RN vs. LPN Scope of Practice
According to Greenwood (n.d.), RNs and LPNs share some of the same types of responsibilities as it relates to caring for patients, including administering medications. However, there are significant differences between the two when it comes to their scopes of practice and levels of education, critical thinking skills, planning and responsibilities. For example, RNs supervise LPNs, also LPNs are limited in their role in the nursing process of assessing, planning, implementing and evaluating patient needs. RNs are more independent in charge of coordinating these areas. Concerning implementing patient care plans, RNs make determinations on what is best for the patients and the LPNs initiate the plans, under the supervision of the RNs. This is because critical thinking skills are required to implement effective care and evaluation plans and this level of skill is not taught in an LPN curriculum (Greenwood, n.d.).
Specifically, a scope of nursing practice pertains to specific tasks an RN or an LPN is authorized to perform in their state, as mandated by the state board of nursing. Additionally, an RNs scope of practice includes more highly complex tasks than that of the LPN, including administering medications (Greenwood, n.d.). Information on scope of nursing practice requirements for a particular state is found in the state’s Nursing Practice Act .
Nursing Practice Act of California
As it relates to the administration of medication, the California Board of Nursing Practice Act for RNs states “Notwithstanding any other provision of law, a registered nurse may dispense drugs or devices upon an order by a licensed physician and surgeon if the nurse is functioning within a licensed clinic…” (CA.gov, Section 2725.1). The California act also mandates that RNs are not allowed to dispense drugs exclusively as their jobs or in a pharmacy. Nor are they allowed to operate any type of drug retailing business such as a pharmacy. Additionally, RNs are not allowed to dispense drugs included in the California Uniform Controlled Substances Act.
Another state regulation on registered nurses governed by the California Board of Nursing relates to how impaired nursing professionals are dealt with. California has the Diversion Program in place to protect the public by identifying RNs who are impaired in their professions because of mental illness or chemical dependency. The Diversion Program also gives impaired RNs access to intervention and treatment programs. When impaired RNs are identified, they are placed on suspension and monitored accordingly (CA.gov).
Research in this Paper Compared to My Workplace
In my workplace, there are strict protocol processes and checks and balances put in place to ensure things run smoothly. Nurses where I work are all very contentious and try to follow the rules according to how they are regulated. There have been times when procedures were not followed according to protocol but everyone was very good about correcting any problems that may have arisen from those incidents. Everyone in my workplace looks out for each other and tries to make sure that, no matter what, the patients are well taken care of, especially when it comes to safe medication procedures for them. Errors in medication dispensing are avoided as much as possible by following protocol when dealing with medications.
Principles of Safe Medication
According to the California Medical Association, safe medication practices are important for the safety of patents, assurance that medications are used properly, and the reduction of liability loss. To ensure the success of safe medication practice efforts, established principles are in place to help medical professionals cut down on medication errors. These principles include 1) familiarity with prescribed medications, 2) knowledge of patient’s recent drug use, and 3) knowledge of patient allergies.
Familiarity with prescribed medications may lead to prescribing errors. It is important that medical professionals understand appropriate dosage, indications and contraindications of medications, as well as any side effects associated with the medications (Safe Medication Principles, n.d.).
Knowledge of patient’s recent drug use helps eliminate surprise drug interactions. It is important for medical professionals to ask patients about all of the drugs they are currently taking or have recently taken. This includes over-the-counter medicines, herbs and vitamins of any sort. Knowledge of patient allergies is also important to help prevent treatment failure or unwanted reactions to prescribed drugs.
The science of pharmacology in RN nursing practice is essential to ensure safety in drug administration and use. RNs need a basic understanding of pharmacology to better handle a patient’s possible adverse reaction to a particular drug. It is best to know what to expect once a drug is administered to a patient, and the inclusion of the science of pharmacology in the curriculum of RNs is necessary to increase competence in the healthcare setting, as it relates to administering medicines, complying with regulations and offering the best possible care to all patients.
CA.gov. (2012). Diversion Program. California Board of Registered Nursing website. Retrieved from http://www.rn.ca.gov/diversion/whatisdiv.shtml
CA.gov. (2012). Regulations: Article 2. Scope of Regulation. California Board of Registered Nursing website. Retrieved from http://www.rn.ca.gov/regulations/bpc.shtml#2725.1
Greenwood, B. (n.d.). RN Duties vs. LPN Duties. Houston Chronicle online. Retrieved from http://work.chron.com/rn-duties-vs-lpn-duties-9254.html
Ndosi, M. E., & Newell, R. (2009). Nurses’ knowledge of pharmacology behind drugs they commonly administer. Journal Of Clinical Nursing, 18(4), 570-580. doi:10.1111/j.1365-2702.2008.02290.x.
Pharmacology. (n.d.). Dictionary.com. Retrieved from http://dictionary.reference.com/browse/pharmacology
Safe Medication Principles. (n.d.). California Medical Association. Retrieved from http://www.safer.healthcare.ucla.edu/safer/archive/general735.pdf