We feel your struggles, Jody, at our clinic. We are integrating as well from private practice with a larger enterprise. We have for the 1st time brought in RN toour Ambulatory clinics to triage, and it did not go well with our MAs who have been performing their version of "triage" for literally decades. Yes, they are offended when told they are suddenly not "qualified' to do what they feel they have been doing all along. T True - your state statutes and nursing board are your irrefutable references as to why prior practice or LPN "triage" no longer (and perhaps never did) apply.
At a quick glance of IL statutes, it does state LPNs can "conduct a focused nursing assessment". However, what your LPNs may not yet acknowledge is that it also states that their role and assessment
contributes to "collaboration in the development and modification of
the RNs or APRN's comprehensive nursing plan." Making a triage decision, even in under an organizations guided/formal triage tool, is still
developing and executing the plan, which is the scope of the RN under these statutes. I copied the statutes below, for quick reference, from
https://www.ilga.gov/legislation/ilcs/ilcs5.asp?ActID=1312&ChapterID=24. In addition, here is a link to what the Joint Commission has to say about LPN roles in the hosptial care setting. Although not directed to ambulatory care, it does demonstrate that even in a more acute care setting when rapid assessments are vital to prevent clinical deterioration, LPNs assessments are for data collection that must be presented to the RN for evlauation and development of nursing plan (plan being a triage decision in the ambulatory setting).
https://www.jointcommission.org/standards/standard-faqs/critical-access-hospital/provision-of-care-treatment-and-services-pc/000001666/Not sure if this is the input for which you were looking, but being born and raised from Peoria, IL, I felt I had to at least attempt to contribute as we are both dealing with the same growing pains.
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(1) Conducting a focused nursing assessment and
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contributing to the ongoing comprehensive nursing assessment of the patient performed by the registered professional nurse.
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(2) Collaborating in the development and
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modification of the registered professional nurse's or advanced practice registered nurse's comprehensive nursing plan of care for all types of patients.
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Tiffany Pryor
Registered Nurse - Family Care Triage
Cleveland Clinic Martin Health
Stuart, FL
386-316-4185
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Original Message:
Sent: 07-14-2022 09:37
From: Jody Will
Subject: Screening vs Triage
Hello,
I am an ambulatory educator for an organization with 56 clinics that consists of a mix of primary care and specialty. We have recently acquired a couple clinics that were previously private practice. The staff in this clinic consist of a mix of RN's and LPN's. The LPN's are struggling with the fact that we told them they cannot 'triage' and they feel offended by this. We have showed them the organizations scope of practice and have given them the difference between triage and screening but this is not satisfying them. Does anyone have an algorithm, articles or anything to assist us with education on this topic?
Thank you in advance!
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Jody Will BSN RN
Sarah Bush Lincoln
Mattoon IL
(217)238-4772
jwill@sblhs.org
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