Urgent: Board of Nursing, LPN Scope of Practice issue and YOUR input needed!

What’s Going On?
The Minnesota Board of Nursing wants to significantly change the Nurse Practice Act to alter scope of practice language.

This is NOT a friendly change.

Their proposals reflect a corporate health care employer’s dream to muddy the lines of responsibility between RNs and LPNs – allowing health care facilities to get more work for less money. It also pits our two practices in a fabricated fight that will only result in jeopardizing public safety.

With that in mind, MNA has serious concerns for the safety of patients and nurses regarding the Board of Nursing’s proposal to expand the scope of licensed practical nurses.

This initiative of the Minnesota Board of Nursing is based on a 2008 Minnesota Board of Nursing’s Report on Implementation of Recommendations of the MN Colleagues in Caring LPN Practice Committee.  This paper addressed the incongruence among practice, regulation, and education for licensed practical nurses based on a limited survey of nurse members.

The upcoming Board of Nursing “Listening” sessions are focused on changes in the definitions of assessment and delegation, as proposed in the Model Nursing Practice Act recommended by the National Council of State Boards of Nursing (NCSBN) who have no regulatory authority.  The definition of the practice of practical nursing in the current MN Nurse Practice Act uses the term “observation” rather than “assessment.”  Delegation is specified exclusively within the definition of the practice of professional nursing.

MNA is opposed to this proposal for the following reasons:

Concern for public safety
The concern for public safety has been highlighted in multiple studies regarding appropriate skill mix and level of education of nursing staff.  Many of these studies showed that better patient outcomes, based on nationally recognized nursing-sensitive indicators, occur in hospitals and nursing homes with a greater number of RN hours per patient day.  We are concerned that expansion of LPN scope of practice without an expanded education will further exacerbate the ability of the board to protect the health and safety of the public.

Lack of evidence to support this proposal
There is very little conclusive evidence regarding the appropriate role of licensed practical nurses, particularly in the realm of patient safety. It seems premature to make assumptions and propose a new model of practice without a sufficient evidence base.  We are concerned that the proposal utilizes current LPN practice to drive policy interpretation rather than professional nursing standards driving safe and effective nursing care.

Inconsistency with professional nursing standards
The functions of assessment and delegation within professional nursing standards are located within the role of the registered nurse. The weakening of these definitions in statute also will further the interests of the health care industry in reducing cost.

This initiative of the MN Board of Nursing is fueled by the National Council of State Boards of Nursing (NCSBN) who is also proposing the adoption of the Interstate Compact in all states.  MNA has consistently opposed the adoption of the Interstate Compact in Minnesota which would focus the licensing of nursing at the national level, rather than a state level.  MNA believes this expansion of the scope of practice of LPNs is another initiative by the MN Board of Nursing promoted by NCSBN.

Please see the schedules below for “Listening Sessions” in your area. We need MNA RNs to attend these sessions and weigh in on the seriousness of this issue and how it would impact patient and nurse safety!