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Discussion

Scope of Practice

I have been an LPN for 16 years; I have a very clear understanding of my scope of practice. I have been with this company for 1 year. In that time, there have been several instances that the physician and office manager have asked me to work outside of my scope, which I have refused. One issue that continues to come up if filling out FLMA paperwork. I understand that I can fill out the secretarial aspects of the paperwork, such as patient name, address, phone number, physician, name, phone number and address. The physician insists that I need to fill out the medical questions and all she has to do is sign the form. Please tell me if this is within my scope or not. 

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each state is a little different, so I suggest you call your state BON and ask them. You could look at it as collecting data not assessing so I would think you could do it but I defer to your state BON.

If all you are doing is transcribing information vs making an assessment and/or diagnosis. I'm not sure what the hesitation is. When they sign it, they are attesting to the veracity of the document.

It is my understanding, as an LPN, that I can fill in admin data (patient name, date of birth, demographic info) and directly observed vitals, height, weight only on FLMA forms. 

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niferbu said:

It is my understanding, as an LPN, that I can fill in admin data (patient name, date of birth, demographic info) and directly observed vitals, height, weight only on FLMA forms. 

This is my understanding also, the physician and PA want me to fill out how long the patient can stay out of work and the other medical portions. They also, don't want to review anything, they just sign want to sign it.

I guess it depends on you level of comfort. You take telephone or verbal order so in the same vein they can tell you what to write. A nurse working with a doctor in the same setting for 10+ years will know what the doctor wants and expects without them having to say it.That being said, this is NOT your responsibility and you are not accountable for anything on that form. It's their license and signature and their responsibility.

sue1000 said:

This is my understanding also, the physician and PA want me to fill out how long the patient can stay out of work and the other medical portions. They also, don't want to review anything, they just sign want to sign it.

Oooh, that's a  little different. Hard stop there and I am an RN, unless there are specific standards or an approved algorithm. That's asking you to make a clinical judgment and I would say that it within their scope and not a nurses.

Agreed. I have been running into this a lot more over the last decade or so, physicians wanting to simply sign and not make the decision. 

Copying data is one thing, but making determinations is another. When it reaches the line on my scope of practice, I make them fill their part out. My license is on the line. 

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