Lvn Scope Of Practice Essay Topics

What Does LPN Stand For?

Licensed Practical Nurse (LPNs), also known in some states as Licensed Vocational Nurses (LVNs - CA & TX).

What Do LPN's Do

What the LPN does depends on the “scope of practice” laws in the state where you work.  Each state board of nursing regulates what the LPN can and cannot do.  In general, LPN's provide patient care in a variety of settings within a variety of clinical specializations.  LPN's usually:

  • Administer oral and intravenous medications
  • Chart in the medical record
  • Take the patient’s vital signs
  • Change wound dressings
  • Collect specimens such as blood, urine, sputum, etc
  • Insert and care for urinary catheters
  • Care for patients with tracheostomy tube and ventilators
  • Insert and care for patients that need nasogastric tubes
  • Give feedings through a nasogastric or gastrostomy tube
  • Care for ostomies
  • Monitor patients for a change in clinical condition
  • Call the physician if needed
  • Perform CPR in emergencies
  • Are supervised by an RN

Although each state sets the scope of practice for the LPN, each organization can narrow the scope.  It is important, therefore, to know what the specific organization does not allow the LPN to do.  In some organizations, but not all, the RN is expected to carry out the following tasks:

  • Start, monitor, and/or discontinue intravenous catheters or the intravenous fluids
  • Start, monitor, or change critical intravenous medications that stabilize the heart or blood pressure
  • Take phone or verbal orders from the MD
  • Administer intravenous medication that are given “push” or very quickly
  • Care of central intravenous lines (that go to or near the patient’s heart)

What are an LPN's Duties?

LPN duties often vary depending on the state where they work. Some state regulations allow LPN's to provide medication to patients, while others allow LPNs to administer intravenous drips.

In general, LPN's are responsible for assisting registered nurses and doctors by providing basic medical care to their patients. Some of the typical job duties performed by LPN's include:

  • Changing bandages, catheters, and IVs
  • Checking vital signs like blood pressure and pulse rates
  • Feeding patients who are unable to feed themselves
  • Keeping detailed records of patients’ overall health
  • Reporting any changes in patients’ health to doctors and nurses

These are just a few of the standard duties performed by LPN's, and their day-to-day routines may vary depending on the needs of the hospitals, physician’s offices, or nursing homes where they work.

Additional duties LPN include:

  • Greeting Patients and Recording Their Information

LPN's are often the first point of contact that a hospital, doctor’s office, or other healthcare clinic has with patients. After patients are called back to be seen by a doctor, LPN's record their medical history, known allergies, height, weight, internal body temperature, blood pressure, pulse, and breathing rate. These signs give doctors and registered nurses a good indication of patients’ overall health before any additional tests are administered.

One of the most important day-to-day responsibilities for LPN's is to collect patient samples for routine laboratory testing, such as urine, feces, saliva, and other bodily fluids. In addition, some LPN's are trained to draw blood to test for certain diseases and infections.

  • Monitoring Patients’ Health

Registered nurses and doctors may need to see several dozen patients in a single day.

Because of those demands, LPN's are asked to monitor their patients’ health throughout the course of their shift. Close monitoring is especially important after major surgeries, accidents, and when patients have received new medications. LPN's are trained to quickly identify adverse reactions or complications and notify doctors and registered nurses immediately.

  • Counseling Patients and their Families

LPN's are often tasked with providing a human touch to routine healthcare. They often teach patients and their family members how to administer medication, which symptoms to be aware of after the patient goes home, which activities to avoid, and how to adopt and maintain a healthy lifestyle. Read more about what LPN's do.

Where Do LPNs Work?

The U.S. Bureau of Labor Statistics estimates that LPNs were employed in roughly 719,900 jobs in 2015. These nurses worked in a variety of settings, including:

  • Elementary schools, middle schools, and high schools
  • Home health care organizations
  • Nursing homes and nursing care facilities
  • Physicians’ offices and other private practices
  • State, federal, and private hospitals
  • Universities

In addition, LPN's can find work in other settings by working as missionaries, serving in the military, or working as consultants for healthcare companies. Other nurses use their patient care knowledge and familiarity of healthcare settings by working as medical coders, billers, transcriptionists, and customer service representatives. Evaluate the many potential practical nursing careers.

LPN Work Settings

The most common places that an LPN works includes but is not limited to:

  • Hospital - The hospital setting provides care to patients that are acutely ill or have just had major surgery.  The LPN will work under the supervision of the RN in caring for patients.  Most community hospitals hire LPNs, however is the larger teaching hospitals that have or wish to acquire “magnet status” from The Joint Commission (the accreditation organization for hospitals) do not hire LPNs. The work schedule depends upon the facility but usually is 12 hour shifts with every other weekend off and rotating shifts.
  • Rehabilitation – The rehabilitation setting provides care to patients that are in the process of gaining backs skills a recent medical or surgical event.  Patients are expected to be improving while there with the help of physical therapists, occupational therapists and speech therapists.  The LPN and RN work side-by-side in caring for patients.  For example, a patient may have required a hip replacement in the hospital but still need to gain muscle strength, crutch walking skills, and practice walking on difference surfaces.  The patient can transfer to a rehabilitation setting to accomplish those goals.  The work schedule depends upon the facility but usually is 12 hour shifts with every other weekend off and rotating shifts.
  • Nursing Home – This setting provides care to patients that are not expected to improve and may be there for very long periods of time.The LPN may be in charge of patient care in this setting.  As an example, if stroke patient may be in the hospital initially after a stroke.  But after being stabilized, they moved to a rehabilitation center to work on getting back speech and movement skills.  But once the patient’s progress has plateaued and if there is not sufficient support for care in the home, the patient may be cared for in a long term care facility or nursing home.  The work schedule depends upon the facility but usually is 12 hour shifts with every other weekend off and rotating shifts.  Some long term care facilities choose 8 hour shifts.
  • Home Care - Many patients can live in their homes or a family member’s home with the support of additional health care providers.  The type of care provided in the home depends on what the patient needs.  Some complex patients need LPN care several hours per day so that family is able to sleep.  Some patients need LPN oversight to make sure the medical plan continues at home and to provide patient education.  The shift hours worked depends on the number of hours needed per day or per week.  The episodic visit may last from 1 -2 hours.
  • Medical Office or Urgent Care Clinic - This setting provides office visits for patients to see their healthcare provider, usually for a well care checkup. The LPN can assist by taking important patient vital signs, medication history, weight, and follow up with necessary tests that may be ordered after the visit.   The LPN hours will depend on what times and days the office is open to seeing patients.   There may be occasional weekends.
  • School – Students in the school setting often require episodic care for minor illnesses such as lice, sore throats, or vomiting.  Elementary schools, high schools, and colleges may hire an RN or LPN to provide this care.   If the student in younger, a parent picks them up from school to take home.  If the student is in college, care is provided until the student is safe to drive or walk home unless emergency care in a hospital is needed.  The work hours depend upon the hours the school is open and students are on site.

LPN Areas of Practice

There are some very exciting areas of nursing practice from which the LPN can chose to work.   Each area is very unique – as is every LPN!  It is a great idea to work in many areas of nursing over time to increase your “marketability.” Read about 8 roles of the LPN and the various LPN careers.

  • Pediatrics – This area of nursing care specializes in sick patients ages newborn to age 18.
  • Labor and Delivery - Nursing in this specialization cares for pregnant woman just prior to delivery of a baby, during the delivery, after delivery, and care of the well newborn.
  • Neonatal – Neonatal unit nurses care for sick newborns and premature infants just after delivery.
  • Oncology – Patient needing an oncology nurse usually have one of the many forms of cancer.  Oncology nurses administer chemotherapy, help treat pain and nausea, and assist with procedures.
  • Neuro ICU – The nurse in Neuro ICU cares for patients after brain surgery or severe head injury. They specialize in neurological assessment of patients and know how to monitor the patient for improvement or deterioration.
  • Trauma ICU – The Trauma ICU nurse cares for patients after an accident of some type.  This can be a car accident, motorcycle accident, building collapse – anytime there are multiple systems involved with injury.
  • Burn Unit – When a patient is burned over a large percentage of the body, nurses specialized in dressing changes, pain management, and monitoring for sepsis – all while working in a team over a period of time as patient healing occurs.
  • Cardiac ICU– Patients receive nursing care in a Cardiac ICU after heart surgery.
  • Emergency Room – The emergency room nurse cares for patients that are suddenly unstable from an illness just after an accident.   Patients are quickly stabilized and then transferred to an ICU.
  • Rehabilitation Nurse – Rehabilitation nursing involves working with physical, occupational, and speech therapists to help the patient gain back skills that were lost due to illness or injury.
  • Gerontology Nurse – Nurses that specialize in gerontology care for the unique needs of elderly patients.

See what BSN careers are available provided you continue to further your nursing education. Find a practical nursing job now!

Finding Your LPN Job

After you decide which area of practice is the one where you want to work, search out locations where employers offer this type of care.  For example, if you want to work in a Burn Unit, it may be necessary to search all the area hospitals to find out which one has a Burn Unit.  Burn Units are usually located in a hospital designated a Level 3 Trauma Center.  Go to that hospital’s website and find their “Careers at Our Hospital”.  Click on the link and do a search for jobs – looking specifically for jobs in your desired area of practice.  Carefully look at the title to make sure an LPN position is available and then read the position description, hours and shifts to be worked, and any salary quotes.  Compare jobs between facilities and narrow your decision down to your favorite 2 job opportunities. Read about the core values of nursing professionals. Click here if interested in finding a position: LPN Jobs.

Completing an LPN Job Application

Many job applications are submitted online but some are still hard copy.  Before you start, gather a couple important documents:

  • Employment History - You will the name of the facility, address, phone number, and supervisor’s name and direct phone number.
  • Education History.  Gather the name, address and phone number of your high school and nursing school.  It is a good idea of request an unofficial grades transcript from your LPN school in case your job requests it, although probably not.
  • License Information - Make sure you know the date you took your LPN exam and in which state.  Some employers do not require a copy of your license because Human Resources will do an online check to validate that you do have a license in the same state as the place you are applying to work. If you are looking to work in another state find out how to transfer your LPN license accordingly.
  • Follow Instructions - How you complete this online or paper application says a lot about you.   Make sure to look up the correct spelling of words and use good grammar.  Fill out all the spaces to the best of your ability.  Not following instructions can indicate how you would perform with instructions on the job.  You want to make a good impression!
  • Test Preparation - Many hospitals require a math test prior to hiring the LPN.  Be prepared for simple ratios, IV drip conversions, medication names and purposes.  Ask what is the cutoff for pass/fail.  Be careful and take your time unless it is a timed test.  The test may be part of the online application or something you take when you return for an interview.
  • Submission - Before you turn in the paper application or hit the “submit” button, review all the information one more time and make sure it is complete.  Some employers will not accept incomplete applications.

LPN Interview

If you have been asked to come in for a job interview, there are a few important things to keep in mind.  First, do some online research about the organization for which you are applying.  What type of care do they specialize in and in what care setting?  How many patients do they see per year?  Learn as much as you can ahead of time about the job you are looking to get.  What does the role do and not do in the organization.  Wear the appropriate attire for the position and bring a copy of your resume.  Practice potential questions and answers with a friend.  There are many interview videos available online to help prepare you.

More about interviewing in our LPN Interview Guide. For specific topics refer to the below:

Starting Work as an LPN

When you agree to a job offer and salary, the next step is that you are given a date to start work.  It may be necessary to have a pre-employment physical exam done which can include drug testing.  Prepare by purchasing any needed items such as nursing scrub outfits or a stethoscope.  You will be issued a computer security username and password that will allow you access to timekeeping, medical records, and registration systems.  You will need to complete several educational requirements specific to your role and department within the first couple days of starting in an organization.

LPN Work Orientation Period

The first month or so of work in an organization is called your orientation period.  The purpose of an orientation period is so the organization can decide if you have the skills needed to do the job and for you to decide if the job is a good fit.  Depending upon your role and the setting, your orientation period may last up to 6 weeks.  There will be a preceptor, or mentor, assigned to orient you and have you demonstrate competency.  At the end of the orientation period there is usually an evaluation process to get performance feedback from your supervisor.

LPN License Renewal

Once you have already obtained your LPN state license for the first time, there will be a date that your license expires.  Pay closely to this date and refer to your state licensure requirements regarding renewing your license.  Requirements vary from state to state – some states require only money to renew.  Other states have additional continuing education credits (the number of hours varies) and proof before renewal is allowed.

LPN Continuing Education Credits

Some State Board of Nursing require a certain number of continuing education credits in order to renew your LPN license at the time of expiration. Continuing education credits are accredited videos, articles, lectures, or conferences that provide education to the LPN to assure competency. Each state’s policy differs so refer to our guide to LPN CEU state requirements or via third party resource for a list of all states and their continuing education requirements. Read more ways to obtain CEU's for LPN's.

Advancing LPN Education Options

  • LPN to RN/BSN Online - Achieve Test Prep

    *Must Be a LPN/LVN

    LPNs earn your ADN or BSN degree online in up to 1/2 the time and cost of traditional programs. With No Waiting List to get started, Free Books, and Low Cost financing options available, this is the perfect way for LPNs, LVNs, and Paramedics to earn your Associates Degree in Nursing and your RN license. Our convenient, instructor led test-out program allows you to learn at an accelerated pace and earn college credit-by-examination which then is eligible to be transferred to an ACEN accredited nursing school or 100's of universities nationwide.

Featured Article

Ending the Stigma: An LPN’s Viewpoint

Some days I wake up and everything feels calm, my vision is clear, the world is mine to conquer. I dance upon the ashes of my past and I have a sense of overwhelming joy. Other days I have a hard time twisting my scars into lessons. My bed feels like the safest place on the planet, hiding me from Continue Reading

As a nurse, one must follow a scope of practice, what is expected of them within their role of the nursing profession. These guidelines shape the responsibility of the professional nursing organization and serve to protect the public. According to, Nursing’s Social Policy Statement: The Essence of the Profession (American Nurses Association, 2010, p. ) defines contemporary nursing: “Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. ” I believe my role, as a nurse is consistent with the scope of practice outlined by ANA and the contemporary definition cited. As a nurse, I strive to be clinically competent and aware of the constant challenges that one faces on a daily basis.

Being well informed promotes health and prevents further illness and injuries. One goal I try to set aside every week is to attend a weekly ground rounds meeting, where additional education is provided on a specific case study. This opportunity allows me to stay current and up to date on new medications available, research findings and team collaboration feedback from staff on effective treatment options for optimal patient outcome.

In addition, completing required competencies and being a member of Oncology Nursing Society also strengthens my knowledge and skill in providing the best evidence based practice to an individual and their families. Being a resource nurse for my unit allows me the opportunity to share my knowledge with the staff and actively participate in mentoring young nurses build a strong foundation and develop critical thinking skills. Education is critical in the nursing profession. Lifelong learning must be an ongoing process due to the rapidly growing population and technology advancements in our society today.

I believe it is the responsibility of the nurse to facilitate this process and collaborate with other nurses in their field to continue to work together to strengthen the role of the nurse in an environment that requires continuous education and competencies. “Registered nurses must continually reassess their competencies and identify needs for additional knowledge, skills, personal growth, and integrative learning experiences” (American Nurses Association, 2010 p. 13). State legal regulations and professional standards of nursing The Ohio Board of Nursing defines nursing and the scope of nursing practice.

Rules and regulations are in place to determine compliance set in motion by the Nurse Practice Act. Responsibility is outlined by establishing standards for nursing education programs, eligibility to sit for the state licensure exam, renewal criteria of that license, and setting standards for continuing education to meet renewal criteria. The Board is also responsible for defining the standards of delivering safe nursing care for registered nurses and protecting the community with these standards.

Another role the Board is responsible for is reviewing and investigating violations of this Nurse Practice Act and determining if a nurses license is to be denied, revoked, suspended, or restricted in any way (Ohio Nurses Association). It is essential that nurses maintain an understanding of the legal regulations within their nursing practice. The Ohio Board of Nursing requires all Ohio nurses to have continuing education on Ohio law with a total of 24 continuing education hours every two years for license renewal (Ohio Board of Nursing).

As a professional, I feel it is my primary responsibility to understand the law and regulations defined before me, this knowledge allows me to safely practice nursing care and deliver the best care to my community. I have worked in other states as well, and of those states I have worked, Ohio is the only one requiring a continuing education credit with a focus on state law and regulations. I feel every state should have continuing education credit requirements for renewal and at least one of the required credits have a focus on law. It is important as a professional to have knowledge of this.

To have a check and balance system in place to make sure one is justly maintaining these standards and expectations in delivering a safe competent nurse to our community is vital to the population as a whole. Provisions 7, 8 and 9 “Provision 8 describes the nurse’s moral obligation to society. Provision 9 describes the responsibilities of the nursing profession to both the individual nurse and society in general. Provision 7 provides the necessary linkage between individual competence and evolving professional standards of practice, in addition to giving nurses a responsive and collaborative role n health policy for the overall advancement of the profession” (Fowler & Association, 2010, p. 91).

Initially, these Provisions were never intended to be carved out of stone, but historically, they have been a guide and continue to be a guiding force of moral and ethical standards to follow. I pride myself on working for a hospital that fosters an environment on ethical integrity and professionalism. Because of this strong thread, it motivates me to do more, achieve more, and be more than I am today. I want my patients and my community to feel that they are receiving the best nursing care.

An example I recently explored was implementing a grid to follow based on patient’s diagnosis and treatment pathway prior to admission to the floor. I work in the hospital’s rapid admissions unit. My goal is to have the patient to their room in 30 minutes or less. Of recent, we have received a lot of admissions for pancreatitis, however, I have noticed that the patient arrives to my unit without pain management options, i. e. PCA pump. This has delayed the patient’s comfort and care prior to arrival to HRAU leaving me scrambling to get pain orders, equipment and recover any customer service issues.

This grid allows a framework to use as a guide of anticipated orders and outcomes. I presented this grid to my nursing manager, our staff and the ER manager and charge nurses for their collaborative input and suggestions. So far it has been effective, and we are working on additional areas to cover as well. Nursing is continually evolving and as a professional it is our job to facilitate education within our community of nurses so we can better serve our patient population. Philosophical forces influencing practice

Philosophy is an attitude toward life and that attitude evolves from every nurses belief system. One’s attitudes are shaped by their environment and an accumulation of life experiences, I define nursing as a way to give back. Giving good nursing care doesn’t stop at being knowledgeable about medicine and having the very best in technology. It goes beyond, by reaching that individual on a spiritual level and connecting with them. I have always believed that one cannot be taught how to show compassion, an individual either possesses that ability or they do not.

I have always believed that that is one of my strongest qualities, and this has been reconfirmed back to me by my patients through the years. To truly interact with a person you need to gain their trust, once that has been achieved through a therapeutic environment, healing is then possible. Ethical principles influencing practice There are standards in place to dictate the need to protect patient’s values, beliefs, culture and safety. It is difficult at times, when dealing with challenging patients and having to handle the stress of our jobs to remain open and unbiased.

It is nice to have a reminder that our patient’s values come first and respect their choices. Our role is to educate them about their treatment plan and make sure they are well informed, while letting go of our own attitudes. Determining, nursing practice are essential for dealing with day-to-day ethical issues (Jormsri, Kunaviktikul, Ketefian & Chaowalit, 2005). I recently had an Asian woman who presented with abdominal pain and requested to have cupping performed by a healer specialized in the field. I was initially at a loss, how was I going to find someone to perform cupping.

I wanted to help this woman and when I asked my colleagues and manager they had no suggestions. So I contacted the department that handles cultural awareness and was able to get a lead on whom to call. After, two hours of my day spent looking for someone to call, I finally had my answer. I came back to give my patient an update on the progress and she was so relieved. It was like you could see the anxiety drain out of her. By the end of the day, the therapist arrived to do cupping with her and she was relaxed and expressed that she truly felt like I heard her.

It was not easy and I did find myself getting frustrated with the process of trying to make something work that I knew very little about. I’m happy I followed through with it, because in the end every patient has a right to believe what they believe, even though her values and attitude toward medicine is very different than my own, I was able to put aside my own views and attitude and really help someone else. Conclusion Many might say nursing is a science and some might say nursing is an art.

I believe it is both. To be a successful nurse one must have the passion to continue their education and apply their knowledge through the science of nursing, and have the efficacy and compassion to provide the art of caring. Without caring the nurse is unable to connect with the patient and if the nurse cannot connect, trust will not develop between the nurse and the patient. I have always believed nursing is a calling and it is one of the most challenging jobs to have, but by far it has been the most rewarding.


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