My facility is using LPNs more frequently and is hiring them for more jobs. Is this illegal?
Monday May 18, 2009
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I’m an RN with a BSN, and our facility is using more and more LPNs. We’ve recently gone into low census, and it seems the RNs are being called off (more frequently) than the LPNs. Can my organization legally get away with this? Also, I’m waiting to get on a weekend program; two jobs were just posted, but the postings state, “LPNs only.” Is this discrimination? If I apply for these jobs, can they choose not to interview me because I’m an RN?
Larry
The decision to use a particular nurse licensee (e.g., LPN, RN, APN) depends first and foremost on the state nurse practice act and rules. The scope of practice of each nurse must be carefully evaluated before any employer can decide which level of nurse will be used in a facility and what the duties of that nurse will be. Other laws and regulations that impact an employer’s decision for staffing include state licensing laws for the facility (e.g., hospital licensing act) and Medicare/Medicaid regulations. Standards of practice developed by professional nursing associations (e.g., the American Nurses Association and the American Association of Nurse Anesthetists) also affect such decisions.
LPNs have an important part in the delivery of healthcare to patients. Their scope of practice, however, is more limited than that of RNs, and their practice is a dependent one, meaning that supervision of their care and the delegation of care to the LPN must be done by a healthcare practitioner named in the state nurse practice act (e.g., RN, physician). In some states, LPNs have been given the authority for an expanded scope of practice in the area of infusion therapy. It is probably true that an additional factor influencing an employer’s decision about the use of LPNs is that their rate of pay, or their salary, is less than that of the RN, and less than that of an RN with a bachelor’s degree.
There is no mandate that an employer pay a specific salary for any employee, except the mandate of paying the minimum wage as set by Congress. An employer’s decision, then, to utilize more LPNs than RNs may be well within the many laws, regulations, and professional standards that affect that decision. If, however, you think the LPNs are not only replacing RNs in number but are performing nursing care outside their scope of practice, a consultation with a nurse attorney or attorney in your state would be important. The attorney can discuss this issue with you, and if it is determined that the LPNs are performing purely RN responsibilities (e.g., nursing assessments, charge nurse duties), or performing their duties without the required supervision or delegation of care, the attorney can advise you on where to voice those concerns.
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.
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