RN/LPN Co-signatures, roles etc.

[RAIZIE]

Hi All- Question for you!

In NY State, do LPN notes etc require RN co-signature?

What is the practice in YOUR hospital?

Also, what are the PRACTICAL differences in what RN's and LPN's do where you work?

[SuesquatchRN, BSN, RN]

No. A nurse's note is a nurse's note.

If I, an LPN, discover something that requires assessment - open skin area, dyspnea, etc. - I must notify the RN. The RN evaluates it.

I dispense meds and administer treatments.

[RNsRWe, ASN, RN]

Like Sue said, a nurse's note is her or his own legal entry, regardless of which licensure they have.

Practical differences where I work? An LPN cannot hang blood, do IV pushes, work with PICC lines in any way (no meds through them, no blood draws for lab, no dressing changes, etc). They can't do initial assessments for new admits, although they can collect data to assist with the physical assessment the RN will do afterward. They cannot take telephone orders from MDs (can't figure that one out for anything). That's the majority of it.

[pagandeva2000, LPN]

I work in a clinic and we cannot administer flu or pneumovax without an RN assessment ( I think that is stupid if the physician placed an order...I can see if it is a walk-in patient with no physician assessment). No RN has to co-sign a note for me. But I did hear that at some nursing homes, an LPN can create a care plan for a new patient, but the RN must co-sign that. It makes sense to me because we aren't really supposed to do initial assessments.