The practice of nursing as a Licensed Practical Nurse is defined as performing tasks & responsibilities within the scope of supportive & restorative care; medication administration and specialized tasks under the direction of a Registered Professional Nurse of licensed or otherwise legally authorized physician or dentist.

A. Clinical/Technical/Service
1.    Participates in the application of the nursing process to an assigned group of patients.
2.    Demonstrates those behaviors which reflect the scientific knowledge, judgment, and technical skills of a Licensed Practical Nurse
3.    Performs job duties under supervision of a Registered Professional Nurse.
4.    Demonstrates a competent level of approved skilled nursing care tasks and procedures using approved technical skills related to vital signs, pulse oximetry, venipuncture, starting standard peripheral IVs only (not midlines or long peripheral lines), urinary catheter insertion/catheter care; and simple dressings, remove/discontinue a peripheral line.
5.    Administer IV fluids, provided completion of annual competency IV therapy training.
6.    Monitors patients receiving blood and blood products and TPN under the direction of the RN, who administers the transfusion.
7.    Makes recommendations in the application of the nursing process.
8.    Participates in planning, and administers direct patient care, including activities of daily living (ADL).
9.    Performs point of care testing including blood glucose.
10.    Performs nursing procedures as defined in the nursing procedure manual.
11.    Administers medication as defined in nursing policy. ALL routes except cannot administer medications IV push/bolus (except for a Normal Saline or heparin flush) or via a central line. LPNs do not administer chemotherapy or immunotherapy.
12.    LPNs cannot administer first dose of an IV drug. The RN will administer the first dose of an IV drug and assess for side effects, after which the LPN can administer subsequent doses.
13.    LPNs working exclusively in chronic outpatient hemodialysis settings may, under the direct supervision of a Registered Professional Nurse (RN) and after completing an approved hemodialysis training and competency program, perform dialysis-related tasks as permitted by the New York State Education Department (NYSED) Office of the Professions and 10 NYCRR §700.4(b). See Section D for more details regarding role of LPNs in the Outpatient Hemodialysis setting. 
This exception does not permit independent practice or unsupervised access to central venous lines.
14.    Assists in patient assessment after the RN has completed the initial patient assessment, including pain management.
15.    Carries out medical and nursing orders. Cannot accept verbal orders or carry out RN standing orders.
16.    Makes, reports and records observations on assigned patients within the EMR.
17.    Observes and reports any signs and symptoms of change in a patient’s condition to the appropriate person.
18.    Participates in health teaching to patients and families following the RNs development of the teaching plan.
19.    Establishes an environment that promotes optimum physical and emotional comfort.
20.    Performs purposeful hourly care checks and supports the patient experience in accordance with Relationship Centered Care Professional Practice Model
21.    Organizes supplies and equipment necessary for carrying out the plan of care is identified and communicated by the charge nurse/designee.  
22.    Contributes specified data to the patients’ medical record.
23.    Demonstrates the knowledge and skills necessary to provide care, based on physical, psychosocial, educational, safety, and related criteria, appropriate to the age of the patients served in assigned area.
Age Specific Competencies (Neonate/Infant, Pediatric, Adolescent, Adult, Geriatric)
a.    Identifies physical, behavioral and emotional characteristics typical for the age group.
b.    Modifies approaches based on patient age-specific needs and responses to treatment.
c.    Provides care for patients based on age-specific needs.
d.    Uses communication techniques which are age appropriate.
24.    Behavior demonstrates an awareness of the goals of the Nursing Department
25.    Supports the patient experience to achieve safe and quality care.
26.    Adaptation to changing departmental needs reflects awareness of institutional needs.
27.    Time management meets needs of unit/department.
28.    Interprets hospital policies and regulatory standards of care.
29.    Recommends changes in nursing practice of practical nurses and policy through the appropriate leadership person or nursing committee.

B. Organizational/Managerial
30.    Participates in the Nursing Department Quality Improvement Program/ activities.
31.    Maintains patient/employee confidentiality in the management of information.

C. Educational/Professional Development
32.    Participates in the development of other staff members.
33.    Meets regulatory, licensure and annual health assessment requirements.
34.    Participates in patient care conferences.
35.    Maintains nursing care standards through participation in workshops, in-service programs and staff meetings.
36.    Maintains competence through participation in continuing education and other appropriate experiences.

37.    D. Communication/Relationships
38.    Demonstrates a professional, courteous, and respectful attitude in dealing with patients, families and significant others.
39.    Displays courtesy, professionalism and respect during interactions with all members of the hospital staff and extended community.
40.    Responsible to the leadership person of the unit
41.    Provides direction, assistance and support to auxiliary staff.
42.    Participates in interdepartmental and intergroup communication to provide a continuity of patient care.
43.    Participates in departmental committees, as assigned.
44.    Adheres to the MSHS legal and ethical standards.
45.    May be required to perform other duties as assigned.

D.  LPNs in the Outpatient Hemodialysis Setting
An LPN can practice in the chronic hemodialysis outpatient department under the direct supervision of an RN. The LPN will participate in educational programs on a regular basis, including initial orientation and continuing in service training to care for patients with central venous access devices (CVAD). The training should include a written examination and competency demonstration.  
A Hemodialysis LPN may:
•    Administer bolus of medications by IV push in a chronic outpatient hemodialysis treatment center, excluding first dose administration which is administered by an RN.

The RN will access and care for patient’s initial catheter use. Subsequently, and following the MSHS CVAD care policy, the LPN can: 
•    Identify and set up supplies necessary for accessing a CVAD.  
•    Initiate treatment with a CVAD.
•    Draw blood specimens from a CVAD.
•    Perform CVAD dressing change and exit site care.
•    Monitor and adjust flow rates of central venous catheter access device/line.
•    Intervene if there is a catheter/blood line disconnection or other complications associated with a CVAD.
•    Provide CVAD care at the end of dialysis treatment.