nursing care plans.... lvn or rn

[LVNwannaBE2007]

i have a question i got in a heated debate today with my DON over if care planning is a rn or lvn school... (btw she was one of my lvn teachers) yes they teach you how to write a care plan in lvn school but i was also told it was an rn skill...... but lvns follow it for a plan of care for the patient... can someone help me out here?

[TheCommuter, BSN, RN]

I have been an LVN for about 2 years to this date. I hand-wrote plenty of care plans while in school, but I have never devised any care plans while working as an LVN. I simply follow the pre-printed care plans that arise from the daily care plan meetings, even though I'm probably the only person who reads them. The care plans can be found in an obscure tab toward the back of every patient's chart.

[txspadequeenRN, BSN, RN]

i have done them and updated them more than i care to admit. i think it depends on the facility you work at more than anything...

i have a question i got in a heated debate today with my don over if care planning is a rn or lvn school... (btw she was one of my lvn teachers) yes they teach you how to write a care plan in lvn school but i was also told it was an rn skill...... but lvns follow it for a plan of care for the patient... can someone help me out here?

[LVNwannaBE2007]

ok i understand that but who initially writes them... rn or lvn?

[txspadequeenRN, BSN, RN]

i have initially wrote many and i mean many care plans... but thank the good lord for pre- printed ones...

ok i understand that but who initially writes them... rn or lvn?

[txspadequeenRN, BSN, RN]

now that i think about it we have a lvn that does nothing but write out care plans ...we have not upgraded to the fancy pre-printed .. however i have worked in places that do have them..saves mountains of time.

[TheCommuter, BSN, RN]

ok i understand that but who initially writes them... rn or lvn?

At the facility where I am employed, the care plans are pre-printed for a variety of conditions, risks, and diagnoses (pain, fall risk, alteration in comfort, etc.). No care plans are written; they are automatically computer-generated. Several members of the facility's "care plan team" must sign the pre-printed care plans to indicate approval of the patient's plan of care. This team consists of 1 RN (the DON) and several LVNs (the ADONs).

[caliotter3]

I was taught that even though LVNs learn care planning in school, that care planning is an RN function. Every employer that I've worked for had an RN's signature on any care plan that I've ever seen, whether preprinted or written out. I was also taught that it is the LVN/LPNs responsibility to follow the care plan and to report any significant changes to the RN so that the RN can revise the care plan as necessary. It does not surprise me that many places would have LVN/LPNs actually doing the care plans but having an RN read them and sign off on them.

[Virgo_RN, BSN, RN]

In my state, I am allowed to contribute to the plan of care, but an RN writes the care plan. At my facility, we have pre-printed care plans that we simply individualize for the patient. That is an RN function.

[txspadequeenRN, BSN, RN]

i think it also makes a difference what area you work in . in hospitals rn's probably do the care plans but in ltc the lvn's are heavily involved. believe me it is a chore someone else can take care of.

[CyndieRN2007]

I got this off the Texas BON website...

Can a LVN initiate/develop the nursing care plan?

Staff recommends you review Rule 217.11, Standards of Nursing Practice, as well as the Guideline for LVN Scope of Practice (available on the “Nursing Practice Information” section of the BON web site under "Scope of Practice.") Rule 217.11(2)(A)(ii) and (iii) clarifies that LVNs may not initiate care plans, but they should contribute to the planning and carrying out of nursing care and participate in the development of and modifications to the ongoing nursing care plan. Only the

RN

may develop the initial nursing care plan and make nursing diagnoses [Rule 217.11(3)(A)(ii) and (iii)]. This difference between LVN and

RN

scope of practice is based on differences in educational preparation of nurses licensed at each level as defined in the Differentiated Entry Level Competencies for Graduates of Basic Nursing Education Programs in Texas (DELC). DELC may be viewed in its entirety or downloaded from the “Nursing Education Information” page of the BON web site.

[meownsmile, BSN, RN]

I think technically even though a LVN/LPN can follow and use a preprinted care plan the plan itself has to be initially written and divised by the RN. The care plan is part of the nursing diagnosis and LPN/LVN's can not diagnose as far as i know. Many places have care plans already in place based on their facilities capabilities and these were written by RN's. When you have a patient admitted or there is a change in care status of a patient im sure any one of them can be implemented by an LVN/LPN. If you call transferring one into a patients chart writing, then ok. But again technically all the interventions, diagnosis, outcomes have to come from an RN.