LVN's in a ASU setting

[Nuwubeachlover]

Hello all, I have a question regarding LVN vs RN nurses in a pre-op area in an ambulatory surgery center. I have worked in a surgery center for the last couple of years and the facility has fazed RN nurses out of the pre-op area and only have LVN nurses. The nurses admit the patient ask them pre assessment questions, check sugars, start IVs, other pre-op tasks and deems them ready for surgeries. Now, is this working out of the scope for an LVN? Basically doing the job a RN should be doing. BTW I am in California. I checked the board for clarification, and an LVN has to work under the direction of an RN or physician. These nurses basically work as individual practitioners, and I am not trying to start an lvn vs rn debate here, the fact is I work here and this seems wrong, am I at risk being an employee here with my license?

[nursel56]

Hi Nuwubeachlover!

All of the tasks you mentioned are clearly within the scope of practice for an LVN in California (assuming the LVN has an IV certification).

So my question would be why you consider an LVN working in a surgery center to be an "independent practitioner"?

Not sure exactly why you think your license is at risk in any way, either.

Perhaps if you provided a little more detail about your concerns we could provide more helpful advice.

[Nuwubeachlover]

Yes, the tasks are in the LVN scope, but not alone without guidance. There is not a single RN. I was just wanting some feed back on if this is a normal occurrence. I assume care for patients once I take them from the pre-op area and this is where things are blurred for me. I was told from an RN friend of mine who does preop for a hospital that no, this is not correct and this is a mismanagement by the facility to save money by using LVN nurses instead of an RN, I never thought of it that way, but I have never seen this before so I am curious. MY RN friend also said I need to protect myself because if something were to happen to the patient I could be liable.

[sallyrnrrt, ADN, RN]

Ok, the patient is usually seen and assessed by CRNA, or anesthesiology....and frequently their surgeon..... That is two physicians or one advanced practice nurse and physician....

[Alex Egan, LPN, EMT-B]

So there are no physicians? You said it in your first post and your absolutely correct. An LPN needs to work under the direction of an RN, physician, or other professional as allowed by your specific state. Also direction is not supervision. Direction requires protocols or instructions, and the the provider be available for any situation that the LPN is unsure of or falls outside the scope of their practice. Supervision requires the physical presence of the advanced provider. (To my understanding)

LPN is not under RN. LPN does requires an advanced provider to be involved in their area of practice.

i think this is a very good question for you to ask and research. It is important that you understand the scope and limits of your practice under the law. Be sure not to confuse someone else's policy for law. A facility can restrict practice however they wish but the law is most important.

[brownbook]

I assume any ambulatory surgery center has to have a physician, whether anesthesiologists or surgeon, in charge of the facility, part of the governing body, part of the board of directors, etc., something like that? Do only CRNA'S work at your facility?

I assume that as long as there is a registered nurse, anesthesiologits, or surgeon, physically present, even if that person is also in an OR doing cases, or working in PACU, then you are working under the direction of a RN, or MD.