Renewal
Do LPNs need to take continuing education courses?
Every state has specific requirements when it comes to continuing education for LPNs. Each state board of nursing decides how many continuing education credits are mandatory for license renewal. LPN license renewals must be completed twenty-four months after the last renewal. Check with your state board of nursing to find out which courses and topics are approved and therefore will count towards the continuing education requirement.
Practice
The Role of the Nurse in Delegating Nursing Interventions
Delegation means transferring to a competent individual the authority to perform a selected nursing task in a selected situation. The nurse retains the accountability for the total nursing care of the individual. Supervision is the provision of guidance by a qualified nurse for the accomplishment of a nursing task or activity with initial direction of the task or activity and periodic inspection of the actual act of accomplishing the task or activity. Assistive personnel refers to individuals who are trained to function in an assistive role to the RN or LPN in the provision of patient care activities as delegated by the licensed nurse. This term includes but is not limited to licensed nursing assistants and unlicensed personnel. The RN and LPN delegate tasks based on the needs and condition of the patient, potential for harm, stability of the patient's condition, complexity of the task, predictability of the outcomes, and the abilities of the staff to whom the task is delegated. Although a variety of tasks and services may be performed by assistive personnel, the nurse may not delegate nursing judgment, including patient assessment, care planning, and evaluation of care. The delegation process involves four steps: decision-making, communication, surveillance and supervision, and evaluation and feedback. Different nurses may carry out the various steps of this process when a task is delegated to an assistive person. For example, the nurse who evaluates the outcome may not be the nurse who initiated the delegation. Vermont RNs and LPNs have the authority to delegate nursing interventions that may be performed by others. Decision-making regarding the delegation of nursing care must be focused on the protection of the health, safety, and well-being of the patient/client. Tasks delegated to assistive personnel are to be performed under specific circumstances and after proper assessment. These tasks are not transferable by assistive personnel to another care setting or for another patient without proper assessment and re-delegation by a qualified nurse. The LPN may delegate specific tasks to LNAs, other LPNs, and unlicensed personnel only after the RN has assessed the client.Responsibilities of the delegating nurse:
- review the patient assessment and plan the delegation
- communicate with the assistive person, confirming understanding of the task and verifying that the assistive person accepts the delegation
- supervise the delegation by monitoring the performance of the task and assuring compliance with standards of practice, policies, and procedures
- evaluate the effectiveness of the delegation and provide feedback as indicated.
Responsibilities of the assistive person:
- ask questions and seek further education or clarification of expectations, as needed
- accept the delegation, if able to safely and competently perform the task
- perform the task as directed by the nurse, seeking supervision as needed
- document the care provided.
Responsibilities of the organization or employer:
- provide policies and procedures to support the delegation process
- assure adequate time for effective clinical training
- maintain and assure access to documentation of assistive personnel competencies
- provide resources needed to support safe delegation, including adequate staffing and appropriate skill mix.
Delegation may take place in a setting in which nurses are not in a position to provide supervision and to intervene and take corrective action if needed. Examples include delegation to personnel in a group home, adult day care, or assisted living facility; or delegation to a medical assistant in a physician office or to non-nursing personnel in a school. The authority for the assistive personnel to perform a task may come from an individual who is not a nurse or from statutes or rules. As an alternative to nursing delegation, the nurse's role may be limited to specific aspects of the delegation process, such as educating the assistive personnel on performing the task and validating competence on a single occasion or periodic basis. When the nurse will not be able to complete all the steps of the delegation process, including ongoing supervision of the task and evaluation of the outcome, the nurse is advised to communicate with others involved in the patient's care in order to clarify the nurse's responsibilities. The nurse is advised to take reasonable action to assure patient safety in the absence of the nurse. For example, the nurse may provide written instructions for a situation when complications arise and a nurse is not available.
Licensure
What is the role of a state board of nursing?
The boards of nursing are agencies established by state governments in order to protect the public's health and welfare by ensuring the safe and effective practice of nursing. The boards of nursing create and update the standards for safe care, issue certifications, renew licenses, and through enforcement of statutes and regulations, safeguard the people from unauthorized, unqualified, and improper application of services by individuals in the practice of nursing. There are differences from state to state with regard to who determines the specific administrative responsibility of the board and who oversees the board of nursing but in general they report to either a state agency, the governor of the state, or some other state organization or official. Licensed nurses are monitored for compliance to state laws and regulations and action is taken in the event of unsafe nursing practice. Representatives who serve on a board of nursing are appointed to their position according to state laws and are usually RN, LPN or advanced practice registered nurses.
Board representatives are tasked with prescribing standards for nursing education programs, approving nursing programs preparing persons for licensure, providing for evaluation of nursing education programs and related clinical facilities, approval of examinations for licensure, issuance of nursing licenses to qualified applicants, verification of licensure status of nurses, investigation of complaints and convening of hearings upon charges calling for discipline of a licensee, creating or updating rules, regulations, policies, and practice standards, the requirements for maintaining nursing licenses, as well as taking disciplinary action on nurse licenses and enforcing the Nurse Practice Act which is a law of each state or territory. It is the responsibility of each licensed nurse to be familiar and comply with the rules, regulations, and requirements of each state they are practicing in. The Nurse Practice Act includes penalties that can happen if a licensed nurse does not follow the nursing law, the educational requirements and other qualifications needed for getting a license, what nurses are allowed to do, and the titles that can be used.
Exam
Can I take the NCLEX in a different state?
The NCLEX-PN exam is administered on a computer at approved test sites throughout the United States. First, the nurse graduate chooses a test center where to take the examination. Since all states administer the same exam, it is not required that a candidate sit for the examination in the same state in which he or she applies for licensure. Each exam is individualized according to the responses given to previous test questions but all exams follow a standard plan. A minimum of eighty-five (85) questions must be answered by a candidate in order to determine a pass or fail status. Some candidates may be answering items for up to five hours in order to finish the test. Every question is multiple choice and each item needs to be answered in order to move to the next one. Candidates with disabilities need to notify the test center in order to receive special accommodations. The NCLEX-PN exam has no more than 205 questions but you can pass with only 85 if you answer correctly. Those who fail the test can take it again but must wait at least forty-five days to retest.
Education
LPN Training Program Structure
Most year-long practical nursing programs include both classroom study and supervised clinical practice (patient care). Classroom study covers basic nursing concepts and subjects related to patient care, including anatomy, physiology, medical-surgical nursing, pediatrics, obstetrics nursing, pharmacology, nutrition, and first aid. Clinical practice usually takes place in a hospital but sometimes includes other settings.
Career
What do LPNs do?
To become an LPN you must first complete a practical nursing program and obtain a diploma. The program prepares you for working as a Licensed Practical Nurse. Individuals who complete an LPN program become familiar with various aspects of client care such as providing basic bedside care, administering medicine, measuring and recording client's vital signs, monitoring intravenous catheters and tube feedings. LPNs may be responsible for supervising nursing assistants but just like CNAs, they may also help patients with personal hygiene, nutrition, turning and ambulation. Practical nurses are trained to evaluate and apply wound dressings, collect various fluid samples for laboratory testing, record a client's daily food and fluid intake and output, and conduct basic lab tests.
LPNs are responsible for gathering client information such as health history and present health condition. When needed, an LPN helps registered nurses or physicians conduct tests and procedures. Important aspects of an LPN's job are to monitor a client's response to medication or to a specific procedure, to communicate with other health care professionals regarding a patient's current health status, and to help determine the best outcomes of care for a client. After successfully graduating from the program, you are eligible to take the NCLEX-PN (National Council Licensure Examination). Those who pass the NCLEX-PN exam have the legal right to practice the profession of practical nursing.
Organizations
National League for Nursing
Dedicated to excellence in nursing education, the National League for Nursing is the preferred membership organization for nurse faculty and leaders in nursing education. NLN members include nurse educators, education agencies, health care agencies, and interested members of the public. The NLN offers faculty development programs, networking opportunities, testing and assessment, nursing research grants, and public policy initiatives.
Cleveland Clinic Free Nursing CMEs
The Center for Continuing Education has been committed to sharing a wealth of knowledge with physicians, nurses, and other medical professionals across the country and all over the world for more than 75 years. The Center for Continuing Education is responsible for one of the largest and most diverse CME programs anywhere.