Licensed Practical Nurse (LPN)-Emergency Department, Per Diem

GENERAL SUMMARY The Licensed Practical Nurse#s directed scope of practice will contribute to the assessment of the health status of stable patients by participating the development and modification of the strategy of care while maintaining safe and effective nursing care rendered directly or indirectly. A Licensed Practical Nurse will practice under the supervision of an Emergency Department Registered Nurse, with appropriate delegation of tasks and / or assessment working collaboratively in a team nursing model. The Emergency Department Registered Nurse performs initial focused patient assessment(s) and a comprehensive reassessment(s) every two hours, minimally, on patients being cared for within the team nursing model assignment. FUNCTIONAL DUTIES AND RESPONSIBILITIES LPN Roles and Responsibilities The LPN can accept a delegated task from an RN, APRN who is providing guidance and direction in the care of a patient within their care in the team nursing The LPN CANNOT perform an initial assessment. The LPN can collect data using protocols, screening tools, policies, and procedures to assist in determining The LPN may not modify a patient care protocol or care The LPN may contribute to the established nursing goals, diagnosis, and plan of care by communicating recommendations to the supervising RN, ARNP, or Physician. The LPN will maintain annual competencies and required education training or certifications for their role in the LPN can provide / perform in conjunction with the supervision of an RN or APRN or physician : Patient Care Follow an established facility protocol or authorized provider#s order to provide care, education and / or directives to a patient. Complete delegated tasks when working with an RN in a triage role as Care for the patient who has been initially assessed by an RN and deemed stable with expected outcomes collecting data using a structured format in eDH. May delegate tasks to LNA or ED Technician appropriately assuming responsibility for the delegated task and assuring the delegatee is competent to perform the Enter drug allergies or verified medication into patient Complete screening questions during the patient#s ED stay collecting data for the healthcare Provide wound care as directed by RN / APRN to include wound staging, wound assessment, and wound dressings. Monitor patients on CPAP and BiPAP after initial settings have been established by a qualified Apply a cervical collar after RN / APRN assessment and completion of department specific cervical collar application competency. Initiate and monitor patient restraints, per hospital Initiate and maintain IV therapy on stable patients, to include Mediport access and PICC lines. Blood Administration Obtain blood products from blood bank following NLH Blood Bank policy and Observe a stable patient receiving blood / blood product administration after the initial 15-minute assessment by an RN / APRN and collect vital signs and pertinent data. Intravenous Initiation and Medication Administration LPNs who have successfully completed the New Hampshire Board of Nursing approved Intravenous (IV) course may insert and initiate peripheral IVs, provide care for, and administer intravenous solutions / medications under the direction / delegation of a RN or APRN. (LPNs must complete the ED Mediport and CVAD access competency prior to accessing / caring for / obtaining blood specimen from Mediports or central venous access devices (PICC lines and Central lines). Gather and set up equipment or solutions for infusion through a peripheral access device as directed by the ED RN. (Assist in equipment set up for trauma / critical care patients). Administer continuous or intermittent medicated and un-medicated isotonic (D5W, Normal Saline, Lactated Ringers) intravenous solutions through peripheral access lines in patients greater than 32 kilograms. Administer saline and / or Heparin flushes through a peripheral IV catheter by direct IV push Discontinue and remove peripheral IV LPNs may administer first dose medications on stable patients after an initial ED RN comprehensive assessment with direct supervision of the delegating RN or (Exceptions are high alert medications such as heparin, insulin, fentanyl). LPNs Cannot : Be the primary nurse for ED Perform a Trauma 2 or Trauma 1 Act as the ED triage Provide care or interventions to patients under 32 kilos (70 lbs.) and / or 13 years old Perform deep suctioning on patients with a tracheal appliance or those necessitating open deep Assess for post procedure Assist the APRN / PA-C / MD with invasive procedures as a primary Provide primary care to unstable patients, including urgent and emergent situations. Deliver primary nursing care to hemodynamically unstable patients, or patients who are actively deteriorating in health status. Complete initial comprehensive assessments for ED Complete the initial comprehensive admission assessment for inpatients (boarders). Accompany patients off the unit requiring continuous telemetry (Nurse must have ACLS) Initiate patient restraints or complete the required 2-hour nursing restraint assessment Complete a Suicide / Behavioral Health specific initial LPN cannot perform medication administration for the following : Administer medicine to a pediatric patient under the age of 13 years Administer high alert medications (i.e., heparin, insulin, vasoactive, sedation meds, ketamine). Initiate blood product Administer tPA (Alteplase) Administer PPN, TPN or Lipids. Administer hyper- or hypotonic Administer Rabies Administer chemotherapy agents Administer Lidocaine 1% with Epinephrine subcutaneous Override medication in the Omni cell POSITION REQUIREMENTS# Knowledge / Skills / Abilities Experience Education NH Board of Nursing Approved IV Therapy Certification required upon hire or within 6 months. Graduate of an accredited school of practical nursing Licensed Practical Nurse (LPN) in the State of NH required

• GENERAL SUMMARY
• The Licensed Practical Nurse's directed scope of practice will contribute to the assessment of the health status of stable patients by participating the development and modification of the strategy of care while maintaining safe and effective nursing care rendered directly or indirectly.

A Licensed Practical Nurse will practice under the supervision of an Emergency Department Registered Nurse, with appropriate delegation of tasks and / or assessment working collaboratively in a team nursing model. The Emergency Department Registered Nurse performs initial focused patient assessment(s) and a comprehensive reassessment(s) every two hours, minimally, on patients being cared for within the team nursing model assignment.

LPN can provide / perform in conjunction with the supervision of an RN or APRN or physician :

Patient Care

Blood Administration

Intravenous Initiation and Medication Administration

LPNs Cannot :

LPN cannot perform medication administration for the following :

NH Board of Nursing Approved IV Therapy Certification required upon hire or within 6 months.