Why are LPNs allowed to supervise RNs in Long-Term Care?

[RNnLTC]

What I don't understand is why are LPN's allowed to supervise RN's in Long-term care? Due to the education of an RN vs an LPN, this has caused problems! I'm an RN and have been working in Long-term care for the past year. The unit manager on my unit is an LPN and is always trying to delegate things to me, question me as to why I do certain things, why I take some things serious and not other's...and she doesn't approach it in a way as if she was trying to learn, she attacks it. As an RN I was taught the disease process, what to watch for and what to expect! I was also taught to educate families regarding the disease process and be able to explain to them what is happening when their loved one is experiencing a decline. In doing-so, I was recently scolded by my unit manager in her saying "you're practicing outside of your scope of practice!" Really? The DON didn't think so...It just annoys me that the Scope of Practice for RN and LPN in Michigan clearly states that an LPN cannot clinically supervise an RN, yet this is actually happening at my facility! What can I do about this?

[Crystal-Wings, LVN]

Good lord. I'm not even going to add my two cents except to say at the LTC I'm at there's an RN who seems to be incapable of making decisions or getting orders put in correctly and is constantly asking the LPNs to do/fix things for her. I'm tired of it and have started ignoring her calls to my station. I've literally had to tell her what to do on multiple occasions but I can't say anything because apparently she has "a lot of experience".

[TriciaJ, RN]

Since it's your job to educate patients and families, why don't you educate your LPN supervisor, too?

Next time she demands to know why you've taken a course of action, don't get defensive.  Regardless of how she asks, pretend she's just asking for information and educate her the way you would a patient.  Keep your tone pleasant and refuse to get your back up.  Remember she doesn't have your education so you're just helping her fill in some gaps.

Maybe you're misinterpreting her motives, maybe not.  You'll have a lot more power in the situation if you don't take the bait.

[Sami Vish]

So I'm an LPN, but I received the full education of an RN. I passed all of my classes; however I could not pass my program's exit HESI and therefore only received a certificate of Practical Nursing and then sat for the NCLEX. I earned two additional degrees in related fields prior to to my nursing certificate. I've also worked in other industries at an expert level. I'm very educated and I have to routinely remind my mangers that I am not an RN and therefore my scope is limited. Don't assume just because a nurse has this title that it automatically means they are less educated. We have varying education levels, just like RNs have varying education levels. Instead think LPNs have more limited scopes of practice than an RN.

That said, this unit manager's interference in your work has nothing to do with her being an LPN and has everything to do with her desire to micromanage. You should most definitely report her behaviors to your supervisor.

But to actually answer the question you asked, I work in New Mexico and I don't know about every state, but I know that in this state Long-term Accute Care Settings fall under the same regulations as Skilled Nursing facilities. In my state it is within the scope of practice of an LPN to act as a Charge Nurse in the SNF setting as long as there is an RN somewhere in the building. The idea is these patients should be relatively stable and not requiring repeat critical assessment. I've worked in Long-Term Acute Care and those patients are definitely not stable. I've never understood why in my state these two very different settings have the same policies and regulations. Maybe it's the same in your state.