I also think things differ by state. I am in California (I am an LVN) and I can take a physicians order and I can note my own orders and do my own chart checks. I am also held accountable for my own actions. Yes, the RN covers my IV pushes and IV piggy backs. But I am given my own assignment of 5 patients. (I work in acute care) I cannot hang ANY antibiotics IV, no meds. Just maintenance IV's. I cannot do anything with central lines or PICC's other than change the PICC dressing. I CAN hange blood, but again I am in California and I am IV therapy and blood withdrawal certified. and I NEVER complain to the RN';s about doing the brunt of the work. We all work equally hard. I help out when needed, just as they help me. We work as a team. Truthfully, we do. Maybe it is because the Charge tends to cover me? I make a list of my piggy backs and pushes.
As for the S**T hitting the fan, when things go wrong in my hospital, it's the one person who is in charge of the patients care who gets it, and if that happens to be me, the LVN, the RN does not get in trouble. I can say this with confidence because I was recently written up for something, and the RN covering me did not get put on the incident report!
One was that I gave a pt with a blood sugar of 68, apple juice (her request) and she was fine. But per the MD he wanted her to have an amp of D50. When I told the charge RN (supposedly the RN covering me) that the pt was 68 she said "did you give juice" told her I was giving some now. Later in report I noticed the MD order for D50 under 80. Well by then the patient was fine. I tokld Charge RN that I should have given D50 (Which I cannot give because its IV push) and she said "Well too late now" But I got written up for violating the hospital's emergency hypoglycemic protocol.
Second write up was the day I came back to work after a 4 month medical leave of absence. I was ON orientation working directly under an RN. I acknowledged a medication wrong (Pharmacy had input it wrong) Initially I was told I only acknowledged the order, later in my write up I was told I had given it. According to the Union, I can't be written up for something while orienting under the RN. The RN never got talked to about this either.
That being said, I don[t want the RN to get talked to, It was my mistake. Not hers. So again, different facilities, different policies.
Being an LVN is not so bad ;-) But I am working on my RN :-)