Published Jul 9, 2006
blardyblardyhelp!!
14 Posts
I am a new LPN and am a little confused on weither or not LPN's can teach. I have to do admitts and d/c at my SNF and want to make sure this is ok under my scope of practice (Oregon). My NPA (Nurse Practice Act) says "provide, under the direction of a RN, health care clients using established protocols, can someone disect this please! I am so nervous my facility is asking me to do things beyond my scope because I am so new I just don't know(first LPN job, start in a few days). I have so many questions, is it ok to call the Dr. intead of the RN like my facilities policy and procedure says when my NPA says collect data and in a timely mannor report it to a RN, ofcoorifice it also says communicate nursing interventions and responses to care to the appropriate members of the health care team. And develop work assignments, Is all this OK??? I am scared out of my wits and tend to phych myself out (as in right now) Does this all sound corect, will I stay with-in my scope doing admitt's, D/C's, (ie, teaching), Calling Dr.s instead of RN, and making assignments? I am sorry, I just need some support, I am so nervous and have worked so hard..as all of you know. I just want to do the right things. Please help!
EricJRN, MSN, RN
1 Article; 6,683 Posts
If you don't get many responses here, you might try posting this on the Oregon Nurses Forum, where more people should be familiar with your state's NPA.
Good luck!
TheCommuter, BSN, RN
102 Articles; 27,612 Posts
Six years ago I attended school in southern California to become a medical assistant, and my instructor was an LVN. The so-called 'Director of Education' was also an LVN.
Last year I attended LVN school in southern California and one of my clinical instructors was an LVN.
smk1, LPN
2,195 Posts
I am a bit confused about the type of teaching you are asking about. It sounds like you are concerned with doing admissions and discharge teaching. As a student I really have no idea except to say that you should check the Oregon state NPA. I can't imagine why this would be a problem though, with the possible exception of needing an RN to do the initial admit assessment. I witnessed LPN's doing patient teaching regarding meds during clinical last term and this was in the state of Washington. If something was unclear they just called the one of the RN's in to talk with the patient. I also know that we had a LPN as one of our clinical instructors when we did CNA training.
missqueenqann
18 Posts
Where in Washington State
VivaLasViejas, ASN, RN
22 Articles; 9,996 Posts
I can help you here, as I'm an Oregon nurse.
LPN's can do discharge teaching, e.g. medications, wound care, s/sx to report to the MD etc. under the general direction of an RN (emphasis mine). What it means is, you do the teaching and go over the paperwork with the patient and/or family, and both you and the RN sign it.
Any specialized task that an LPN wouldn't ordinarily do, such as maintenance of an implanted port, would have to be taught by an RN, but 95% of the time they're going to have home health come in once or twice a week to do flushes and dressing changes.
So the answer to your question (which is NOT silly at all, BTW) is, Yes, LPNs can teach, again "under the direction of an RN", but we're so busy ourselves that we rarely darken the door while the LPN is in a room discharging a patient/resident. It is also within your scope of practice to call a doctor and take orders; however, an RN must note and sign off on them.
Hope this helps.
Critical LPN
30 Posts
I can help you here, as I'm an Oregon nurse.LPN's can do discharge teaching, e.g. medications, wound care, s/sx to report to the MD etc. under the general direction of an RN (emphasis mine). What it means is, you do the teaching and go over the paperwork with the patient and/or family, and both you and the RN sign it. Any specialized task that an LPN wouldn't ordinarily do, such as maintenance of an implanted port, would have to be taught by an RN, but 95% of the time they're going to have home health come in once or twice a week to do flushes and dressing changes.So the answer to your question (which is NOT silly at all, BTW) is, Yes, LPNs can teach, again "under the direction of an RN", but we're so busy ourselves that we rarely darken the door while the LPN is in a room discharging a patient/resident. It is also within your scope of practice to call a doctor and take orders; however, an RN must note and sign off on them.Hope this helps.
From Indiana but find most LPN Practice Acts are pretty much the same in their broad scope of text. Technically speaking according to an attorney I conferred with a few years ago , LPN Acts tend to focus that it is OK to do discharge teaching as plan of care or "managed Care" (if used in your institution) , is done upon admission by the RN who is supposed to update and modify plans, Thus under this, we as caregivers are allowed to proceed with the care needed within our scope of practice (really note: as the institution we work at, allows.). This does not include anything on admission except those duties as care of the patient. (I will bet though that many of the LPNs out there will agree that they had to do the admission forms/historys on patients they received on their shifts.):chuckle This is against most states true meaning of the Act I found. Really the only thing that we as LPNs are not to do it that(The inititial History/Admission Form). These were meant to be done by the RN, as the RN is the only person who is qualified to admit,assess,intiate a plan of care appropriate for that patient according to the intial interview. Most other things that are rumored not to be in our scope of practice are not necessarily true. As long as we are taught, repeat back the procedure correctly and check off verbally and or written test as is the same procedure for the RN, then we may perform that duty as long as under the guise of an RN. You note that would and does include many things. It is noted that in specialized areas, that LPNs do the same procedures as in homecare,hospice etc. that supposedely only and RN can do in the hospital.
Each institution's policies and procedures are different thus you must seek out the info as you get settled in, to protect yourself.
As far as teaching possibilities, it can be endless. I as an LPN took on not only being and BLS/ACLS instuctor but became an Instructor Trainer and also managed the program after our main education instructor left our hospital one year. No RNs stepped up to the plate in ICU/CCU/PCU either, to plan the education monthly programs and manitain stats of employee attendance, making the required employee needs list and reviews. I also had the job of JACHO/Board of Health policy review and forming internal policy/procedure reviews and make-up new policies committee which I chaired. I did all of this for 3 years before the Critcal Care Nurse Specialist came who proceeded to tell me to keep up the good work and just call her if I needed her to sign something since she was supposed to be doing all this but also split between two different hospitals. Being used?, Yes. Being independant and gathering great managerial and delegatorial experience as well as utilizing talents that normally would never have been tapped by the hospitals nowadays?------You betcha! Now that is well rounded and was patient/staff focused. Valuable experience for later also.
So you see that if you apply yourself and show interest in an area and allow yourself to become a valuable asset, you can teach about most anything. However, you are supposed to be under the guise of and RN. But as stated above, most do not have the time to seek you out to be a shadow over you. The problem then becomes getting signatures which is always the age old argument----do I have to seek them out? Or is it the RNs job to correctly be reviewing my charting, work, procedures, and putting her name to it? AH----HAH!!!! This is the problem. Hospitals consider that they are more acute and that they staff better(tee-hee), thus the RN has the time to do what is in their scope of practice and follow the LPN up to co-sign the work. In a world where we are all so busy running around to get even the most important orders and care done, we have to really know and begin to trust in each other. Degrees make a title, not a nursing professional. A true professional learns what it is in his/her power and scope to do and more, to the eventual end of better and improved care. Perhaps if we really look at most of the ACTS and SCOPES of CARE that we have shoved in all our faces and truly read them along with some legal counsel, we would find that our jobs can be and are, more similar than we thought and it is just sometimes the ill informed that separate and divide us, causing this NURSING SHORTAGE!!! I believe it is in each individual nurse to excel and find her niche. Who says that a Masters degree nurse can only teach or be head of a department? Maybe she/he enjoys the close and rewarding beside contact but chose to further her degree to be better at what she does. Who says an LPN can never achieve anything other than working in an ECF?(No disrespect intended, I feel this is the most challanging and potential rewarding when adm. works with staff)? Maybe he/she is constantly gathering CEUs and attending seminars/reading the latest books and or nursing magazines to keep abreast of the latest care in or out of her area of work. Is she/he any less dedicated to the nursing profession and perhaps more so than another nurse who has her RN but does no more to further her knowledge base after her degree?
:balloons:We need to celebrate our (all of nurses and assistants) chosen choices and work toward that original common bond we all have..........To heal the sick by "first do no harm". Healing may be actually helping the patient to get well,,, or,, to help them to pass over easily and with the dignity they deserve from us professionals.
Check your institution's policies and always keep note of changes in who and what is being done in your unit so not to get caught in the trap "its OK, you can do it this one time because we are so busy " . While not in stone, your written rules are all that will protect you in a court of law. Make changes for the better, for all of us do have a license and it is up to each one of us to protect ourselves and each other.
:groupwelcome:Yea!!!!!!!!!!
RXCT
61 Posts
Here in Ct the LPN can teach a few things...CNA classes and Nurs. Assistant programs.
It makes sense.......if we can patient teach then why not teach students other professions...we teach our patients a variety of things..why not the nurs assistant programs?
Hoping LVN2BSN
191 Posts
If you're speaking of teaching students, I'm in California and the assistant to the Dean of Nursing is an LVN who also instructs quite a few courses.