LPN Duties and Scope of Practice — Complete Guide (2026)

LPN Duties and Scope of Practice

The job of a Licensed Practical Nurse looks different in Texas than it does in California — and different again in a nursing home versus a busy hospital floor. That's the part nobody tells you in nursing school. Your scope isn't one fixed list. It's a moving target shaped by your state's Nurse Practice Act, your facility's policy, and the supervising RN on your shift.

This guide cuts through that. We'll walk through the lpn responsibilities you'll actually see on shift, the gray areas — IV push, central lines, NG tubes — and the hard limits even the most experienced LPN can't cross. Practical, not theoretical.

Short answer up front: in most states an LPN can take vitals, administer most meds, do wound care, insert and care for foley catheters, manage NG tubes, check blood glucose, document patient data, and reinforce teaching the RN started. What you can't do — anywhere — is the initial nursing assessment, the care plan, and most IV push meds without extra certification.

Why so much variation? Each state board writes its own rules. The National Council of State Boards of Nursing (NCSBN) provides model language, but every legislature tweaks it. Pennsylvania lets you do things New York forbids. Florida allows IV therapy with a 30-hour course. California restricts LPNs (called LVNs there) on certain meds that Texas LVNs handle daily.

If you're prepping for licensure, walk through the lpn duties covered on the NCLEX-PN. The exam tests scope decisions constantly — "Which patient should the LPN see first?" or "Can the LPN delegate this task to the CNA?" Knowing the boundaries isn't trivia. It's the test.

What "Scope of Practice" Actually Means

Scope of practice is the legal answer to one question: what tasks can this license holder perform without breaking the law? For LPNs, that answer comes from your state's Nurse Practice Act (NPA) plus the rules written by your state Board of Nursing. The NPA is statute. Board rules are regulation. Together they define what's legal.

Three layers stack on top of each other. State law sets the floor. Facility policy can narrow it — a hospital may say its LPNs don't do IV starts, even if the state allows it. Individual competency caps the whole thing. If you've never inserted an NG tube, you can't do one safely even if state law and hospital policy both permit it.

Here's the rule every LPN should memorize: just because you can doesn't mean you should. Competency is a personal standard. State scope and policy are the legal ceiling. Both have to align before you touch the task.

Worth knowing: scope creep is one of the most common reasons LPNs lose their licenses. Not bad intentions. Just slow drift — a charge nurse asks for help, you say yes, six months later you're routinely doing things that aren't yours to do. Document refusals when you make them. Reference the NPA section. Your future self will thank you.

Continuing education is the third axis of competence. Every state requires CE hours for license renewal — most ask for 20 to 30 hours every two years. Pick courses that close your competency gaps. If your scope allows IV push but you haven't done one in two years, that's a CE topic, not just a checkbox. Pharmacology updates, wound care, infection control, and ethics are evergreen choices. Save the certificates digitally and on paper.

Can LPNs Do Wound Care? Yes — Including Complex

This question comes up constantly, so here's the direct answer: yes, LPNs do wound care in every state. The real question is what type of wound care.

Basic dressing changes, sterile technique, irrigation, packing, simple debridement — these sit squarely inside the lpn scope of practice in all 50 states. You'll do dozens of these in a long-term care shift. The skill level required is genuine. Wound staging (I through IV plus unstageable), recognizing infection markers, knowing when to escalate — these are clinical-judgment calls LPNs make every day.

Complex wound care is where it gets interesting. Wound vacs, advanced dressings, sharp debridement, and specialty products like collagen matrices — these require additional certification in most states. The lpn wound care certification route runs about 30–60 hours of training plus a competency exam. Wound, Ostomy, and Continence Nurses Society (WOCN) offers the WCC credential, which LPNs can earn. Some LPNs build entire travel-nurse careers around the WCC after gaining a few years of bedside experience. Specialty wound clinics actively recruit certified LPNs because the demand outstrips the supply of wound-trained RNs.

Why Documentation Beats Memory

What you document on every wound: size in centimeters (length × width × depth). Tissue type — granulation, slough, eschar, epithelial. Drainage — amount, color, odor. Surrounding skin condition. Patient pain rating. Whether the wound is improving, stable, or declining. Photo documentation if your facility requires it. Trended together across days, this is the data the wound care nurse uses to adjust the treatment plan.

Sterile technique is the line LPNs cannot blur. Open the kit on a clean surface. Don sterile gloves. Don't touch anything non-sterile. If you contaminate, restart. The CDC estimates over 100,000 healthcare-associated infections each year link to wound contamination. The LPN at the bedside is the first defense. Hand hygiene before and after every dressing change. Fresh PPE for every patient.

Wound photographs deserve their own protocol. If your facility uses photo documentation, the camera must be the facility's (not a personal phone), the date and time must be on every image, and the patient identifier must be included. Photo consent should be on file. Done right, photos save lives — done wrong, they end careers and trigger HIPAA citations.

NG Tube Insertion and Catheter Tasks

NG tube insertion is a great example of how scope splits. In most states LPNs insert standard nasogastric tubes for feeding or decompression under RN supervision. Pennsylvania, Texas, and Florida all allow it. New York requires LPNs to complete a state-approved course first. California is more restrictive — LVN insertion is allowed but the facility must document competency for each LVN. Always check current Board of Nursing position statements — they update yearly.

What's almost never in LPN scope: complex placements like Dobhoff tubes (small-bore, weighted-tip), feeding tubes that require fluoroscopic guidance, and percutaneous endoscopic gastrostomy (PEG) tube changes within the first 30 days of placement. Those are RN or physician territory. A fresh PEG site is fragile — disrupting the stoma tract can cause peritonitis, and that's why early changes are restricted.

For catheters: foley insertion and care is standard LPN scope everywhere. Suprapubic catheter care — usually yes, but insertion is RN-only. Central venous catheter care (PICC lines, ports, tunneled catheters) — LPNs can dress and flush in most states with additional training. They cannot insert. The line between "care" and "access" is a hard one: care is in scope, gaining initial access usually isn't.

IV Therapy and Medication Limits

IV therapy is the single biggest scope variable across states. lpn iv certification opens doors — without it, your IV scope is essentially zero in most facilities.

What certified LPNs can typically do: start peripheral IVs, hang maintenance fluids, administer IV piggyback antibiotics, monitor IV sites, and discontinue peripheral lines. Some states allow IV push of select medications after additional training — heparin flushes, normal saline flushes, certain antibiotics. Texas and Florida are more permissive here. New York and California are stricter.

What's almost universally restricted: IV push of cardiac meds (digoxin, lasix, adenosine), chemotherapy, blood and blood products (initial hang — LPNs can monitor), TPN initiation, and any medication requiring titration based on continuous patient assessment.

Right patient, right drug, right dose, right route, right time. Add three more for safety: right documentation, right reason, right response. LPNs working in long-term care often pass meds to 25–30 residents in one med pass. The five rights aren't optional shortcuts — they're how you don't kill someone on a hectic Tuesday afternoon.

High-alert meds get a second check. Insulin, heparin, opioids, and chemo agents — every facility's policy requires two-nurse verification before administration. The second nurse independently checks the order, the drug, the dose, and the patient. Skipping this step is one of the fastest paths to a sentinel event.

Med passes get interrupted constantly. Phone calls, family questions, a CNA needing help. Stay focused. Returning to a partially-prepared med tray after a distraction is exactly when wrong-patient errors happen. Many facilities now use "do not disturb" vests during med pass — wear it without apology. Wrong-patient med errors are reportable to the state board.

What LPNs Cannot Do — The Hard Limits

These boundaries hold in nearly every state. Knowing them keeps your license intact. The single biggest one — the duties of a lpn versus an RN — is the initial nursing assessment. That belongs to the RN, no exceptions. LPNs collect data, document trends, flag concerns. The RN integrates that into the assessment and the care plan.

State-by-State Scope Highlights

The differences are real. Here's how four big-population states show the spread:

Texas. LVNs have a broad scope — IV therapy with certification, NG insertion, wound care including some debridement under RN supervision. Texas is among the most permissive states for LVN duties.

California. LVNs handle most routine bedside care but California is more restrictive on IV push and certain skilled tasks. The Board of Vocational Nursing publishes a detailed scope document — read it before starting any job there.

Florida. LPNs can complete a 30-hour IV therapy course that opens up peripheral IV starts and most IV medications. Florida also has a strong long-term-care LPN tradition with broad medication scope.

New York. Among the strictest. LPN scope is narrower for IV work, NG insertion requires state-approved coursework, and the Board of Nursing actively enforces scope violations. Check the Office of the Professions website before practicing.

Smaller-population states vary just as much. Pennsylvania has a long-standing LPN-friendly culture in skilled nursing. Indiana publishes detailed declaratory rulings (worth reading — they show how the board interprets edge cases). Ohio recently updated its NPA to clarify wound care scope. Always pull the current statute when you move, not the old one your friend told you about three years ago.

Compact licensure changes the picture too. The Nurse Licensure Compact (NLC) lets RNs work across member states on one license — but the practical-nurse equivalent (sometimes called the LPN/VN Compact) has fewer member states and a slower rollout. If you're considering travel work, check whether both your home state and your target state are NLC participants before you commit. Single-state licensure plus reciprocity is the alternative path, and it takes longer.

LPN Code of Ethics and Delegation Rules

The LPN code isn't one universal document. The National Federation of Licensed Practical Nurses (NFLPN) publishes the most widely used lpn code of ethics. State boards reference it. Your nursing program teaches it. NCLEX-PN tests on it.

The core principles: act with honesty and integrity, accept responsibility for your actions, protect patient confidentiality, refuse to participate in unethical practice, maintain competence through continuing education, and respect the dignity and rights of every patient.

Delegation — What LPNs Delegate to CNAs

LPNs can delegate certain tasks to certified nursing assistants. The Five Rights of Delegation still apply: right task, right circumstance, right person, right direction, right supervision. You can delegate vital signs, hygiene care, ambulation, basic positioning, intake/output measurement, and routine documentation.

You cannot delegate any task that requires nursing judgment — medication administration (in most states), wound care, tube management, patient teaching, or assessment of clinical status. The LPN retains accountability for the delegated task — if the CNA does it wrong, the LPN gets the citation. Verify before you delegate: is the CNA trained on this task? Have they done it before? Are they currently competent? The Five Rights aren't a memorization exercise — they're how delegated tasks stay safe.

Receiving Delegation From RNs

RNs delegate to LPNs constantly. What you can accept depends on your state scope and your own competency. The RN remains accountable for the delegation decision, but you're accountable for performing the task correctly.

Refuse any delegated task that falls outside your state scope, outside your facility policy, or outside your personal competency. Document the refusal and the reason. This isn't insubordination — it's professional duty. State boards have suspended LPN licenses for accepting tasks they weren't qualified to perform.

The Documentation Standard

If you didn't chart it, you didn't do it. That's the legal standard. Every med given, every assessment data point collected, every refusal of care, every conversation with the RN — chart it. Timely, accurate, and objective. Avoid subjective opinions in nursing notes ("patient seems anxious" — what specifically did you observe?).

Use direct quotes when documenting what the patient said. Use measurements and observable behavior, not interpretations. Chart in real-time when possible, not at the end of shift when memory fades.

Late entries are allowed but must be clearly labeled as late entries with the actual time of the event and the time of documentation. Boards have suspended licenses over backdated notes — the rule exists for good reason. Honest, contemporaneous charts protect patients and protect you.