Licensed practical nurses (LPNs) can be delegated a wide range of clinical tasks, from medication administration and wound care to IV therapy and patient monitoring. The specific list varies by state, but the general principle is consistent: LPNs handle routine, predictable nursing care after a registered nurse completes the initial patient assessment and creates a care plan.
Understanding what falls within an LPN’s scope matters whether you’re an RN figuring out how to distribute your workload, an LPN clarifying your own boundaries, or a nursing student preparing for the NCLEX. The key is knowing not just what tasks are allowed, but what conditions need to be in place for delegation to be safe and legal.
Clinical Tasks LPNs Can Perform
LPNs are trained to carry out a broad set of hands-on clinical duties. These include drawing blood samples, performing glucometer readings, removing sutures and staples, inserting nasogastric and feeding tubes (those that don’t require guide wires), and reinserting gastrostomy tubes in established tracts. They can irrigate urethral catheters, remove suprapubic catheters, and reinsert suprapubic catheters when the tract is well established.
Monitoring is a significant part of the LPN role. LPNs can perform cardiac monitoring on telemetry units, monitor patients on mechanical ventilation (with RN verification of assessments), and monitor patients receiving total parenteral nutrition or continuous subcutaneous infusions. They can perform nasal and tracheal suctioning, administer tuberculosis skin tests, and conduct newborn hearing screenings.
LPNs can also receive telephone, verbal, and written physician orders and process them according to facility policy. They can perform sterile dressing changes on central venous lines, perform peritoneal dialysis exchanges (with an RN assessing the patient at least every 24 hours), and even reduce a prolapsed rectum or uterus in certain settings. The common thread across all of these: they are tasks with predictable outcomes performed on patients whose conditions are relatively stable.
Medication Administration and IV Therapy
Medication administration is one of the most frequently delegated responsibilities, and it’s also where confusion tends to arise. LPNs can administer oral, topical, intramuscular, and subcutaneous medications in virtually every state. IV therapy is where rules diverge significantly.
In states like Washington, a competent and appropriately trained LPN can insert and remove peripheral IV lines, administer medications via IV push, piggyback, or bolus methods, and even transfuse blood products. These tasks extend across peripheral, central venous, arterial, and subcutaneous infusion devices. Other states are far more restrictive, limiting LPNs to monitoring existing IV lines without starting them or pushing medications.
The critical qualifier in every state is “appropriately trained.” An LPN cannot perform IV push medications simply because the state allows it. The individual nurse must have completed specific training, demonstrated competency, and be working under a physician’s order. If your facility hasn’t verified that training, the task shouldn’t be delegated regardless of what state law permits.
What LPNs Cannot Do
The single most important restriction is that LPNs cannot perform the initial patient assessment. An RN must evaluate the patient first, establish a baseline, and develop the nursing care plan. This distinction is fundamental to the LPN scope of practice everywhere in the United States. Once that initial assessment and care plan exist, LPNs can collect data, take patient histories, and monitor for changes, but they report those changes to the RN rather than independently modifying the plan of care.
LPNs also cannot make independent nursing diagnoses, develop or formally revise care plans, or delegate tasks to other LPNs. They work within what’s called a “dependent and directed” scope, meaning their practice requires supervision from an RN or another qualified healthcare provider. Tasks that require complex clinical judgment, rapid decision-making in unstable situations, or specialized nursing knowledge beyond their training should not be delegated to an LPN.
The Five Rights of Delegation
The American Nurses Association and the National Council of State Boards of Nursing use a framework called the Five Rights of Delegation. If you’re an RN deciding what to hand off, these five criteria need to be met every time.
- Right task: The task is legally permitted under your state’s nurse practice act, falls within your facility’s policies, and doesn’t require the kind of clinical judgment only an RN can provide.
- Right circumstance: The patient’s condition is stable enough that the task carries predictable outcomes. A patient at high risk for complications may need RN-level care even for tasks an LPN could normally handle.
- Right person: The specific LPN has the knowledge, training, and demonstrated competency to perform the task. A task being within the LPN scope generally doesn’t mean every LPN is qualified to do it.
- Right direction: You’ve clearly communicated what needs to happen, when it needs to be done, what to document, what the patient’s limitations are, and what outcomes to expect.
- Right supervision: You’re available to oversee the work, answer questions, and receive feedback once the task is complete.
Skipping any one of these creates both a patient safety risk and legal liability for the delegating RN. The nurse who delegates a task remains accountable for that delegation decision, even when the LPN carries out the work.
How Supervision Requirements Work
LPN supervision isn’t one-size-fits-all. The level of oversight required depends on several factors: the LPN’s education and clinical experience, the stability of the patient, the complexity of the task, and the resources available in the practice setting.
A highly experienced LPN caring for a stable patient in a long-term care facility may need only indirect supervision, where an RN is available by phone or on the same unit. A newer LPN performing an unfamiliar procedure on a patient with multiple comorbidities would need direct, on-site supervision. Kentucky’s Board of Nursing frames it well: the degree of supervision scales with the potential for the task to impair the patient’s well-being and the level of clinical judgment the task demands.
In practice, this means the same LPN might work with minimal oversight for routine vital signs and medication passes but need an RN physically present for something like monitoring a patient on mechanical ventilation. The setting matters too. In home health or rural clinics where RN presence is limited, the tasks delegated to LPNs may be adjusted to match the supervision that’s realistically available.
Why State Rules Vary So Much
Each state’s Board of Nursing defines LPN scope of practice through its own Nurse Practice Act, which is why a task perfectly legal in one state may be prohibited in another. IV push medications are the classic example: allowed in Washington, restricted in many other states. Some states publish detailed task lists. Others use broader language about “routine care” and leave interpretation to individual facilities.
This means your facility’s policies are just as important as state law. Even if your state permits LPNs to transfuse blood products, your hospital may have an internal policy restricting that task to RNs. Always check three layers: state nurse practice act, facility policy, and the individual LPN’s documented competencies. A task is only appropriate to delegate when all three align.
Patient Education and Emotional Support
LPNs play a significant role in patient education, particularly in long-term care, home health, and outpatient settings. They teach patients about managing chronic conditions, understanding treatment plans, and following medication schedules. They build relationships with patients and families that often span months or years, making them a practical frontline resource for day-to-day health questions.
What LPNs provide in these settings goes beyond clinical tasks. They offer emotional support, help families navigate long-term care plans, and serve as a consistent point of contact. When a patient’s condition changes, LPNs are often the first to notice because of that close, ongoing relationship. Their responsibility is to promptly report those changes to the healthcare team so interventions and care plan adjustments happen quickly.