Nurses in Minnesota are waiting to learn if the state Board of Nursing will change the rules regarding the scope of practice of licensed practical nurses. Years of discussions are winding down and may yield an answer in the coming months.
After years of trying to clear up confusion over the roles of licensed practical nurses and registered nurses, the Minnesota Board of Nursing is inching closer to a conclusion.
The confusion swirls around the definitions of two words that differentiate the scope of practice of each type of nurse: observation and assessment. The Minnesota Nurse Practice Act licenses LPNs to observe and care for patients, while it says RNs are to assess and care for patients, among other duties.
Disparities In Education And Practice
In 2002, nursing educators approached the Board of Nursing (www.nursingboard.state.mn.us) concerned about disparities between what LPNs were learning and doing on the job. The board convened committees to research LPN practice throughout Minnesota and formulate a document to clarify the issue.
Hundreds of comments have poured in from throughout the state. The question now is whether the Nurse Practice Act should be changed, or if the board can alter its rules with public input but without changing the law, according to Rene Cronquist, an RN and attorney with the nursing board.
"It is fine-tuning the language, being more precise, using words that seem to make more sense to people," Cronquist says. "If we could be clearer, there could be greater consistency and not inadvertently exceeding scope of practice."
Exceeding scope of practice and patient safety are what concern the Minnesota Nurses Association (www.mnnurses.org), which represents RNs and some LPNs in the state, according to MNA President Linda Hamilton.
"We want the board to enforce the law as it's written," says Hamilton. "The board is redefining the meanings of the words so the LPN will be responsible for the work of an RN and that is work that they're not educated to do."
The board's research has found no evidence that patient safety has been compromised, according to Cronquist.
Many Factors Contribute To Confusion
The combination of increasingly sick patients and the ongoing nursing shortage have contributed to the confusion, particularly in long-term care facilities statewide and in rural hospitals, where Hamilton says some employers expect LPNs to do RNs' work. "This is not an attack on LPNs," she adds.
The Minnesota Licensed Practical Nurses Association (www.mlpna.com), which represents 1,200 of the state's 24,000 practical nurses, wants the rules clarified to give LPNs the ability to work to the capacity of their license.
"The LPN role has been deteriorating in the workplace," Tauer says. "LPNs in hospitals settings in metropolitan areas are almost nonexistent. We feel the clarification of this rule will help utilize LPNs in hospitals, clinics and nursing home settings across the state."