1) I am a LVN and read in Position Statements 15.27 and 15.28 that it is the LVN’s responsibility to ensure that he or she has an appropriate Clinical Supervisor. Who can be my clinical supervisor?
Each LVN is required to ensure that he or she has the appropriate supervisor prior to accepting an assignment, a position or employment. The Nursing Practice Act (NPA) Section 301.353 states that “the practice of vocational nursing must be performed under the supervision of a registered nurse, physician, physician assistant, podiatrist, or dentist.” Rule 217.11, Standards of Nursing Practice, (2) further goes on to require and explain that “the licensed vocational nurse practice is a directed scope of nursing practice under the supervision of a registered nurse, advanced practice registered nurse, physician’s assistant, physician, podiatrist, or dentist. Supervision is the process of directing, guiding, and influencing the outcome of an individual’s performance of an activity.”
LVNs provide valuable and essential nursing care in different types of health care settings. When LVNs work in settings, such as hospitals, long-term care facilities, rehabilitation centers, or skilled nursing facilities, RNs are mostly likely to serve as the LVN’s supervisor. LVNs also work in private physician or dentist offices, where physicians, dentists and podiatrists function as the LVN’s supervisor. Because LVNs may practice in these various health care settings, the clinical supervisor is a term used to describe the different licensed healthcare providers that are authorized in the NPA to supervise and direct the LVN’s practice, i.e.: registered nurse, advanced practice registered nurse, physician, physician assistant, podiatrist or dentist. These types of clinical supervisors oversee the nursing practice of a LVN by monitoring the health status of patients and then directing the LVN’s actions to ensure the delivery of safe and effective nursing care.
2) In Position Statements 15.27 and 15.28, I read that LVNs are responsible for providing safe, compassionate and focused nursing care to assigned patients with predictable health care needs. What does predictable mean in this statement?
The LVN in Texas provides nursing care to patients with health care needs that are predictable in nature, under the direction and supervision of a registered nurse, advanced practice registered nurse, physician, physician assistant, podiatrist or dentist. The term predictable describes health conditions that behave or occur in an expected way. A predictable health condition does not mean that the patient is always stable. Instead, predictable health conditions follow an expected range or pattern that allows the LVN with his or her clinical supervisor to anticipate and appropriately plan for the needs of patients.
For example, it is appropriate for a LVN to care for a patient with a diagnosis of asthma. The disease process for asthma, while sometimes acute in nature, is predictable or well-known, and the symptoms can be anticipated. The LVN assists his or her clinical supervisor in the development of a plan, in which the LVN provides care, prevents possible complications and stabilizes the symptoms of asthma. In addition, when complications arise or events occur that are outside the predicted range, the LVN must be able to recognize this change in condition and notify his or her clinical supervisor.
- Texas Board of Nursing (2010). Differentiated essential competencies (DECs) of graduates of Texas Nursing Programs
- Texas Board of Nursing (2011). Position statement 15.27, The LVN Scope of Practice
- Texas Board of Nursing (2011). Position statement 15.28, The RN Scope of Practice
- Texas Occupations Code, Chapter 301.002(5). Definition of Vocational Nursing
- Texas Occupations Code, Chapter 301.353. Supervision of Vocational Nurse
- 22 Tex. Admin. Code §217.11 (1). Standards of Nursing Practice
- 22 Tex. Admin. Code §217.11 (2). Standards Specific to Vocational Nurses