Key Takeaways
- LPN/LVNs function under the direction of RNs, physicians, and other licensed healthcare providers
- The nursing process for LPN/LVNs focuses on data collection (not comprehensive assessment), planning, implementation, and evaluation of assigned tasks
- Effective collaboration requires clear communication, mutual respect, and understanding of each team member's scope of practice
- LPN/LVNs contribute to the care plan but do not independently develop or modify nursing diagnoses
- Documentation must accurately reflect care provided and observations reported to the supervising nurse
Collaborative Care and the LPN/LVN Role
The Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) provides essential patient care as part of a collaborative healthcare team. Understanding your role within this team structure is fundamental to safe, effective nursing practice and NCLEX-PN success.
The Healthcare Team
Modern healthcare delivery relies on interprofessional collaboration—multiple disciplines working together to achieve patient outcomes. The LPN/LVN works alongside:
| Team Member | Primary Role | LPN/LVN Interaction |
|---|---|---|
| Registered Nurse (RN) | Care coordination, assessment, care planning | Direct supervision, receives delegated tasks |
| Physician/Provider | Diagnosis, treatment orders | Follows orders, reports findings |
| Nursing Assistant (CNA) | Basic care, ADLs | May supervise, receives reports |
| Physical Therapist | Mobility, rehabilitation | Reinforces exercises, reports progress |
| Dietitian | Nutritional assessment and planning | Monitors intake, reports concerns |
| Social Worker | Discharge planning, resources | Reports patient/family needs |
| Pharmacist | Medication management | Clarifies orders, reports reactions |
The LPN/LVN Scope of Practice
Your scope of practice is defined by:
- State Nurse Practice Act - Legal authority that defines what LPN/LVNs can do
- Facility policies - May be more restrictive than state law
- Individual competency - Your demonstrated skills and training
- Supervising nurse directives - Specific instructions for patient care
The most restrictive of these applies. If state law permits a task but facility policy does not, you cannot perform it.
The LPN/LVN Nursing Process
While RNs use the full nursing process, LPN/LVNs participate in a modified version:
| Phase | RN Role | LPN/LVN Role |
|---|---|---|
| Assessment | Comprehensive assessment | Data collection, focused assessment |
| Diagnosis | Formulates nursing diagnoses | Contributes observations |
| Planning | Develops care plan | Contributes to planning, follows care plan |
| Implementation | Implements and delegates care | Provides direct care within scope |
| Evaluation | Evaluates outcomes, modifies plan | Evaluates assigned tasks, reports findings |
Data Collection vs. Assessment
Critical Distinction:
- Data collection (LPN/LVN): Gathering objective and subjective information
- Assessment (RN): Interpreting data to make clinical judgments
| LPN/LVN Can Do | LPN/LVN Cannot Do |
|---|---|
| Measure vital signs | Interpret significance of abnormal values |
| Observe wound characteristics | Diagnose wound healing stage |
| Note patient statements about pain | Develop pain management plan |
| Report changes in condition | Make nursing diagnoses |
| Perform focused data collection | Perform admission or comprehensive assessment |
Effective Communication in the Team
Clear communication prevents errors and ensures continuity of care:
SBAR Communication Tool:
| Component | Description | Example |
|---|---|---|
| S - Situation | What is happening now? | "Mrs. Jones is having increased difficulty breathing" |
| B - Background | What is the context? | "She was admitted for pneumonia, O2 sat was 94% this morning" |
| A - Assessment | What do I observe? | "Currently O2 sat is 88%, respiratory rate 28, using accessory muscles" |
| R - Recommendation | What do I need? | "I think she needs to be assessed. Should I increase her oxygen?" |
Reporting to the Supervising Nurse
Always report immediately:
- Changes in vital signs outside parameters
- New symptoms or complaints
- Changes in level of consciousness
- Patient or family concerns
- Medication reactions or refusals
- Falls or safety incidents
Documentation Requirements
LPN/LVN documentation should be:
- Accurate - Reflect exactly what occurred
- Timely - Documented as close to the event as possible
- Complete - Include all relevant observations
- Objective - Use factual, observable data
- Legible - Clear and readable
Example of good documentation:
"1400: BP 148/92, patient reports headache rated 6/10. RN Smith notified. Ice pack applied to forehead as ordered. 1430: Patient states headache improved to 3/10."
On the NCLEX-PN
Expect questions about:
- The LPN/LVN role within the healthcare team
- Appropriate reporting of findings
- Data collection vs. assessment
- When to notify the supervising RN
An LPN caring for a patient notes that the patient's blood pressure has increased from 128/82 to 168/98 mmHg. What is the LPN's priority action?
Which activity is within the LPN/LVN scope of practice?
When using SBAR communication, what does the "A" component include?