Skip to main content

Oregon State Flag An official website of the State of Oregon »

Oregon.gov Homepage

LPN Frequently Asked Questions

If you cannot find the information you need at one of the links below, access the OSBN scope-of-practice decision guide, the OSBN interpretive practice statements, or the Nurse Practice Act. The Board does not answer any practice questions by phone or questions sent to the general OSBN e-mailbox. To submit a written practice question, please email us at osbn.practicequestion@osbn.oregon.gov. However, if your question is answered in the FAQs or in a practice statement, you will be directed back to the website. 

​A:  The Nurse Practice Act (NPA) is silent on this question. However, hours worked in such a role do not count for the renewal of the LPN license.​

​A:  It depends.  It depends because Oregon's Nurse Practice Act (NPA) does not expressly authorize the performance of any intervention for all LPNs.  To determine whether a specific activity, intervention or role is within one's individual scope of practice, the LPN must apply nursing practice standards found in OAR 851-045-0065(2)(a) and (b).
 
These individual scope of practice standards identify eight specific criteria the nurse must apply to their own situation. Only when the nurse determines that all criteria are met may the nurse accept the assignment. 

​A:  Oregon's Nurse Practice Act does not contain lists of medications approved for administration by all LPNs.  First, an LPN must determine whether the administration medication is within their individual scope of practice in their practice setting. To do this the LPN must apply OAR 851-045-0065(2)(a) and (b)​ individual scope of practice standards. These individual scope of practice standards identify eight specific criteria the nurse must apply to their own situation. Only when an LPN determines that all criteria are met may they accept an assignment to administer a medication.

When the activity is found to be within an LPN's individual scope of practice, the LPN remains responsible for the application of additional 851-045 standards. This includes 851-045-0050 standards related to LPN scope in the practice of nursing, and 851-045-0065(9) standards related to the licensee's responsibility in the acceptance and execution of medical orders. 

​A:  It depends on the factors below. 

Clinical Direction of LPN Practice
LPN practice may only occur under the clinical direction and supervision of an RN or a licensed independent practitioner (LIP), such as a physician, per the Oregon Nurse Practice Act.  Clinical direction is the communication from the RN to the LPN for the implementation of the RN's comprehensive plan of care or the communication from the LIP to the LPN for the implementation of the LIP's treatment plan.

When clinical direction of LPN practice does not exist, there is no authority for the LPN to engage in practice.  This would include situations where a clinic/service nurse 'help line' receives calls from people who are not patients/members of the clinic, and do not have an established plan or care or treatment plan.  The RN or LIP must establish a plan for these clients to direct care for the LPN.  A general triage protocol does not take the place of a plan of care or treatment plan.  A general protocol cannot provide the LPN with authority to act beyond their scope of practice.

Established Plan of Care or Treatment Plan
When the client has an established plan of care and the presenting problem is included on that plan of care, the LPN may engage in a focused assessment with the client to determine if the presenting issue is addressed in the established plan of care.  If the issue is part of the established plan of care, the LPN can reinforce the existing plan.  If the issue is not addressed in the established plan, the LPN must defer to the RN or to the LIP who is able to provide a comprehensive assessment and formulate a new plan. The LPN cannot independently formulate a new plan (even a focused plan of care) outside of the client's known problems.

Triage, which is often needed when functioning “on-call" after normal business hours, is all about gathering data, clarifying questions, determining the status of the client and then determining the plan of care (i.e., the next steps for the client). When there isn't an established plan of care, these functions are outside of LPN scope of practice.

​A:   Oregon's Nurse Practice Act (NPA) does not regulate staffing, work breaks, labor agreements, or HR matters. The following links are provided as a courtesy:

​A:  This question is not expressly answered by Oregon's Nurse Practice Act (NPA) and the term "patient abandonment" is not found in the NPA.  However, per OAR 851-045-0070​, the action of a nurse accepting an assignment then leaving or failing to complete the assignment without notifying the appropriate personnel and confirming that assignment responsibilities will be met, is conduct derogatory to the practice of nursing. 



​A:  No.  LPN licensure does not grant prescriptive privilege.  Only a health care provider whose Board-authorized scope includes prescriptive authority may prescribe.   

​A:  Not as a requirement for OSBN licensure.

​A:  Only if the LPN holds a CNA or CMA certificate issued by the Board.  Hours worked in another role would not count toward practice hours for LPN license renewal.

The person working in a position as a CNA or CMA must hold the appropriate certificate from the Board.  This would not preclude the LPN from being assigned and accepting an assignment to complete the duties typically assigned to a CNA/CMA as these duties fall within the LPN scope of practice.  The LPN accepting such an assignment remains accountable for their actions and decisions, cannot refer to themselves as a “CNA" or “CMA," and would be responsible to disclose their role for that shift to the client or the care team.

The LPN with a current license may apply for either a CNA or CMA certificate through the Board.  If accepting a CNA/CMA position with the appropriate Board-issued certificate in place, the LPN would need to be clear with the employer that the work is limited to the authorized duties for CNAs/CMAs and the name badge would need to say “CNA" or “CMA."

​A:  A key scope of practice difference is that the RN has an independent nursing practice and the LPN has a dependent nursing practice. These differing scope of practice authorities are grounded in the type of nursing education program completed by the licensee.

At the RN level of licensure, the Nurse Practice Act (NPA) makes no requirement for clinical direction or supervision of practice. Division 45 of the NPA grants the RN the authority to conduct an independent nursing assessment, develop a plan of care, and evaluate outcomes related to the plan.

While a practice setting may enact supervision requirements related to the RN's role within the setting, the RN remains independent in their nursing practice.

At the LPN level of licensure, the practice act does make requirements for clinical direction and supervision of practice. Division 45 of the NPA specifies that LPN practice may only occur under the clinical direction of a RN, or, under the clinical direction of a licensed independent practitioner (LIP) such as a physician.

Clinical direction of LPN practice means the communication from the RN to the LPN for the implementation of the RN's established plan of care or the communication from the LIP to the LPN for the implementation of the LIP's treatment plan. Any practice by an LPN that occurs outside of an established plan of care is not consistent with LPN scope of practice.

Foundational to the LPN's implementation of the established plan of care is the LPN's completion of a nursing assessment. At the LPN level of licensure, this is a focused assessment.  Focused assessment means recognizing the priority condition at the time of intervention within the parameters of the established plan of care or treatment plan.

Additional resources:
  • OSBN Sentinel - November 2017, Oregon's NPA: The foundation for scope of practice differences in LPN and RN practice. 
  • OSBN Sentinel – November 2018, Focused assessment and the licensed practical nurse.

A:  The difference is in scope in the practice of nursing granted with each license type.  
 
The RN is independent in their practice of nursing. This means the RN conducts independent client assessments and independently develops plans of care based on their independent assessment.  The RN's independent scope in the practice of nursing is described in OAR 851-045-0060. 
 
The LPN has a dependent or clinically directed practice of nursing. This means the LPN's practice occurs within the parameters of an RN's plan of care for a client, or within the parameters of an NP's, MD's, DO's ND's, or dentist's treatment plan for a client. The LPN conducts a focused assessment and generates a focused plan of care which prioritizes interventions from the RN's, NP's, MD's, DO's ND's, or dentist's plan to be carried out with the client. The LPN cannot conduct a focused assessment or generate a focused plan of care outside of the parameters of the established plan providing clinical direction of their practice. The LPN's clinically directed scope in the practice of nursing is described at 851-045-0050. 

​A: It depends.  It depends because Oregon's Nurse Practice Act (NPA) does not expressly authorize the performance of any procedure or intervention by all LPNs. The requirement of the NPA is that an LPN must only accept an assignment within their individual scope of practice. For an LPN to determine whether the performance of a specific cosmetic procedure is within their individual scope of practice, they must apply nursing practice standards in OAR 851-045-0065(2).

These individual scope of practice standards identify eight specific criteria an LPN must apply to their own situation. Only when an LPN determines that all criteria are met, may they consider the procedure to be within their individual scope of practice.

When performance of the cosmetic procedure is found to be within an LPN's individual scope of practice, the LPN remains responsible under their license to practice consistent with additional 851-045 standards. These standards include but are not limited to 851-045-0050 standards related to LPN scope in the practice of nursing, and 851-045-0065(9) standards related to the licensee's responsibility in the acceptance and execution of medical orders.

As LPN licensure does not permit the diagnosing of medical conditions or permit the prescription of treatment for conditions, and the LPN's clinically directed practice role within a cosmetic practice is as a practice team member who assists with implementation of a health care provider's treatment plan for a client. This means that prior to, during, and following the performance of a cosmetic procedure for a client, the LPN is responsible for their own practice of nursing (with the client) and remains accountable for their own decisions and actions. 

​A:  The answer is no because LPN licensure does not grant independent assessment or planning. For a situation that presents outside of the parameters of an RN's plan of care, the LPN is responsible for collecting client data and then communicate data collected to the RN.  



RLM014_LO.jpg