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Other practice settings

Part 4: Restricted activities for licensed practical nurses
BCCNM has developed limits and conditions for specific practice settings that are less common for LPNs. To work in these settings, LPNs need additional education or formal post-basic education. 

​​Practice Setting​

BCCNM Limits and Conditions
​1.

Ambulatory Care

LP​Ns working in ambulatory care clinics or offices where surgical procedures are performed:

  1. Require a unit orientation that is consistent with LPN entry-level competencies

  2. Ass​ist with surgical procedures:

LP​Ns do not administer:

  1. IV push medications

  2. IV medications through a central venous access device, or a central venous line

  3. Intrathecal medications

  4. Intra-osseous medications

  5. Medications into epidural spaces

  6. Medications into perineural spaces

  7. Inhaled substances or medications for purposes of anaesthesia or procedural (conscious) sedation

LP​​Ns work in a team nursing approach to provide care and monitor clients under:

  1. General anesthesia

  2. Intrathecal anesthesia

  3. Epidural anesthesia

  4. Procedural sedation

LP​​Ns work in a team nursing approach to care for clients recovering from epidural anesthesia after successfully completing additional education.

​2.

Antenatal Care

LPNs working in antenatal clinics require a unit orientation consistent with LPN entry-level competencies.

LPNs provide antenatal care:

  1. To healthy women with an uncomplicated pregnancy

  2. In ​a team approach with medical practitioners, midwives, registered nurses and/or nu​rse practitioners

Als​​o see Restricted Activities with Orders #17

​3.

​Emergency Room

LPNs working in emergency rooms require a unit orientation that is consistent with LPN ​entry-level competencies.

LPNs do not triage clients in emergency rooms (ERs).

LPN​s work in a team nursing approach to provide care for clients with stable or predictable states of health

A​​​lso see Non-R​estricted Activities #2 and #3

​4.

​Hemodialysis

LPNs working in hemodialysis settings carry out hemodialysis:

  1. For clients with stable or predictable states of health

  2. After successfully completing post-basic education through an in-house program offered by a health authority affiliated with BC Renal

  3. By following decision support tools established by a health authority affiliated with BC Renal

  4. When a registered nurse is immediately available

  5. Using ​​an arteriovenous (AV) fistula or AV graft

LPNs working in hemodialysis settings manage, access and maintain central venous lines and central venous access devices used specifically for hemodialysis by:

  1. Changing dressings on central venous access lines specific to dialysis access only

  2. Measuring visible central venous access lines specific to dialysis access only

  3. Carryi​​ng out dialysis through a central venous access line specific to dialysis access only

​LPNs working in hemodialysis settings administer solutions, substances and Schedule I, IA, II and III drugs by any route, including intravenous and IV push, as part of routine hemodialysis procedures.

LPNs working in hemodialysis settings do not administer:

  1. Intrathecal medications

  2. Intra-osseous medications

  3. Medications into epidural spaces

  4. Medications into perineural spaces

  5. Inhaled substances or medications for purposes of anaesthesia or procedural (conscious) sedation

LPNs w​​orking in hemodialysis settings monitor clients receiving blood or blood products in a team nursing approach.

​LPNs working in hemodialysis settings do not start transfusions of blood or blood products.

​5.

Mental Health and Substance Misuse

LPNs working in settings where substance misuse or a mental health disorder is the primary diagnosis require an orientation that is consistent with LPN entry-level competencies.

LPN​s work in a team nursing approach to provide care for clients whose primary diagnosis is substance misuse or a mental health disorder after successfully completing additional education.

​6.

Perioperative

LPNs work in a scrub or circulating role in the operating room (OR):

  1. After successfully completing formal post-basic education

  2. When a r​egistered nurse is immediately available

LPNs do not administer:

  1. IV push medications

  2. IV medications through a central venous access device, or a central venous line

  3. Intrathecal medications

  4. Intra-osseous medications

  5. Medications into epidural spaces

  6. Medications into perineural spaces

  7. Inhaled substances or medications for purposes of anaesthesia or procedural () sedation

LPNs w​​​orking in a perioperative setting work in a team nursing approach to provide care and monitor clients under:

  1. General anesthesia

  2. Intrathecal anesthesia

  3. Epidural anesthesia

  4. Procedural sedation

​7.

Postpartum Care

LPNs working in postpartum settings require a unit orientation consistent with LPN entry-level competencies that includes:

  1. Infant resuscitation as part of a cardiopulmonary resuscitation (CPR) course for health professionals

  2. The Neonatal Resuscitation Program (NRP) modules 1-4 and 9

  3. ​​Newborn and maternal assessment, including breastfeeding, consistent with the Perinatal Services British Columbia (PSBC) Newborn Clinical Pathway and the Postpartum Clinical Pathway

LPNs provide care for mothers and newborns:

  1. W​ith stable or predicta​ble states of health

  2. W​hen a registered nurse, nurse practitioner, midwife and/or medical practitioner is immediately available

LPNs take heel pricks after successfully co​​mpleting additional education.

​8.

Medical Aesthetics1

​​​LPNs successfully complete additional education2 before providing medical aesthetic procedures.

LPNs a​dministering injectable drugs or substances or implantable devices for medical aesthetic purposes only do so:

  1. Wit​h a client-specific order from a health professional3, and

  2. When the ord​​​ering health professional, or another health professional who has assumed responsibility for the care of the client, is present within the facility when the procedure is being performed and immediately available for consultation.


Foo​​t​​notes

​​1
​“Medical aesthetics” refers to elective non-surgical outpatient clinical procedures that include the performance of a restricted activity (activities listed in sections 6 and 7 of the Nurses (Licensed Practical) Regulation) and are primarily intended to alter or restore a person’s appearance.
​2
​“Additional education” is structured education (e.g., a workshop, course or program of study) designed so that LPNs can attain the competencies required to carry out a specific activity as part of LPN practice. Additional education builds on the entry-level competencies of LPNs, identifies the competencies expected of LPNs, includes both theory and application to practice and includes an objective, external evaluation of LPNs’ competencies.
​3
​“Health professional” has the same meaning as in the Nurses (Licensed Practical) Regulation.

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Vancouver, BC  V6C 1S4
Canada

info@bccnm​.ca
604.742.6200​
​Toll-free 1.866.880.7101 (within Canada only) ​


With great respect, we acknowledge that BCCNM’s office is located on the unceded territories of the hən̓q̓əmin̓əm̓ speaking peoples – xʷməθkʷəy̓əm (Musqueam), and sel̓íl̓witulh (Tsleil-Waututh) Nations, and the Sḵwx̱wú7mesh-ulh Sníchim speaking peoples - Sḵwx̱wú7mesh Úxwumixw (Squamish Nation) whose historical relationships with the land continue to this day.​