A: It depends on the factors below.
Clinical Direction of LPN Practice
LPN practice may only occur under the clinical direction and supervision of an RN or a licensed independent practitioner (LIP), such as a physician, per the Oregon Nurse Practice Act. Clinical direction is the communication from the RN to the LPN for the implementation of the RN's comprehensive plan of care or the communication from the LIP to the LPN for the implementation of the LIP's treatment plan.
When clinical direction of LPN practice does not exist, there is no authority for the LPN to engage in practice. This would include situations where a clinic/service nurse 'help line' receives calls from people who are not patients/members of the clinic, and do not have an established plan or care or treatment plan. The RN or LIP must establish a plan for these clients to direct care for the LPN. A general triage protocol does not take the place of a plan of care or treatment plan. A general protocol cannot provide the LPN with authority to act beyond their scope of practice.
Established Plan of Care or Treatment Plan
When the client has an established plan of care and the presenting problem is included on that plan of care, the LPN may engage in a focused assessment with the client to determine if the presenting issue is addressed in the established plan of care. If the issue is part of the established plan of care, the LPN can reinforce the existing plan. If the issue is not addressed in the established plan, the LPN must defer to the RN or to the LIP who is able to provide a comprehensive assessment and formulate a new plan. The LPN cannot independently formulate a new plan (even a focused plan of care) outside of the client's known problems.
Triage, which is often needed when functioning “on-call" after normal business hours, is all about gathering data, clarifying questions, determining the status of the client and then determining the plan of care (i.e., the next steps for the client). When there isn't an established plan of care, these functions are outside of LPN scope of practice.