I work at a clinic in which LPNs are allowed to give IV conscious sedation. What’s the rule on this?
Friday June 5, 2009
E-mail to a friend
| 
Print This |
Select Text Size:
advertisement
Our free-standing pain clinic has both RNs and LPNs. RNs give IVP conscious sedation and the LPNs are also allowed to do the same without restriction. RNs do not supervise the LPNs in any way. LPNs are treated as if they have an RN license, and management uses them interchangeably with RNs. I have voiced my concerns about this practice, but it always falls on deaf ears. I know in hospitals LPNs are restricted from this practice. Is this legal?
Brant
You have probably answered your own question about the LPNs' scope of practice and the use of them by management. It is assumed your concern is based on a review of the state nurse practice act and its rules concerning LPNs’ scope of practice. For certain, LPNs cannot provide nursing care without some supervision or direction from another healthcare provider as identified in the state nurse practice act (e.g., RN, physician, APN). LPN practice is a dependent one.
Some states do allow LPNs expanded role responsibilities after completing an approved course in role expansion. An example is the LPNs’ ability to provide some aspects of infusion therapy under certain circumstances with specified oversight. In terms of conscious sedation, however, it seems unlikely an LPN would be given the authority to administer this therapy. In fact, the American Association of Nurse Anesthetists (www.aana.com) clearly states conscious sedation can be safely administered by qualified healthcare providers — that is, CRNAs, anesthesiologists, other physicians, dentists, oral surgeons, and specifically trained RNs who assist in the process (See “Conscious Sedation: What Patients Should Expect” at the AANA Web site).
The use of LPNs in the manner you describe needs to be carefully evaluated by a nurse attorney or attorney in your state who can review your concerns and identify where you need to go with them. As examples, anyone who is licensed by the state board of nursing and is participating in the use of LPNs in a prohibited manner may be disciplined when reported to the board. The facility might have its license disciplined for utilizing personnel in violation of mandated rules and regulations. Another implication the attorney may review is how the facility is billing for the use of the LPN services. In other words, is the rate for an RN billed for the use of the LPN? These and other issues can be addressed during your consultation.
Cordially,
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.
