able to prioritize the whole unit and help in any situation.

hoping others will chime in!

canchaser, BSN, RN · Jun 12, 2012

Where I've worked, LPN can not give Ivp meds but can do ivpb meds. They must be iv certified to do this. Can't hang blood but can check it. So the RN must spike it. Can't do an admission assessment or ER triaging of pt.

missnurse01, MSN, RN · Jun 12, 2012

Where I've worked, LPN can not give Ivp meds but can do ivpb meds. They must be iv certified to do this. Can't hang blood but can check it. So the RN must spike it. Can't do an admission assessment or ER triaging of pt.

when I was in NH they could give select iv meds/abx...but no blood and not even check it. when I worked in cali they couldn't give anything IV but could give blood. in GA there are no rules/regs specific to lpns, so they can do almost anything but triage and initial assessment. when I worked in the er there, they could give all IV meds, during a code, etc. so different across the u.s.!

BuckyBadgerRN, ASN, RN · Jun 12, 2012

LPN's in my state can do trach cares, suction, sterile dressings.

CT Pixie, BSN, RN · Jun 12, 2012

Ok, so I know to delegate stable pts to an LPN, but can anyone provide specific examples of tasks or pt care that is w/in their scope of practice? Some say they can suction, give IV meds, trach care, sterile dressings?????

In Connecticut an LPN can suctionm give certain IV meds (if they are IV certified), do trach care and steile dressings. And while I can't do the initial 'assessment' a patient, I can 'data collect' and present my information to the RN who then has to verify it and sign off on it. In other states it's different.

The problem with the NCLEX with this type of question is the answer really can vary from State to State. I was always questioning during LPN school why we were being taught and tested on skills/procedures we were not allowed to do. I was told that the LPN scope varies from State to State and that the NCLEX will and does give questions on all of it, not just things specific to your State (since its a National test).

wooh, BSN, RN · Jun 12, 2012

It doesn't matter what LPNs can do here and there. NCLEX is country-wide.

You can delegate tasks. You can delegate stable patients.

You cannot delegate teaching. You cannot delegate assessment. That will usually knock your choices down to where you can pick an answer.

For prioritization, it's always ABC. Discharges have an open airway, are breathing and circulating, so you can knock them off the list of needing to be done first.

Mandychelle79, ASN, RN · Jun 12, 2012

charge role usually must be an expert in their field, and able to prioritize the whole unit and help in any situation.
hoping others will chime in!

sorry, I had to LOL about this. I was in charge my first day off orientation, on my first job as an RN.

HouTx, BSN, MSN, EdD · Jun 12, 2012

Hint - "delegate" means that the RN retains the entire responsibility for outcomes. Delegation is asking someone to 'work under your license'. That is not how RNs work with LV/PNs... because they also have licenses. Instead, RNs "assign" work & tasks to LV/PNs. They are working under their own scope of licensure and are responsible for the outcomes they product. The RN who makes the assignments is responsible for validating the ability/competency of staff to whom he assigns or delegates tasks.

Example: An RN team leader assigns treatments & med administration to an LPN because that is well within the LPNs scope of licensure and she has had competency validated for these tasks. If the LPN makes a mistake, the RN is not liable because he had no way of knowing that the LPN would not follow established P&P. When the RN delegates vital signs to the CNA, the RN maintains overall responsibility and must provide supervision & check the outcomes to make sure the task was completed correctly.

Your state nurse practice act will have information about what can be delegated to unlicensed personnel.

QuenymamiRN · Jun 12, 2012

No IVs for lpns except to dc it. No venous access devices as well. LPNs can do trachs. Never assign teaching, assessing, or evaluating. Never assign unstable, immed post op

GitanoRN, BSN, MSN, RN · Jun 12, 2012

i was in charge my first day off orientation, on my first job as an rn.

wow! i'm impress therefore, my hat goes off to you, :thankya: as i wish you the best in all of your future endeavors...aloha~

GitanoRN, BSN, MSN, RN · Jun 12, 2012

ok, so i know to delegate stable pts to an lpn, but can anyone provide specific examples of tasks or pt care that is w/in their scope of practice? some say they can suction, give iv meds, trach care, sterile dressings????? i'm not sure these are all correct. i also read that lpns cannot do discharge planning, is this true? it makes sense b/c involves teaching. also, if asked on nclex to prioritize 4 pts and 3 have specific needs and the 4th is a discharge pt, can that pt. wait?
also, as far as the charge nurse can anyone tell me the role they play for the nclex? since positions like this vary per facility i'm not sure how to grasp how they function when answering nclex questions.
thank you, i test soon and feel more confused than ever!

at this level, the nclex is nationwide therefore, you must approach this to your best knowledge base on your education during your nursing program. however, the task for lpn's that you're referring to, vary from facility and state of one's location in the real world. having said that, i would suggest you go over your review on lpn's duties in your text book, to get a better understanding and a concrete answer that would apply for the nclex questioning. wishing you the very best in all of your future endeavors....aloha~