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I was let go from my LPN position at a large hospital because of a restructuring of RNs. Some LPNs had positions created for them. Is this legal?

Monday April 22, 2013
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Question:

Dear Nancy,

After 15 years, I was let go from my LPN position at a large hospital because of a restructuring of RNs, which I understand. Another reason was that LPNs are not able to do assessments and can only contribute to the RN's assessment. However, I had been doing assessments on my unit without an RN all these years. I also was assessing the patients assigned to me during the shift. They said this is not a new rule and it had just slipped through the cracks all these years. Do I have grounds for any type of lawsuit to protect myself for performing these skills outside of my scope of care? Some LPNs had technician positions created for them, but it was a lateral move, so they kept the same rate of pay. Others became technicians with a significant pay cut. Jobs were not posted on the job board, but held for certain LPNs. Is this legal?

Nellie



Nancy Brent replies:

Dear Nellie,

Your question contains two issues that can be discussed here. Initially, what an LPN can and cannot do is based on the state nurse practice act. Many states indicate that LPN practice is not an independent one, but rather requires the supervision of an RN or other healthcare provider when functioning within their scope of practice.

Moreover, LPN practice is generally defined as assisting the RN in the delivery of nursing care as opposed to initiating and independently providing nursing care. This is a common difference between what an RN's scope of practice is as compared with that of an LPN. This distinction is not only based in state nurse practice acts, but also supported by professional nursing associations, such as the American Nursing Association. You may want to check with your local LPN association for its adopted statement on this.

It may be that your state practice act allows an LPN to perform an assessment without RN follow up, but it does not seem so based on your question. Keep in mind that even if the state act allows an LPN to assess other regulatory sources or accreditation organizations, including federal law, may not. That is not to say that LPN practice is not meaningful and helpful. LPNs have, and in some settings continue to, greatly contribute to excellent patient care. In regard to your second concern, your best bet is to consult with a nurse attorney or attorney in employment law who can analyze the process involved with the elimination of the LPN as staff. In addition to this issue, discuss with the attorney the practice of LPNs in your state, so you can resolve any concerns you have about your role for all those years.

Sincerely,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.