Practical Nurse Scope of Practice

The Registered Practical Nurse (RPN) in Canada or Licensed Practical/Vocational Nurse (LPN/LVN) in the United States practices within a defined scope that includes: providing direct patient care, administering medications (oral, topical, subcutaneous, intramuscular — IV medication administration varies by jurisdiction and additional certification), monitoring patient status, performing wound care, collecting specimens, documenting care, and reporting changes in patient condition to the registered nurse or physician. The RPN/LPN uses clinical judgment within their scope to assess patients, identify deviations from expected findings, and communicate changes to the supervising nurse or provider. The scope is bounded by entry-level education (diploma/certificate in practical nursing), regulatory standards (College of Nurses or Board of Nursing), institutional policies, and personal competency. The Three-Factor Framework helps determine scope: complexity of the patient, predictability of the outcome, and risk of the intervention. RPNs/LPNs typically care for patients in stable, predictable situations with low-risk interventions. When patient complexity increases, outcomes become unpredictable, or interventions carry higher risk, care should be escalated to an RN or NP.