At another site, RNs also commented that greater LPN skill utilization would provide “workload relief” for RNs by removing the need to assist LPNs with more complex tasks. One also suggested that LPN scope utilization would affect RN scope as well, stating: If [LPNs] were allowed to work in a broader scope of practice it would free up the RNs to be more what the RN has been trained to do, and down the line. It would be a whole shift, if they were allowed to do more.
- RN, Site 4
At Site 6 (a high scope site), two LPNs mentioned that freeing up RNs was an organizational strategy and the administrator concurred, commenting that by allowing LPNs to perform a wider range of tasks, the RN role had been enhanced, allowing them to focus on the most complex patients. Team dynamics. RNs played a significant role in LPN scope utilization in other ways. LPNs and RNs at two sites identified opportunities provided by RNs for LPNs to practice new or infrequently used skills, such as changing complex dressings or starting IVs. RN acceptance of LPN role expansion appeared to link to such opportunities. As one RN remarked, “We all need to be working to our level of ability and our level of training. Otherwise, we are frustrated.” A number of LPNs spoke positively about the support and assistance provided by their RN coworkers and charge nurses. Guidance, demonstration, instruction, and mentoring were identified as supportive RN strategies. Several LPNs indicated their appreciation for this support. Other members of the care team also supported greater LPN scope utilization. Interprofessional communication and practice was one supportive strategy that was identified. Participants from several sites referred to the advice and support provided by physicians and therapists on their units. LPNs at three sites were said to provide helpful advice and support to their peers. In contrast, at the other three sites, only one LPN worked on the unit for each shift. At one site, EMTs provided care on the unit while remaining on call for emergencies. An LPN
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Final Report: Understanding Licensed Practical Nurses’ Full Scope of Practice September 28, 2012