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LPN Frequently Asked Questions



​A:  The Nurse Practice Act (NPA) does not prohibit the LPN from working in a non-nurse position or role.  However, hours worked in such a role do not count for the renewal of the LPN license.

When a person works in a health-related role or position that does not require a specific license or certificate by the State of Oregon, that person is functioning as an unregulated assistive person.  A number of health-related technician positions fall into this category such as surgical technician, OB technician, and emergency department technician.  Work done in such a position is not the practice of nursing.

The LPN functions under the Nurse Practice Act and may only count hours as LPN practice that are in line with the NPA.  For example, an OB technician may be mainly assigned to set-up a surgical room for a C-section to be performed.  This type of task is not considered nursing practice as it does not involve a defined plan of care under which the LPN would function.

Key questions the LPN should ask if considering a “technician" position are:
  • Are there individuals already in the role and acting under the same job description who are not LPNs?  If so, this role is not the practice of nursing.
  • Does the position require the LPN license to be maintained?  In some cases, an employer requires certain training or a license to apply for a position so that the individual has an appropriate medical background, but maintaining the license is not required.
  • Does the job description clearly define aspects of the job that are LPN practice (e.g. conducting focused assessments, contributing to the plan of care, documenting client care and responses to care, etc.)?
  • Is there an RN involved in making assignments for care and providing comprehensive assessments of clients?
Review Oregon Administrative Rule Division 45 for more information on the scope of practice for all licensed nurses and for LPNs specifically.

​A:  It depends on the LPN's educational preparation, competencies, and the practice setting.

The Nurse Practice Act does not provide lists of procedures or interventions that a nurse may or may not carry out.  Each individual nurse must determine how to proceed within their practice setting and based on their individual practice competencies.  The Board of Nursing has developed a useful tool to guide the nurse.  Utilize the Vascular and Non-Vascular Access Interpretive Statement to consider key questions before proceeding.

Employers typically have their own policies on types of procedures that are allowed or prohibited.  Knowledge of employer policies is necessary to utilize the Scope of Practice Decision-Making Guideline.  In all cases, the LPN may accept only an assignment for which they possess the knowledge, skills, and documented competency to perform safely.  Competency may be gained through formal educational programs, continuing education or employer-provided training.

Boards of nursing in other states have requirements for the completion of a certification module on intravenous therapy after graduation from an LPN program.  Oregon has no such requirement.  The LPN who did not have training in intravenous therapy as part of the basic education program would have to receive training to be able to provide care in this area.

Please note:  Licensees sometimes take pause on the first question in the Scope of Practice Guideline (Is the role, intervention or activity prohibited by the Nurse Practice Act (NPA) and Rules/Regulations or any other applicable laws, rules/regulations or accreditation standards?).  The NPA is silent on specific activities and interventions associated with client care.  However, other regulatory Boards may have jurisdiction over such activities.  Activities associated with radiology, esthetic procedures, acupuncture, preparation and dispensing of medications, are examples of areas under the authority of other regulatory boards.

Use these links to review how the Board has used the Scope of Practice Decision-Making Guideline to answer some common questions:

​A:  Oregon's Nurse Practice Act does not list medications the LPN may or may not administer.

In all cases the LPN may only administer those medications for which they have the needed knowledge, skills, and demonstrated competency to proceed safely.    If a comprehensive assessment of the client condition is needed before medication administration, the RN or licensed independent practitioner must complete the assessment and direct the involvement of the LPN.

Questions related to a specific role, intervention or activity may be answered by the individual nurse by using the Scope of Practice Decision-Making Guideline.  To utilize the Scope of Practice Decision-Making Guideline, the LPN must access and know the employer's policies related to medication administration.

​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:  This is an employment issue and is not regulated by the Board of Nursing.

The Nurse Practice Act focuses on the way the individual licensee carries out their role in the field of nursing.  Scheduling, hours of work, overtime policies, etc. are Human Resources issues.  Laws related to employment and standards for facility licensing are the best resources for questions in these areas.  For those employed in hospitals, there are nurse staffing laws in place that set the requirement for a facility-based staffing committee.

If there is a situation where the work scheduling is being implemented by a licensed nurse and the result is unsafe client care, the individual nurse may be reported to the Board through the on-line complaint form.  The Board of Nursing investigates individual nurses to determine if there has been a violation of the Nurse Practice Act.  The Board of Nursing does not take complaints about or investigate facilities or departments within facilities.

​A:  No, except for some unique circumstances.

The Board of Nursing has an Interpretive Statement about patient abandonment that helps licensees understand this issue.

In a setting where a nurse may be providing care in a client's home and no other care provider is available to relieve the nurse, it could be considered patient abandonment to leave the client alone.  A nurse working as the sole provider of care in a client's home is advised to fully understand the options open to them, if a relieving nurse is not available.

​A:  No.  A nurse may not independently prescribe or order medications.

When a prescription has expired or all refills on an existing prescription have been dispensed, there is no longer an active prescription in place.  A new prescription must be generated by a person who is authorized by the State of Oregon to prescribe.  Prescribing is beyond the scope of practice for the RN and the LPN.

​A:  No. This is not a requirement for licensure.

Licensed nurse competencies in cardio-pulmonary resuscitation and/or first aid are typically a requirement of practice setting policies, rules governing a setting/service, and/or a specific position description within an organization.

​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.
If you cannot find the information you need at one of the links above, 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.  You may submit a written practice question to Board Staff.  However, if your question is answered in the FAQs or in a practice statement, you will be directed back to the website.  Please allow up to four weeks for a response to your inquiry.