Editing LPN Scope of Practice (section)

== Supervision and the Direction of Care ==

LPN practice is, by definition, directed practice. The LPN contributes to nursing care under the supervision of an RN or another authorized licensed provider. The supervising RN retains accountability for the overall nursing process and for the outcome of care, while the LPN remains personally accountable for the tasks the LPN performs and for reporting findings accurately and promptly.

Supervision does not always mean physical presence. Most boards recognize a range that includes direct or on-site supervision and indirect or off-site supervision with availability by telephone or other immediate communication. Long term care and some community settings commonly rely on indirect supervision, which is one reason LPNs practice with a high degree of autonomy in those settings while still working within a directed scope.

Charge nurse roles are a common point of confusion. In some states and some settings, most often long term care, an experienced LPN may serve as a charge nurse for a unit or shift. Where that role exists, it is an assignment and supervision role for unlicensed assistive personnel and for the flow of the unit. It does not convert the LPN's legal scope into an RN scope, and an RN must remain available consistent with state and facility requirements.