RN signatures after LPN's

[deespoohbear]

First of all, I want everyone to know that I am not bashing LPN's here or trying to get into a debate over RN vs. LPN. I just want a little info.

Our facility still requires RN signatures after LPN nursing assessments are completed. I, for one believe this is a totally outdated practice. My feeling is a LPN has a license and has taken a state exam, so why should an RN be required to sign after them? I for one do not feel comfortable co-signing anything except witnessed & wasted narcs. I was wondering where I could find some information to present to our nursing administration about this practice and what other facilities are doing. Thanks.

[live4today, RN]

originally posted by lpn,future, rn

i am not an rn yet, but as an lpn, i just wanted to say, i do not personally feel bad to read this thread because you as an rn want to provide safe care for our patients and protect your license too. thanks to the rns who are there for us and let us be as independent as we can and be there when we need you so we can all work together for the betterment of all.

i promise you, it is just as or more frustrating as an lpn for you to "come behind" me than you will ever know. yet, i understand and i welcome it for more than one reason, yes, even when i am pondering of the things i can do independently.

i do enjoy working with those (rns) who love to teach even though i can't do somethings as an lpn. you are appreciated and thanks for listening! :kiss

lpnfuturern.....you sound like the type of lpn i would have loved working with. who knows.....the future still awaits us.....but then you'll have your rn by then.......no problem.....we can still work together...rn to rn. :kiss

i do not remember having to co-sign a lpns charting, but the hospitals i worked in did require the rns do the initial assessment on new admits to the unit. :)

[tiger]

when i started at my hospital in 1990 we (lpns) were allowed to do our own assessments. this continued for about 9 yrs. then, they changed it to the co-signature thing. that lasted about 2 yrs. now we are not allowed to do assessments at all. i don't see how i was capable for all those yrs but now with more experience am not.

[Dayray, RN]

I am an LPN in my hospital I can do daily assesments but must either have an RN do inital (direct admits and ER admits) assesments or co sighn them.

Weather you relise it or not, when you work with an LPN you are actually responsible for supervising them. Yes we have a license and yes we are responsible for our actions but so is the RN supervising us.

As an LPN we are always suposed to inform our RN of any abnormal findings and run our interventions by and RN.

It's not a problem if you have an LPN you trust but I would get to know them before you take anything they say for granted. You are entilteled to question them or tell them what intervention to use. Of course they are entilteled to refuse to do as you say if they disagree but then you can assume care of the patient or do the intervention your self and assume the responsabliity.

[mattsmom81]

My facility had medsurg/tele policies like this too and it was a PIA. We finally petitioned for a policy change....and won!! My advice to you: get on the policies and procedures committees and start writing petitions!!

Our NEW policy we negotiated for medsurg and tele areas states every patient had to be assessed by a RN on admission, and once every 24 hours thereafter. This fulfilled the state and facility requirements.

We found this easier to handle than cosigning everything......ie if a LVN had the patient on days, just assign to an RN on nights and vice versa.

And we learned to start the RN's out with a lighter load so they could either pick up admits, or help with admit asessments. :)

[Brownms46]

And many other facilites across the country have done the very same thing...mattsmom. Good to know someone is using their critical thinking caps...

(((((((((((mattsmom))))))))))))

Where I am now...we do not have such problems..:) Thank God I work with in a supportive, less restrictive environment! But there have been times when I didn't, and it choked the joy out of being a nurse. I again have regained that joy! No one has made me feel less than them, and everyone is valued for their expertise, and their experience! Why can't it be that way everywhere??

[shygirl]

Where we are, RN's have to sign after an LPN.

[DIPLOMATICRN4HIRE, MSN, RN]

When I worked on the floor as RN we had all the assessments to do anyway( we did them by shifts), I think its a great Idea that Lpns can now do them , If the Lpns I worked with had a problem they always knew they could come to me for anything at anytime , and I would check it out. As far as the co- sign I understand it and yes I have co -signed after the Lpn as well on orders and such but never on anything as a assessment, the Lpns I worked with had been nurses longer than I was living and they were very quick to pick up on any changes, I trusted thier judgement and I followed up and would do a full assessment of the situations. When a new patient arrived the Lpn would question the patient while the Rn did a head to toe assessment it wasnt policy it was just how we did things to get the paperwork out of the way , after the assessment I would begin to log the paperwork in and begin the careplans as needed. It functioned wonderfully and saved time and kept things as smoothe as possible.

[Teshiee]

That is utter bull ****. LPN/LVN can give meds so my question how do you give pain med don't you have to assess the pain? It is double standard that makes a life of a LVN/LPN hell do this but not that give this but not that. It is so political.

[mattsmom81]

I'm sure the facility restrictions are coming from the risk manager's office. They watch stats for lawsuits and patient outcomes, etc...all the studies and figures for their particular area of the country....and make recomendations to management.

It's just easier for the hospitals to turf all the liability to the RN.. by overly restricting the LPN and force the RN pick up the slack...God forbid the HOSPITAL take any responsibility!!!

That's what the NURSES are for.