A reader asks:
Dear Rick,
I am a LPN working in a methadone clinic. I was wondering if I could perform annual physical exams or if a physician or physician’s assistant can delegate it to a LPN? Could a RN carry out this task? Is it within the scope of practice of LPNs and RNs? This task is not listed in the job description for LPNs and RNs. I have voiced my concerns about this issue to the physician, but the response has been that the physician should sign off the nurses’ tasks and holds all legal responsibility.
Rick Ferri, Ph.D., ANP, ACRN, responds:
This is somewhat of a difficult question to answer since the scope of practice of RNs and LPNs are generally governed by each state’s board of nursing. However, in general terms LPNs collect data about a patient’s condition, but cannot interpret the data or make medical diagnoses, which is required when conducting a physical exam. For example, if listening to a patient’s lungs the LPN notes “crackles,” the LPN cannot translate that finding as the patient having congestive heart failure.
While the LPN practices under the supervision of a RN or physician, no other clinicians can “hold all legal responsibility” for another clinician’s practice. Regardless of clinicians’ credentials, they are responsible to practice according to the scope of practice and to “acceptable standards of care.”
For more information on the scope of nursing practice in your state, please visit the National Council of State Boards of Nursing
Web site.
© 2005. AMN Healthcare, Inc. All Rights Reserved.