What is a Licensed Practical Nurse? 

An LPN is a regulated health care professional who provides nursing care to a diverse clientele in a variety of settings. They practice as members of inter-professional teams and autonomously. They are fully responsible for the care they provide. 

LPNs are: 

• Educated in the theory and practice of nursing 
• Required to be registered with PEICNM to practice in Prince Edward Island 
• Bound by Standards of Practice and Code of Ethics 
• Accountable for maintaining and building their professional nursing competence throughout their career. 

LPNs are qualified to perform a wide range of nursing competencies consistent with their individual scope of practice including medication administration, health assessment, wound care, etc. 

LPNs are educationally prepared to provide nursing services for a variety of clients in diverse settings. The setting may be acute care, long-term care, ambulatory care, community care, and primary care. LPNs frequently assume multiple roles when they provide nursing services for clients. 

What guides the practice of practical nursing? 

• Regulated Health Professions Act (RHPA) 
• Licensed Practical Nurses Regulations 
• Standards of Nursing Practice for LPNs 
• Code of Ethics 
• PEICNM policies, bylaws, practice directives, and other documents 
• Employer policies, guidelines, and procedures 
• Other provincial and federal legislation 

Reserved Activities 

A reserved activity is a clinical activity that can only be performed by specific regulated health professionals as there is a significant risk of harm to the public. The RHPA decides which professional can perform each reserved activity, which means that other regulated health professionals may also be assigned the same reserved activities. This means that collaborative practice is imperative. 

The Code of Ethics and Standards of Nursing Practice also underpin the practice and the performance of reserved activities. As well, practice directives expand on concepts in the regulations and outline specific practice expectations for the performance of reserved activities. 

Reserved Activities for LPNs 

An LPN may only perform a reserved activity if: 

• the reserved activity is listed in the Licensed Practical Nurses regulations, which are discussed below. 
• they meet the conditions outlined in Section 18(2) of the regulations. 
• the reserved activity is within the individual LPN’s scope of competence. An individual LPN’s scope cannot exceed the LPN profession’s legislated scope of practice. Each individual LPN must be qualified and competent with their own scope of practice. 
• they follow employer’s policies. Employer policies provide further direction on an LPN’s practice. An employer may place limits on LPNs and their practice. An employer’s policies must be consistent with the RHPA, regulations, bylaws, standards, code of ethical conduct and practice directives. 

The following are reserved activities for LPNs: 

1. Performing a procedure on tissue below the dermis, below the surface of a mucous membrane. 
2. Administering a substance by injection, transfusion, inhalation, mechanical ventilation, irrigation or enteral or parenteral instillation. 
3. Administering a drug or vaccine by any means. 
4. Putting an instrument, hand or finger
   • beyond the external ear canal, 
   • beyond the point in the nasal passages where they normally narrow, 
   • beyond the pharynx or larynx, 
   • beyond the opening of the urethra, 
   • beyond the labia majora, 
   • beyond the anal verge, or 
   • into an artificial opening into the body 
5. Applying sound energy or electrical energy, other than ionizing radiation. 
6. Applying electrical energy in the form of ionizing radiation to conduct an X-ray for the purpose of dental screening, diagnosis, or treatment. 

Activities that are not reserved 

A profession’s scope of practice is not solely encompassed by reserved activities. The full extent of a nurse’s scope of practice cannot be described by reserved activities alone. The Standards of Nursing Practice would include examples of nursing practice that do not fall under a reserved activity. Some examples are: 

• Assessing the health status of a client 
• Planning and evaluating client care 
• Critical thinking 
• Supporting activities of daily living 
• Communicating with clients and families 
• Collaborating with the health care team 
• Developing professional and therapeutic relationships 
• Documenting 
• Maintaining client safety 
• Mentoring students and new graduates 
• Ensuring infection control