Is it illegal for an Lpn to sign when it requires Rn signature?

I have never thought about this before,but I see it all the time.

When I was an lpn working in LTC and a new admit came,I performed the assessment and signed my name without the Lpn title next to it. I know that legally I wasn't allowed to perform an intial assessment,but the Rn's used to refuse.

The forms would look something like this

Rn signature:

Even when an Rn signature isn't required,like when a pt comes back home from dialysis,the transport forms would have:

Receiving Rn signature:

Yet,my coworkers who are Lpn's sign it without the lpn title.

Am I wrong to assume when a form has "Rn" written on it that it really means any nurse regardless of title?
Not putting your title could be considered fraudulent. You need to consult with facility policy & procedure and your state board of nursing/nurse practice act.

better take this up the chain of command. It could mean that the paperwork needs to be revised to indicate "Nurse Signature". You ought to review your nurse practice act to determine what is and what is not within your scope of practice . I would want it to be more clear before I signed the form. Glad you caught this!

Quote from smartnurse1982Am I wrong to assume when a form has "Rn" written on it that it really means any nurse regardless of title?

I was taught always to include my title, from the time I was a CNA. What we've done when the LPN was the nurse assigned to the pt was s/he signed "Mary Smith, LPN" and the RN would add his/her sig and title with a note "I agree with this documentation. Here.I.Stand, RN" Or of course if we had anything to correct we would note our assessment, but I've never had to do that myself. But you should check w/ your facility's policy

If the form said Physician signature would you feel comfortable signing with or without your credentials?What if it said Physical Therapist?How about Medical Social Worker?Perhaps you have been led to believe that since the term "NURSE" appears in the signature line one could ignore the other identifier. Using that argument I will ask would you be willing to sign the space identified for the Certified Nurse Midwife or Nurse Practitioner?Clearly you need clarification on this matter from your employer AND you must consult the regulations in your state. However, it is easy to use critical thinking to arrive at the conclusion that it is never okay to assume that you may sign a document in an area designated for a specific health professional.

It seems everyone assumes nurse automatically translates to Rn when that isn't the case.Anyway,I an Rn but I was just looking at the forms transport has us sign when they drop the pt off home.The forms have Rn signature but there are times when an Lpn is there,and I've always wondered where they signed or how.I have also saw on the Ltc forum where the Lpn does the assessments but the Rn signs off on them.The lpn doesn't sign anything.

Some RN got in a huff because Our IV tubing labels say "RN initial" on it and since all of us RPNs change the IV tubing too we just initial it...change the labels to say "nurse initial" if it's such a big deal then!

Yes, just change the forms to say "nurse" signature rather than "RN" signature. Easy peasy.

The paperwork didn't belong to the facilty,but to the transport company that brings residents back to the facility.Even if you do cross out Rn and place your proper title,if something happened than technically you would still be on the hook right?

Ahh - that makes it a bit clearer. It's basically an incongruency between your employer and the transport company. The paperwork doesn't mesh. PP was correct, you should point out this discrepancy to your manager... form says "RN", but apparently, your facility's standard process is for an LPN to actually do the task/work. This needs to be straightened out before it becomes an issue. It may not be a big deal, but the form should still be changed... maybe just say "receiving nurse signature" rather than specifying RN; that is redundant anyway since the signature always has to include title.

If something untoward were to ever occur in the situation where an LPN signed a form under a designation of RN signature, the legal ramifications would not be pretty. It is in your professional best interest to change the forms to reflect the policy of the employer and the state's regulations.

Just sign your name with your correct credentials. You're just acknowledging the receipt of the patient; it's not a credentialing debate.As far as your admission assessments, LTC/SNF facilities have 24 hours to complete an assessment upon admission - so if you're that concerned about it, have your manager co-sign the next day.