The practice of practical nursing is defined in Section 961 of Chapter 11, Louisiana Revised Statutes of 1950. According to this law, practical nursing is the performance, for pay, of acts in the care, treatment or observation of the ill and for the maintenance of the health of others and the promotion of health care. Practical nurses may train and/or supervise other nurses, and subordinate personnel. They may also instruct patients.

A licensed practical nurse must practice under the direction of one of the following: licensed physician, optometrist, dentist, or registered nurse. A licensed practical nurse may perform duties consistent with his/her educational preparation. The licensed practical nurse may also, with appropriate training (which is approved by this board, and documented), perform additional specified acts which are authorized by the Louisiana State Board of Practical Nurse Examiners when directed to do so by the licensed physician, optometrist, dentist, or registered nurse.

The Louisiana State Board of Practical Nurse Examiners (LSBPNE) has no "laundry list" of tasks/skills a licensed practical nurse can perform. Such lists tend to limit practice. Scope of practice is a fluid concept. It changes as knowledge and technology expand. Licensed practical nurses must possess the knowledge, skill, and ability to perform their duties, therefore, scope of practice comes down to the competency of the individual licensed practical nurse.

The following list is not inclusive and should not be used to define or limit practice of licensed practical nurses.

The following are some of the tasks (those most frequently inquired about) a licensed practical nurse may perform when the above conditions are met:

• Initiate and maintain IV therapy and administer IV medications by IVPB and/or IVP (including hyperalimentation, blood and blood products)
• Reinsertion of suprapubic catheters
• Accept verbal/phone orders directly from the prescriber (an optometrist, advanced practice registered nurse, physician, or dentist)
• Perform heparinization during hemodialysis
• Serve as first surgical assistant (but may not suture, dissect or cauterize)
• Maintain and administer meds via heparin locks
• Pap smears/GC cultures/IUD string checks/fundal heart tones/Leopolds maneuvers
• Apply Unna Boots
• Load/monitor PCA machines
• Care for clients with external venous catheters (including Hickman, Groshong, Brovia) and specifically: obtain blood specimens/connect and monitor IV fluids/connect IVPB, provide site care (including dressing changes)
• Care for clients with internal venous access devices (including port-a-cath, life port) and specifically: access with and/or remove Huber needle/draw blood/connect and monitor IV fluids and provide site care (including dressing changes)
• Insert a feeding tube in a neonate
• Reinsert a tracheostomy tube in an established tract
• Remove sheaths in a cardiac cath lab and later d/c these lines
• Perform tasks which promote pulmonary health and hygiene (administer oxygen, aerosol and IPPB treatments, suction, perform CPT, etc.). LICENSED PRACTICAL NURSES MAY NOT HOLD THEMSELVES OUT AS RESPIRATORY THERAPISTS OR RESPIRATORY THERAPY TECHNICIANS.
• Perform "head to toe" physical assessments
• The administration of botox, for cosmetic purposes only, is within the scope of practice of licensed practical nurses in the state of Louisiana when certain conditions are met. See Practice Opinions for the conditions.

Please contact our office if you need further clarification on any of the practice issues listed here.