Nursing is a popular industry – especially in these times. Across the field, there are a variety of nursing positions and levels, all of which vary based on a variety of factors. What each nurse is allowed to do is called their scope of practice, and this varies based on their education, training, competence, and role. Essentially, the responsibilities that a Doctor, Nurse Practitioner (NP), Nursing Assistant, Registered Nurse (RN), Intensive Care Unit (ICU) Registered Nurse, or even Licensed Practical Nurse (LPN) have are all different based on a range of factors.
In this blog, we’ll be specifically looking into the scope of practice for a Licensed Practical Nurse in British Columbia.
If you’re new to or unfamiliar with the healthcare field, you may not know what a scope of practice is. A scope of practice refers to the procedures, actions, and processes that a healthcare provider is permitted to carry out within the limits of their professional license. In other words, it’s the duties and responsibilities that a Licensed Practical Nurse is educated and authorized to perform in their work.
In BC, Licensed Practical Nurses are governed under the British Columbia College of Nurses and Midwives’ (BCCNM) Scope of Practice. This scope of practice is based on the Nurses (Licensed Practical) Regulation and sets out the activities that Licensed Practical Nurses are educated and authorized to perform if an employer policy permits it, and if the LPN has competence.
In essence, the BCCNM’s scope of practice outlines the standards, limits, and conditions for Licensed Practical Nurses in BC.
Licensed Practical Nurses can either act within an autonomous scope of practice or with client-specific orders.
An autonomous scope of practice refers to LPNs acting independently in their role. In this particular scope of practice, LPNs will assume all accountability and responsibility for their decisions on client care and for the actions that they do. Throughout all of their work, LPNs will also keep in mind the activities that they are educated, competent, and allowed to perform.
Logically, while LPNs are always solely responsible and accountable for their actions, they do have greater responsibility when acting within an autonomous scope of practice.
On the other hand, client-specific orders are when LPNs follow the direction of another regulated health professional. A client-specific order is an instruction or authorization by a regulated health professional for the LPN to provide care for a specific client, whether or not the care or service includes a restricted or non-restricted activity. When following a client-specific order, LPNs must still remain within their scope of practice and facility policies.
LPNs can carry out orders from nine different health professionals: medical doctors, midwives, naturopaths, nurse practitioners, pharmacists, podiatrists, registered nurses, registered psychiatric nurses, and dentists. In BC, LPNs are only allowed to act on client-specific orders from one of these authorized health professionals, given that they are registered to practice.
It’s important to also note that some skills that LPNs can do require additional education, which refers to structure education, either a workshop, course, or program of study, designed so that LPNs can attain the competencies required to carry out a specific activity as part of the LPN practice. Additional education builds on the entry-level competencies of LPNs, identifies the competencies expected of LPNs, includes both theory and application to practice, and includes an objective, external evaluation of the LPNs’ competencies.
Now that we’ve covered what a scope of practice, we can delve deeper into specific examples of the scope of practice for an LPN.
After successfully completing additional education and by following decision support tools, LPNs can engage in the following actions:
Wound care refers to techniques that enhance the healing of skin abrasions, blisters, cracks, craters, infections, lacerations, necrosis, and/or ulcers.
Licensed Practical Nurses are allowed to provide wound care if a wound care treatment plan is in place. In this scope, LPNs can probe, irrigate, pack, or dress a tunnelled wound only after successfully completing additional education. LPNs can also apply compression therapy, provide negative pressure wound therapy, or carry out maggot debridement therapy.
In the course of emergency cardiac care, Licensed Practical Nurses can use automated external defibrillators (AEDs) after successfully completing a CPR course for health professionals that includes the use of AED.
To provide transcutaneous electrical nerve stimulation, LPNs can also apply transcutaneous electrical nerve stimulation (TENS) after successfully completing additional training.
Licensed Practical Nurses can diagnose and treat anaphylaxis, but they are only allowed to administer Epinephrine to treat it.
To learn more about Licensed Practical Nurses, their scope of practice, or how you can become one, contact one of our advisors below.
