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!
I would keep assessment and teaching in mind and not get confused trying to pinpoint it any closer than that. It would be reasonable that the question would have some element of teaching or assessment to distinguish the choices. If not, then try to think it through, or guess.
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~
oh trust me i was shaking in my shoes, on the verge of tears, and thinking my manager ( who approved it) and my coworkers ( who were pushing for it) were absolutely nuts. but on our unit everyone is expected to be in charge, so a lot of my orientation revolved around the charge role. 2 days later when there was a call off ( and the replacement they found could not be in charge as they were from another unit) while still not comfortable with the idea, i wasnt in panic mode.
now almost 10 months in, i am usually afternoon charge about 75 percent of the time. i work on a behavioral health unit.
What a LPN can do in the real world and what a LPN can do in the "NCLEX universe" are two completely different things.
There are a number of questions framed "in a team of a RN, a LPN and a CNA, who should be assigned which pt?" the RN get the pt requiring an assessment. The LPN gets the pt requiring a dressing change or catheterization. The CNA gets the pt who only needs direct care.( Cause a team of two nurses and an aide are ALWAYS assigned to only 3 pts.)
I will address the delegaton LPN part...LPNs have a state practice act just as the RNs do. Just because the practice act gives them a certain scope level that doesn't mean the facility will have the same; it just can't go over. LPNs are also considered dependent contractors in all states (last time I looked) meaning that they must report any change of conditon to the RN (or MD). So look up both. LPNs scope of practice varies from state to state. In one state an LPN can start IVs and in another they cannot....it's up to the state's practice act.
Thanks everyone, evidentally I wasn't very clear in my question and as another person stated, it doesn't matter what who does what in what state. I'm referring to the NCLEX RN exam. However, while trying to research this topic I'm coming to the conclusion that I'm not going to find "one" list which states a LPN can: and a list of delegated or independent tasts are listed (not just "stable patients) and same for a CNA.
I totally get each state is reg by own BON but it frustrates me that this is not provided since this is what we are being tested on. I get it that I need to critically think BUT since I have NO practical experience I don't even want to begin to "assume" or guess on delegation assign. Just as I expect to be informed and remain safe under my BON as an RN I want to take this test same way. But, I'm guessing I need to get over it and leave it for what it is.
SO, what do you know about assigning tasks to NEW RNs? do you assume they are like LPNs and assign most stable patient? Can they admit, discharge, do sterile changes? (can LPNs do this?), trach care, IV meds, etc? I've been told not to get distracted by a questions stating new RN but......... and Im not sure what they want me to be thinking about questions like this. I'd just like to know, why does it need to be a guess? Or perhaps one of my 13 books is missing that information? I want to be a safe nurse, so can anyone shed some light?
Have been an ER LPN in our rural hospital for 22 years now. No problems as far as the delegation of duties as I respect the knowledge and imput of our RNs and our physicians.
As far as the duties, much has changed over the years at our facility.
Old days ... LPNs could do the initial assessment of any pt. presenting to the ER as well as discharge instructions. We mixed their meds, titrated "critical drips", we inserted Ng tubes, as well as placement of those who pulled out their G-tubes. Only thing we could never do was IV push meds or initiate blood products.
Today ... Initial assessment of a pt. must be done by a RN. No more of any of the above, can still do IV access (rule in that dept.) as this is my forte. Discharge instructions can still be done by an LPN, but even the replacement of a g-tube must be done by a physician and not an RN ...
Never understood any of the reasoning or dynamics behind this, but yet this question ... "Why the waste of skill and talents?" Both RNs and LPNs are accountable under their licensure?
Guess I will have to wait and see what they say next week?
Specializes in Vents, Telemetry, Home Care, Home infusion.
Amemded title to define that OP is looking for information re delegation for NCLEX... all the incofmation is in links I provided from NCSBON --NCLEX producer.
NRSKarenRN, BSN, RN
10 Articles; 19,178 Posts
NCSBN has a decision tree that may be helpful:
Delegation Decision-making Tree
Joint Statement on Delegation
Delegating Across Personnel in Long-term Care