Licensed Practical Nurses (LPNs) are licensed healthcare professionals who provide direct patient care in various settings, including nursing homes, hospitals, and clinics. Their work focuses on patient comfort, safety, and executing established care plans. LPNs perform duties such as monitoring vital signs and assisting with daily living activities. Although LPNs are frequently involved with drug administration, they do not possess the legal authorization to prescribe any medication, in any state.
Defining Prescriptive Authority
Prescribing medication is a specific legal act that involves conducting a diagnosis, selecting the appropriate drug therapy, determining the correct dosage and route, and issuing the formal order or prescription. This highly regulated function is reserved for practitioners with advanced education and training, such as physicians (MD/DO), physician assistants (PA), and Advanced Practice Registered Nurses (APRNs), like Nurse Practitioners (NPs).
An LPN’s scope is fundamentally different from the authority granted to these advanced roles. The LPN’s lack of this privilege is universal, even though APRN prescriptive authority varies by state. The act of prescribing involves independent clinical decision-making that is not included in the LPN’s curriculum or licensure.
LPN Responsibilities in Medication Management
LPNs cannot prescribe, but their role in medication management is constant and highly structured. They are primarily responsible for administering prescribed medications under the direction or supervision of a Registered Nurse (RN) or a licensed prescriber. This task requires strict adherence to safety protocols, including the “five rights” of medication administration: the right patient, right drug, right dose, right route, and right time.
The LPN is authorized to administer medications through common routes, such as oral, topical, intramuscular (IM), and subcutaneous injections. Documentation is a large part of their duty, requiring meticulous charting of the medication given and the patient’s subsequent response, including any adverse reactions. Specialized procedures often remain outside the LPN’s standard scope of practice and are subject to state law and facility policy.
Restricted Procedures
Tasks like initiating intravenous (IV) fluids, giving IV push medications, or administering blood products are typically restricted to RNs. While some states allow LPNs to receive additional training for basic IV therapy, they are generally prohibited from managing high-risk medications, such as chemotherapy drugs. The LPN’s focus is on the safe execution of a pre-existing medical order, not the initial decision to initiate a treatment.
The Role of State Licensing Boards
The specific duties an LPN can perform are governed at the state level, not by a single national standard. Each state has a Board of Nursing (BON) that enforces the Nurse Practice Act (NPA), which defines the scope of practice for all licensed nurses. This framework classifies LPN practice as a “directed” or “dependent” scope.
Because of this dependent classification, an LPN must always practice under the supervision of a higher-level practitioner, such as a physician, dentist, or Registered Nurse. While the prohibition on prescribing is consistent across all states, the rules governing specific administration tasks can vary significantly.
For instance, whether an LPN can start a peripheral IV line, administer certain vaccines, or care for a patient with a central line depends on the specific regulations established by that state’s BON. These boards serve as the definitive source for localized information.