Scope of practice in your hospital as an LPN

[tokmom, BSN, RN]

We have just two or three LPN's in our hospital. I'm not sure if they will ever be phased out. I hear talk.

There is one LPN that is attempting to be placed in a charge position over RN's. The hospital seriously thought about it too. I used to be an LPN and even I think it's backwards to have an LPN be in charge of RN's. There are things they can't do! How much do LPN's do in your hospital?

[OCNRN63, RN]

Not much. Most LPNs have been phased out of the hospital where I work, and an LPN would never be in charge of an RN. No disrespect, that's just how it is here.

[AprilRNurse]

We have just two or three LPN's in our hospital. I'm not sure if they will ever be phased out. I hear talk.

There is one LPN that is attempting to be placed in a charge position over RN's. The hospital seriously thought about it too. I used to be an LPN and even I think it's backwards to have an LPN be in charge of RN's. There are things they can't do! How much do LPN's do in your hospital?

That's not even legal is it?

[AprilRNurse]

The LPN's in our hospital don't take their own assignment. They are scheduled with an RN and together they take more patient's than an RN working alone. The RN assesses, does care plans, and takes/implements new orders, and all IV meds. The LPN does oral meds, vitals, and together they do cares.

[EmmyBnurse]

It all comes down to BON regulations for the specific state. I have been an LPN in ND and MN. In ND I could do virtually everything RN's do. There are some exceptions of course (certain meds, pulling central lines, etc..), but if they work on a med/surg or step down unit there isn't many differences. Now cross the boarder to MN and I am a glorified CNA.

Now I realize when you say that LPN shouldn't be in charge, but I know some LPN's that are much smarter and have many years on these new grad BSN students who strut out of school with a terrible case of RN ego. Your organization was probably looking at those factors rather than the letters behind the nurses name.

[Leelee2]

Lpn's here are used in some hospitals here on Med/Surg. They can take up to 5 patients, do medication admin (with the Exception of IV push drugs), dressing changes, assessments, etc. They have an RN assigned to supervise them/assist when needed. LPN's here are not able to do initial assessment, so if pt is new to floor the RN assigned must come and do the assessment on that pt. Our hospital assigns the LPN's to most stable pt's. RN's get assigned the more critical care pt's.

No LPN would be put in charge position at this hospital. It wouldn't make sense to do so, as the scope of practice is different.

[GM2RN]

The only LPNs where I work FT are in MS where there is no tele and transitional care. They take a pt load but cannot push IV meds so the RNs have to do it for them.

Where I work PT, they don't work in critical care. On the floors where they do work, they don't take their own pt load but work on a team with an RN and sometimes an aide.

[OgopogoLPN, LPN, RN]

I feel I can do a lot as an LPN in BC in acute care. But Alberta by far seems to have one of the widest scopes in Canada.

I take a patient assignment as a team with an RN. So if we have 8 patients, I will take 4 and he/she will take 4. OR, if there are 3 more critical/unstable/lots of IV meds, then I will take 5 and he/she will take the other 3.

I can do assessments/oral and injectible meds/dressings/IV care (except starts and med push).

I consult the RN if I am not sure about something, or if it's out of my scope (although we always try to divy the patients up so I can do everything for my assignment). We work together as a team if we have total cares. Cover each other for breaks. If the RN is swamped with IV stuff or skills I cannot do with his/her assigned patients, I will do their vitals/care/oral meds etc.

It usually works pretty well and I :heart: most the RNs I am teamed up with.

[litlamp]

Where I work LPN's can do alot. The scope of practice in TN for LPN's is very minimal and mainly covers medication administration (push meds). We do everything but hang blood and there is a short list of meds we cannot administer (sedation, oxytocics, chemo, and titrated meds to name a few). Per our scope we cannot push meds anywhere but in a peripheral line and only to pts over 80lbs (never to peds or pregnant pts). I work on a telemetry unit and take my own patient load (up to 4 pts), do the initial and daily assessments (a RN does one initial assessment too but it's very short) deliver patient care, IV meds etc. If certified (IV cert course 40hrs) we can also push most meds.

[ObtundedRN, BSN, RN]

In my state, an LPN could never be charge over any RNs. It comes down to delegation. If the LPN was charge, that would be delegating the patients to RNs, and an LPN can't delegate to an RN. Now if it was a unit full of LPNs, I could see that working. But there are no units of just LPNs...

However, an LPN could be over RNs in an administrative role. Just not in a clinical role.

[APRN., DNP, RN, APRN, NP]

There are no LPN's (LVN's) at either campus in my hospital system in Northern

California. The LVN's have been phased out for several years now. One county over, where I used to work, the LVN's have been phased out of the hospital system there altogether as well.

[Fiona59]

I work in Alberta. As it stands, I can't pierce a Travisol or Blood Bag. The RN pierces it, signs that it's been verified, hangs it on the IV pole and walks away.

I start my own IVs and run my own meds. I'm cytotoxic certified for all routes bar IV. But then there are no IV cytotoxics run on our surgical and medical units.

Residents pull central lines, no RNs on the floor.

I have the skills to drop an NG but hospital policy has decided it's an RN skill but we walk the new RNs through their procedures.

In theory, the PNs are supposed to have "stable" patients. It just doesn't happen. The Charges tend to give the RNs with less than two years experience patients more suited to a LPN and the LPNs with three or more years get the complex patients. Fair? No. Happens all the time.

Charge duties are PN in LTC , in Acute it's RN and frankly for the $10/hour wage difference they can have it. But then I know RNs who never take charge duties because in their words "I don't have the personality to put up with the families BS".

But our PN education here is the old two year, diploma RN course. So make of that what you will.

On the floors of my hospital (one of the busiest in western Canada) it's often four RNs and six LPNs on day shift. There is NO way the LPN could be phased out because our system would crumble. The only units I've never found a LPN are the NICU and PICU.